The Long Road to Health

By Angel Hertslet

Six-year old Allan came to FAME a few weeks ago with a serious medical issue: he could not swallow food.

Most of us count eating food as one of the great joys in life, and how easy it is to take it for granted. Although Allan greeted the medical team with smiles and laughter, his situation was grave: he weighed only 22 pounds (10 kilos), the weight of a healthy one-year old. To complicate things, his small malnourished body was suffering from chest rattling pneumonia.

FAME Medical treated Allan for his pneumonia and started him on nutritional support. After a few days of charming the doctors and nurses, he was stable enough to return home. Yet Allan’s esophagus was still constricted and only a complex surgery could address this congenital problem. FAME Medical began the search for someone who could operate on Allan, sending emails to the extended family of FAME supporters.

Luckily, a few people were well positioned to help him. The first was a doctor in Arusha who had seen Allan before and knew of his need for esophageal surgery. A specialized pediatric surgeon from Finland came to volunteer at her hospital, so she called FAME and invited Allan to return for surgery. The second was an anonymous donor, well aware of his situation, who committed to helping him get the best care possible. It would be remiss not to mention Brad, the nurse practitioner at FAME, and Angel, the social worker, both of whom took on the responsibility of traveling with Allan and his mother to Arusha to support and advocate for the family. I also traveled to Arusha, and serendipitously, had the same blood type (and arguably the same attitude) as Allan: B positive. His mother Mary and I both donated in case he needed a transfusion during the procedure due to complications.

In some cases, an esophagus can be dilated with a balloon or by other means (my grandmother recently had such a surgery), but after laparoscopically exploring Allan’s esophagus, it was clear it could be addressed only through removal of the strictureand resectioning the esophagus to the stomach. The FAME team reviewed possible outcomes with the specialist and guided the decision that it was too dangerous to perform the partial esophagectomy on his compromised body. He needed to build strength to endure the removal of the portion of his esophagus. Operating in his malnourished state could have lead to the worst outcome of all.

As a means to an end, the surgeon inserted a feeding tube, or G-tube, into his stomach, allowing for nutrients to bypass his uncooperative esophagus and enter his stomach directly. I spent some time with Allan and Mary post-surgery and felt such compassion for them. He was clearly in a lot of pain and his mother was doing all she could to soothe him. This feeding tube, while clearly an essential step to improving his nutrition, I knew would be a big adjustment for both of them.

A few days later, Brad and I joined up with the team at Rift Valley Children’s Village (RVCV) to check up on Allan. Another conspiring actor, RVCV, in addition to contracting FAME to provide medical care to the orphanage and community thru a mobile medical service, also provides daily health support, follow-up and education to the community, where Allan and Mary live.
The RVCV nurse, social worker, and nutritionist worked alongside Brad and I to educate Mary about how to feed Allan through the G-tube. You can imagine the joy on all our faces when with our help, Mary mixed together the ingredients to make F-100, a therapeutic milk designed to treat severe malnutrition, and fed it to Allan through the G-tube. “Nice job!” Allan exclaimed in Swahili, and offered his mom a high five.

The right to a healthy life may be universal, but the road to getting there certainly isn’t. Allan isn’t healthy yet, but his future is looking much brighter. He has a short-term solution that is allowing him to properly gain weight and build strength for the first time in six years. He has RVCV within walking distance, and FAME Medical a short drive away. Most of all, he has his dedicated mother who so demonstrably loves him.  She is doing everything in her power to nurture Allan to health.

At some point in the next year or two, Allan will be strong enough for a life changing surgery. He will wake up groggy in bed, free of his G-tube, with his mom nearby. He will take a few weeks to heal. And then, he will sit down to the first proper meal of his life. May the tears of joy – and not of hunger – flow that day.