Nurse Siana Nkya and Safi Mbwambo in the OR

By Volunteer Nurse Practitioner Brad Snyder

It’s being a chameleon, becoming whoever the person you’re with needs you to be. It’s waking up everyday knowing that undoubtedly you will change a life and in return have yours changed. It’s pushing yourself to new limits, frequently on the edge of comfort as you try your best to fix and heal the person in front of you. It’s brainstorming at the bedside with a team of gifted clinicians trying to figure out the cause of a man’s internal bleeding as his blood counts continue to drop. It’s checking on a 1 day old then suddenly grabbing the oxygen and performing a resuscitation when he changes without any warning. It’s coming together in a moment’s notice and becoming one skilled unit, fighting the battle to keep a little life alive. It’s winning the battle.

It’s watching a doctor’s skill as he diagnoses cardiac anomalies with an echo or saves a woman from bleeding out during a complicated C-section. It’s opening books and crunching numbers as you try to solve a medical mystery alongside other uncertain fighters pulling deep on dusty knowledge and experience. It’s coming to a solution while vulnerably admitting that you’re not 100% certain of this plan, but it’s the best we can do with what we have. It’s feeling the slight relief of a definitive partnership amidst ambiguity and uncertainty. It’s seeing a nurse take peanut butter and a spoon into the room of a patient with severe burns and watching her patiently give one spoon at a time. It’s looking into her  determined eyes as she says, “I know I can’t fix the burns but this is what I can do, so I’m doing it.” It’s feeling a rush of compassion flow through your body.

It’s a nurse’s poignant assessment as she picks up danger signs in pregnancy and prevents a catastrophe. It’s giving a woman a chance to be a mother, one of life’s greatest gifts. It’s a counselor gently comforting a suicidal woman buried deep in a cloud of depression with the fear of no way out. It’s giving her a glimpse of light and the possibility that this doesn’t have to last forever. It’s walking into a room as a midwife with experience twice as long as you’ve been alive turns the breech baby of a woman in active labor. It’s hearing the cry of a healthy baby and taking a collective sigh of relief. It’s feeling grateful to have such skilled, passionate people on your team.

It’s hearing the gentle humming of a mother who just lost her 6-year old to a battle against sickle cell disease. It’s walking outside with a father as he holds back tears surrounded by family and friends and giving him a safe space to feel whatever he needs to feel. It’s being a quiet presence as he sobs in your arms in a moment of utter grief and disbelief. It’s realizing that pain like this can only be felt by others who have experienced such a profound loss.

It’s staying up through the night diligently monitoring two premature babies as they struggle to survive in an incubator instead of the safety of their mother’s womb. It’s reading neonatology articles, emailing colleagues and adapting guidelines to what we can do here. It’s watching mothers give their babies life-saving breast milk to keep their tiny bodies growing. It’s praying that it all works out. It’s going home and preparing to wake up and do it all over again tomorrow. It’s holding onto hope. It’s who we are. It’s why we’re here.

Six-year-old Allen before surgery

By Co-Founder, Susan Gustafson

“At some point in the next year or two, Allen 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. An then he will sit down to the first proper meal of his life...”

— Volunteer, Angel Hertslet

Some of you may remember this excerpt from the FAME Blog. If not, you can read the FIRST part of the story here. Six-year-old Allen came to FAME suffering from severe malnutrition and pneumonia. The malnutrition was the result of a congenital problem, a stricture in his esophagus, that prevented him from swallowing food. Well, life took a dramatic turn for Allen 18 days ago today. He and his Mother traveled to Switzerland with volunteer pediatrician, Dr. Verena Moreno on November 5th, and on November 11th he had the surgery he’s been waiting for his whole life: A resection of the narrowed part of his esophagus and an end-to-end anastomosis reconnecting his esophagus to the stomach. Of course, this journey did not materialize overnight.

The complex surgery Allen needed is not yet performed in Tanzania. We had to find a surgeon and a hospital willing to do the surgery AND we had to keep Allen alive long enough to make it happen. For 10 long months, Dr. Verena and the FAME team have been caring for Allan, treating him when he got sick, providing the nutritional supplements he needed to build strength, and teaching his mother how to mix the F-100 nutritional formula and give it to him thru his feeding tube on a daily basis. Mind you, Allen and his mother have no running water in the poor, rural village where they live. Nothing is easy to keep clean, let alone a feeding tube inserted in the stomach.  While only a short-term solution, it was a successful one – one in which Allen’s mother played a central role. She made absolutely sure he received the nutritional formula thru his feeding tube on schedule. She was religious about keeping it clean, and she arranged to bring him in to FAME whenever she had a concern or felt something was amiss. Slowly, Allen began to gain the weight and strength necessary to stay alive while waiting for a miracle.  And the miracle finally came.  Dr. Verena received word that a surgeon and hospital in her home town of Bern were willing to donate their time, expertise and facility to perform the surgery that would save Allen’s life.

The lastest update from Dr. Verena on November 19th was very encouraging, “Allen is recovering well. He is still in the hospital because he has some drainages, nasogastric tube and IV ailmentation. On Monday they will do an X-ray (Barium meal) to see if the anastomosis they did is functioning well. Afterward the drains and the NGT can be removed and I think mid-week he will leave the hospital. The convalescence will be at my home.” 

Allen is only one of many, many children cared for by the FAME team. Fortunately, the vast majority can be treated right here at FAME Medical.  We have been able to maintain and grow our “in-house” programs and services thanks to the generosity and ongoing commitment of our supporters and friends.  Thank you for helping us care for the most vulnerable among us – in a place where the usual safety nets simply do not exist. You are their heroes and ours.

It has been a very rough night. Home from boarding school, a 14 year old boy arrived at FAME late last night.  He was on school break, returning home to the nearby orphanage where he grew up. Dr. Gabriel called for Frank’s assistance but the child died before Frank could get there to help. This is why I don’t think I could ever be a doctor. I can only imagine how it feels when something like this happens, even when you have done everything within your power to save someone. Dr. Gabriel is such a caring and compassionate physician — so dedicated to his patients. True to form, when Frank asked if it would be o.k. for this case to be addressed at Clinical Conference on Friday, Gabriel graciously agreed. Frank and he both wanted to go over the fine details with all the Clinicians, including two visiting doctors, in case there was anything else they could have done or could do should they be faced with another case like this in the future. After reviewing the child’s history (which was sparse), labs, his critical condition upon admission and his response to everything that was done to intervene, the team concluded that he likely died from a post streptococcal glomerulonephritis complicated by either toxic shock syndrome or a pulmonary embolus and that everything that could be done here was done. Knowing that doesn’t begin to remove the sense of loss and sadness, but hopefully one day will provide some closure for those who tried to save him and those who will forever miss him. May this beautiful soul rest in peace. 

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