Comfort Care vs. Heroic Care

I've heard these terms used to describe what is done in the hospitals in America for patients facing critical medical conditions. An ethicist might define these as what extent care and services are used to maintain life versus quality of life issues. I can't begin to comment on that. Greater minds than mine wrestle with those issues daily. Here in Swaziland there is not much of a debate on comfort vs. heroic care. Most people are grateful for any care.
That’s on the physical side. What about spiritual? I think Jesus gave heroic care. Comfort care is what we give when we give a watered down gospel or platitudes so as not to offend. God's wish is that none would perish. Jesus gave everything he had and was rightfully his that we might have a relationship with the God that created us. Dying on a cross as our atonement is heroic. Being slapped, beat, scourged by your own creation is a love that is heroic. There was nothing comfortable about what Jesus taught.
There are people here in Swaziland that give heroic care. Our Bible Club leaders and teachers give heroic care to the children at the CarePoints. There are friends and neighbors who will sit for days with a small child in the hospital to provide comfort, companionship, and love. There are women who cook every day for hundreds of children (not their own) at each CarePoint. These are the heroes here in Swaziland. Taking what little they have and making it an offering to the God that loved them first.
My prayer is that we would not miss the opportunities to be heroic. Not for applause or the limelight, but to be able to hear one day: "Well done good & faithful servant." Take the gift God has given you and be heroic where God has placed (or sent) you.

Pepe

On the 19^th of October, we had to admit PePe to the hospital, she had a high fever, bad cough, sores in her mouth and throat, and she was dehydrated. When I went to her homestead to see her on the Wednesday evening before, her heart was racing and she was extremely hot with fever. Her father said that she had only drunk about ¼ of a coffee mug of water all day. She had eaten one egg and one banana. I instructed him to start offering her a cup of water every hour. He was just letting her sleep and not waking her to offer her food or water. I told him that if we didn’t get some fluids down her, she would have to go to the hospital. When I returned the following morning, she was no better, maybe even worse. I told her father that she needed to go to see the doctor immediately. When the doctor looked at her chest x-ray and examined her, he decided that she needed to start on TB treatment, IV fluids, and IV antibiotics.

When we walked into the children’s ward, PePe looked afraid. When we put her in a bed, she began to cry, and say that she wanted to go home. The nurse had us move her to another bed in a more private room, when she realized that she would be on TB treatment. So I carried her to the room crying that she wanted to go home. By the time I made it to the room and sat her down, I had to go outside before I started crying myself. That hospital is not a nice place. It is very dreary, dirty and run down. The only bright spot about the children’s ward is the new curtains that were made by Barbara Conti (Patrick’s mom). They are such bright cheerful colors and they really help to brighten the place up a bit.

Susan (one of the cooks from the care point) has been helping to take care of PePe on and off for a while. She stayed with PePe the first night. She then had to go out of town due to a death in her family. So, she found someone else from the community to stay with PePe while she was gone. The care giver must take care of the patient and give her the drugs for AIDS twice daily when they are due. All that the nurses do unfortunately, is pass out other medications.

PePe’s father came to visit, the first or second day that she was there. Susan told me later that he made the statement that he was tired of taking care of this child. Susan told him that she would take care of her, if he would let her. He doesn’t want to take responsibility for taking care of her, yet he doesn’t want her to go with someone else.

It has been almost a week and a half since she was admitted to the hospital. During the first four days she received IV fluids, IV antibiotics, and one unit of blood, because she was very anemic. Now, she is able to hold food, fluids, and her medications down without vomiting. She is no longer receiving IV fluids. She gets an injection each day for TB and she is also taking pills as well. The doctors said that she would need this treatment for 60 days, but that she could go home after a couple of weeks hopefully and just come back daily for the injections. The problem is that we are not sure that her father is giving the medications for AIDS consistently and now we add TB meds that need to be given consistently.

I try to go by and visit her every day or every other day. When she sees me, she starts crying to go home. I saw her on Saturday, she is still fairly weak, but at least she is sitting up now. I took her for a short walk outside of the children's ward and she started crying again that she wants to go home. On Friday, Nthombie and I went to see her and talked with her for a little while. We asked her if she knows what happens to us when we die. Her answer was very sad. She said that we are put in a box and then put in a hole in the ground. I then told Nthombie to explain to her that only our body is placed in the ground, but that our spirit goes to be with Jesus. Nthombie explained, using a stuffed animal angel that we had given to her when she went into the hospital. Nthombie is one of our teachers, she has a special gift from God to talk to children. PePe seemed to understand and be satisfied with that. She is still coughing a lot and I can still hear her lungs cracking and popping when I hold her in my lap. I don't know if she will ever be 100% again, but if we can get her to a point that she can have a good quality of life, and not be in pain, I will be happy.

Please keep PePe in your prayers that God’s will be done in her little life, and that we can show her the love of Jesus in everything that we say and do for her.

Raliegh Fitkin Memorial Hospital

RFM for short. The government hospital in Manzini. Drab, run down, dirty.....hopelessness seems etched on the faces of the staff as well as the patients. Pepe was admitted to RFM yesterday. Pepe is 9. Our youngest is almost nine. Joelle dwarfs Pepe in size and energy. They are going to treat her for TB. She has no immune system anymore. Dr. Beyda saw her last week and immediately put her on IV for fluids and antibiotics. At that point he gave her 72 hours if they had not intervened. They bought some time.

We dropped off some of our kids stuffed animals and books for her today. To try and bring some cheer into her room. But in her high fever, I'm not sure how much she even recognizes. We'll visit her again tomorrow and Sunday, and Monday....

Mortality is real. Please pray for Teresa to have words of eternal comfort and peace for Pepe. Pray that Teresa has the strength and courage to be there for Pepe. Pray that Jesus is glorified in this situation.

God intervene in this country! Where is the serpent on the pole to stave off the affliction this country suffers?

Medical Mission Reflection

Reflecting back on this past week with the Mission of Mercy medical team, we saw over 1700 people in 4 and ½ days. Many people came to know the Lord Jesus as their personal savior, and many were also tested for HIV. It is our primary goal that the spiritual needs of the people are met, and then that their medical needs are met to the best of our ability. It is also extremely important that they know their HIV status. Overall it was a great week, and many people were touched and blessed both spiritually and physically. It was a huge blessing for me to work with such a wonderful team of doctors and nurses, as well as all of the others that were a part of the team. Every person more than pulled their weight and sacrificially gave of themselves over and over. I was able to learn so much from this fantastic group of people. They also worked with and taught our Swazi staff of health care workers so much. Our Swazi health care workers are also a great group of people who also gave of themselves over and over this past week. I am so blessed to have such wonderful people to work with! The whole Children’s Cup team worked extremely hard to make this week a success. We also had other volunteers who helped us interpret, register, and counsel the patients each day. Thank you so much to everyone who was involved!

The first day of the clinics was the most stressful for me, primarily because one of our little ones who has been on treatment for HIV for two years was brought to us in extremely poor condition. As soon as Dr. Beyda saw this one, he was very concerned. She was very anemic, weak, dehydrated, with a high fever and cough. Immediately after hearing her breath sounds, he diagnosed her with pneumonia. He said that she needed IV antibiotics and IV fluids as soon as possible. We didn’t have all of the supplies that we needed for these things to be accomplished, so I got on the phone to get the supplies that we needed. Once we got some Tylenol, fluids, IV antibiotic, and oxygen going, she started to look better and her fever came down. Thank God that this team was here and they were able to save this little girls life. The next day, we gave her more fluids and IV antibiotics. She looked much better, but she was having diarrhea and not eating very well. When we saw her on the third day, we started her on oral antibiotics. On Friday, she looked better, but still not eating much and continuing with diarrhea and fever. We took her to see the doctor at the VCT clinic at RFM hospital. He looked at her chart and saw that the last time she was in, her CD4 count (an indicator of the immune system) was extremely low. It had been up to over 100 and now it was down to 7.4, which means that she has absolutely no immunity. We are afraid that her father, who is sick also, has not been making sure that she takes her medications properly, which would explain the drop in her CD4 count.

One of the ladies that cooks at the Care Point had been taking care of her before, and she was doing very well when she was with her. This lady came with us to the hospital, and I asked her to please take this little one back to her house and take care of her while she is so sick. This little girl is 9 years old and she looks like she is 6. My little girl, Joelle, who is 8 is much bigger than her. She also went with us to the hospital, and she was amazed that this little girl was older than her. As I watched the doctor examine her, I couldn’t help but start to cry, as I thought of how healthy she looked just a couple of months ago, looking at her now, so frail, thin and weak. The doctor at the clinic wants to see her back on Monday, and if she is not any better, he will change her antibiotic and possibly test her for TB. Please help us pray that the Lord will intervene and heal this little one, or if she doesn’t make it through this battle, that we will be able to keep her comfortable until the Lord takes he home to be with him. I need wisdom and strength for the task that is ahead, but I know that my God is able to do more than I could ever ask or imagine.

Completion

The Madonsa CarePoint and the "Children's Wellness Centre" in Makholweni are essentially complete! With just final touch ups we'll be in good shape for the medical team arriving this weekend. Dr. Beyda and the team will be spending a day at Madonsa, Mangwaneni, Ngwane Park, and Makholweni next week to provide free health care to the children in each community as well as to the community as a whole. What a blessing! A major part of this outreach is having councilors and pastors from the local churches to be available for prayer. We are hoping that besides touching them physically, we'll have a major (and longer lasting) spiritual impact.