May 22, 2016
We hope all of you are enjoying the springtime. May is such a lovely time of new birth…the flowers, fruit trees, baby birds and the animals. The Karnes’ are no exception. On May 6th we welcomed our newest grandchild, Kallie Jill Karnes into the family. Kallie is David and Betsy’s third child and rounds off our biological grandchildren to ten!
Since coming to Ethiopia the national maternal mortality rate has been remarkably reduced, in fact cut in half. But the sad fact is that even now throughout this country one mother dies every hour somewhere due to complications from giving birth. Motherhood is serious business here.
You may remember in a former newsletter I talked about our frustration because we do not have enough blood for our patients. It has not changed much. Our blood shortage had a sad outcome two weeks ago when we lost a mother to postpartum hemorrhage. Our medical director, Dr. Sok, has tirelessly and fearlessly worked to get us more blood from the government. This week, due to her heroic efforts and making the tough decision to put the hospital on bypass, meaning we could receive no new patients, we finally received an additional 40 units from Addis Ababa, the capital. This will only last a very short time, maybe a week, but the govt. has reassured us that things will get better. I am grateful that we received that blood because we have already used it on several patients and it saved the life of another mother earlier this week who has received five units of blood so far.
Another maternal killer here is pregnancy induced hypertension and its associated complications and sequelae. Last night at 10:30 PM I was called to the emergency room to see a comatose women who had delivered one-week prior at another hospital. She had been induced for severe preeclampsia and her baby died after two days of life. She had hemorrhaged and had received one unit of blood at that hospital. They were out of blood so they referred her to the Black Lion Hospital in Addis Ababa, which is the largest teaching hospital in the country. The family felt that she was not improving so they took her home. She became unconscious 24 hours before I saw her. When I arrived in the ER her family were all huddled around her. Her pupils were dilated and only responded very minimally. She was totally unresponsive. An ultrasound of her liver revealed that it had liquefied and become necrotic. Her hemoglobin was 5 and her platelets were very low. I explained to the family that she was critically ill and was in liver failure, kidney failure and severely anemic and unless God did a miracle she probably would not survive. I told them we would admit her to our ICU and give her supportive care to see if her body could recover but from my experience in my past I was very doubtful. The family decided to take her home and I told them that that was not a bad choice.
The word has gotten out that we have blood at our hospital and we have been receiving many patients from other hospitals because they believe we have blood. We lost another patient two weeks ago when the referring hospital, thinking that we had blood, sent us a critically ill patient in urgent need of a transfusion. But the word on the street was wrong…we had no blood.
One of my saddest cases happened last month. I admitted a critically ill patient at 17 weeks gestation. She had severe hypertension with blood pressures ranging well over the 180/120 range. We kept her in the hospital and watched her carefully. Unfortunately her condition deteriorated to the point that she was going to die if she was not delivered. For the first time in my medical career of over 36 years I had to terminate a pregnancy to save the life of the mother. She was 23 weeks plus 5 days. After the procedure the mother continued to spiral down and her kidneys failed. We sent her to a larger hospital three hours away in hopes that they would perform dialysis. I do not know the outcome.
I am very grateful that Dr. Nate Ross, an OB/GYN from Alabama, and his wife Sheryl are spending this month helping us out. He went with me to the ER last night after which he went to the OR to perform a C-section on another patient who had been referred to us with preeclampsia and in need of blood.
We have had some wonderful success stories as well with the delivery of one mother six weeks early who also had preeclampsia but has gone home with a live baby. Dr. Ross has been a Godsend to us. We also have a new GP, named Dr. Sifora. She has spent the past month with me in OB and has been a wonderful asset to me. She is a recent graduate of medical school in the Philippines and would like to become an OB/GYN in the future. Dr. Sheryl Ross has her PhD in leadership and has been giving leadership training to our nursing, administration and chaplain staff. Because they are here it has made it possible for us to take some time off. We hope to go to Gondor to see our Ethiopian son who is in the university there and on to Axum where we will check on another university student.
Allison speaking: Having a little extra coverage in April by Dr. Bierte from Norway, made it possible for us to take a trip to South Africa to see our kids. Miriam and Chris have bought their first home, an older house with a very substantial yard and lots of possibilities. I think Miriam had been thinking before we got there about all the jobs she was going to assign us. But we like to keep busy. Mark helped Chris with clearing the yard and also hung two tree swings from a massive mulberry tree. I sanded and painted a large jungle gym and also painted 108 French door windows:) The grocery store is always one of our highlights because there are so many foods in the store that we do not get in Ethiopia. It’s easy to want to buy everything in sight. One day I overheard our six-year-old grandson, Mark say to his sister in his cute South African accent, “I love to go to the grocery with Grandpa. He buys us everything we want!” It was pretty true, Diet Coke, chocolate candy, potato chips, yogurt, apples, broasted chicken, cheese, crackers, ice cream, etc. One interesting side note to our trip to South Africa was that we were invited to do a short television interview on the morning news show. Our connection was Miriam who happens to train the news anchor.
Coming back from South Africa presented a few challenges with WRAPS. Inge, my partner, had to go back home to Norway for some family problems. The local transformer went out so we were without electricity at our factory. The only way to keep sewing was to move all five girls into Inge’s house. The power just came back on after two months and we will move back up to our factory next week. On the positive side, because the girls were sewing next door, I was able to do some work with the gardeners at the hospital. It’s Spring time here also and we do all of our landscaping projects in May. We had our last school outreach at another Soddo rural school with Wraps. I felt like it was our best outreach so far. Each time we go out to the schools we learn from our past experiences and seem to get a little better organized.
Mark’s clinic is very close to completion. We are putting in the sinks and hanging the cupboards this week. The tiled floor is in and most of the painting is completed.
Thank you all for your prayers for our work, your prayers for our health and well-being and your sacrificial donations to our work. We cannot do this without you.
Mark and Allison