Special Delivery    From Dr. Mark and Allison Karnes

12/7/03

21/3/11

This past week has been the week of the preemies.  We have had five. The three smallest of these weighed in at 1.1 kg., 1.3 kg., and 1.7 kg., respectively.   With these very small babies come some big challenges to keep them alive.  There are multiple reasons for this.  The first is that their skin is so thin that they lose heat quickly and cannot maintain their own body temperature.  Secondly, they have not acquired the suck reflex so cannot eat from their mother’s breast or bottle.  Also their lungs are immature requiring oxygen.  They are also more susceptible to infection.

I have been so grateful that Stephanie has been here.  She has really taken on the challenge of caring for these little ones.  Since we do not have a functioning incubator, we converted one of our patient’s rooms into a preemie nursery.  Here we have radiant heaters to keep the room warm.  We keep the doors and windows closed so it is quite toasty inside.  When the babies get cool their oxygen levels go down and then they start having seizures. Also these little ones have tiny veins that require IV fluids at very slow rates.   Initially we did not have any NG tubes that were small enough for them but by scrounging around the supply room we were able to find some expired ones which are working quite well.

Speaking of Stephanie, we spoke too prematurely about her license.  We had been told that it would be issued next month.  Well, that has changed.  The powers to be have now stated that she has to work at the government hospital here in Soddo for one year before they will grant her an Ethiopian license.  She will have to work under a young Ethiopian gynecologist who also recently finished his residency.  Words cannot express how disappointed we are with this decision.  On the positive side we are happy that at least she can work in Soddo and not in Addis but we really do not know how this will all play out.  We are awaiting the official letter with the government’s directives concerning this issue and then will meet with the doctor at the other hospital to finalize details.  Until then she can continue working with me at SCH.  We have to trust God in this matter but would really appreciate your continued prayers regarding this and for Stephanie.

On another note, the DeBrabers left Soddo today for Addis and then in a couple of days they will return to Michigan.  They have been such a blessing here and have accomplished a lot in their short sojourn. Will has done some interesting cases and Agnes managed to trip on some construction material and break her hand!  Duane put on a nice fiberglass cast for her today to travel home in.   On Friday after surgery we left for a one night trip to Arba Minch, a town three hours away where there are two beautiful large lakes full of crocodiles.  We stayed at lodge overlooking the Rift Valley and could see the lakes in the distance with the trees canopied below.  On Sat. morning after breakfast we were met by several families of baboons rambling around our lodge. Later we took a boat ride on one of the lakes and saw about a hundred crocodiles sunning themselves on the shore and swimming around our boat.  The largest crocodiles in the world are in the lakes in Arba Minch.  We also saw many hippos and beautiful birds.  We just enjoyed seeing the beauty of God’s creation with the mountains silhouetted against the calm untouched waters.

Our mini vacation didn’t last long.  Within one hour of returning to Soddo on Saturday night I was back at the hospital delivering our ‘last’ preemie.  The baby’s mother had severe preeclampsia and her first baby was born stillborn at 34 weeks.  We believe this baby is about 33 weeks but is very small due to growth restriction.

Duane and Jackie Anderson have arrived back from the states.  Hooray!  It is great having them here as well as the Arselands who returned last night with an ICU nurse from Norway who will be with us for 6 weeks. Duane is our orthopedic surgeon and he brought us more surgical tools to be used in OB and GYN surgery.  We now have enough instruments to have three D & C sets ready to go.  Also it will be easier and safer to perform hysterectomies more efficiently.  Asle and Kari Arseland share our duplex with us and he is our anesthesiologist.  Thank you for your continued prayers and words of encouragement.  Allison’s blog follows and tells the story of one of our very sick mothers.

God bless,

Mark

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