Rachael and oh the places we shall go!

September 24, 2012

Rachael is very sick with malaria.  At first we thought it might be her antiretroviral medication she is taking after a finger stick.  We did test her with a rapid malaria test 2 days ago but it was negative, making me wonder about the accuracy of these tests.  I am very worried about her.  We went into Gulu today to have her test for malaria and typhoid, do the marketing and try to get me some internet time.  She proceeded to get worse even though she rallied for a bit yesterday and this morning and I got a message at the coffee shop that I needed to go to the hospital immediately.  After she took the antimalarial she started to have facial swelling to add to all the aches, pains, high fever, nausea…I am very worried about her but glad I am here to care for her.

She opted to come home to Atiak given the care at the hospital was less than she could here.  We had to provide food and water, they wouldn’t give adequate fluids even though she was clearly dehydrated, and they didn’t even have the medication they said she needed.  And this is the good hospital.

Taking care of Rachael:

Rachael is an absolutely wonderful 23 year old midwifery student (though at this point she is a midwife in every way except licensing) from West Virginia. I was very lucky to get her for a hut mate.  She is gorgeous, fun, intelligent, adventurous and just practically perfect in every way.  She began her midwifery training after living in New Zealand for 2 years and has practiced in the Philippines and Trinidad and Tobago.  I am in love with her.

Midwife Rachael and Stewart, our cook Nitey's son

Midwife Rachael earlier this summer after an amazing night of babies!

September 25^th, 2012

 It has been an overwhelming day and I am so very very tired.  I am not sure where to begin and though I need sleep more than anything, I am waiting for food and will take the time to tell this strange story.  I am sure it will make more sense if you start later, but this is where I am now.

As I write I am in Nairobi, Kenya.  Not anyplace I expected to be on this trip.

I spent last night checking Rachael every hour. She slept well and after adequate fluids she actually seemed to be getting better. I was concerned about some findings and called John and he and a MD at CVMC researched and looked up and even found a physician in Southern Sudan if we needed.  I did a thorough examination and felt that she had not worsened since leaving Gulu. In the morning her fever was gone and she said she felt weak and in pain, but better.  But when I looked at her it was clear she was not – she was jaundiced and when she tried to stand she could not. We decided then to take her to Kampala to the hospital there hoping for better care. However, in the hour it took to arrange everything she got much worse and we arranged for her to be flown out of the country. But first we needed to get back to Gulu hospital where the medivac people would arrange it.  We somehow got another IV in and got on the road. Our amazing driver Paul sped and got there in record time – a little over 2 hours. I can’t even begin to describe the conditions of these roads and how often the ambulance/truck breaks down and all the other things that happen.  The whole time I had to squeeze the IV bag to get even drops of fluid in. In the meantime, her dear friend (somewhere in the Middle East I think) arranged the medivac out.

I was scared, very scared.  The journey was difficult for her and her fever was worsening.  It took hours in the hospital for the air ambulance to arrive to Gulu but finally she was on the flight, and me with her to make sure she was safe and had someone there with her. What a relief to get her with adequate medical care. By the time we left I was very worried about her condition and lab results. She rallied on the plane and by the time we reached Nairobi Hospital she seemed much better – she was able to sit up somewhat and actually smile. 

I can’t even begin to tell you how worried I am.  Her original diagnosis of malaria may be true, but too many other things are going on and they are doing further diagnostics. I feel she is much safer here, but I worry that she will get worse.

As I write this, it is after midnight and I am eating my first meal of the day. I am actually in a pretty nice hotel across the street from the hospital, room service just arrived, and there are flush toilets and a real shower.  I packed only a few things – Uganda clothes at that.

I will meet with the doctor tomorrow morning early to discuss the results of all the tests and x-rays and ultrasounds.

I forgot to mention how the first thing I did on arrival in Kenya was insult the police.  I left the air ambulance with our passports to get them stamped at immigration while they got Rachael in the other ambulance.  But immigration was not there and we could not leave the airport without our stamp.  They insisted we leave our passports with them and I pick them up tomorrow and I freaked.  It was just too much.  I actually said something about 3^rd world countries and passports and corrupt police and really I was just scared.  I had no choice however and after apologizing a zillion times and explaining how tired and stressed I was I hope they understood. They did not seem happy with me, but said they did understand my concerns.  The medivac people advocated to no avail as well but it was agreed the passports would be delivered to me.  In addition, they booked my room and took very good care of both of us.

I will try to post this tonight but it may take a while for me to figure out the internet.

Wish Rachael well. I will be staying with her until she is on the plane back home to West Virginia. Hopefully it will be only a few days, then back to Atiak.