Just a typical Monday

     Interesting how when one becomes accustomed to their daily routine how some unsual things seem to be ordinary and simple. 

     I will describe the day of work I was reflecting upon. It was a Monday morning a national holiday and a day off of work for all the staff that did not have a call in the hospital, myself included. I woke up to a cell phone call at 6am from our nurse who was in Iquitos for the long weekend. She was able to receive a message (as our fixed telephone lines were down) from an outpost about an 8 year old boy who was with a fever and very sick. So my day off turned into a beautiful day trip on the river. I called one of our boat drivers; a nurse technico in the hospital as well. By 730am we had our supplies, IV medicines and fluids, stethoscope, etc and off we went. After 4 hours on the river we found a gentleman sitting in a hollowed out tree trunk fashioned into a canoe. He directed us to the river branch where the patient, one of our technicos and the patient’s father were awaiting our arrival. Our technico from the nearest health post jumped into his boat and started an IV and antibiotics the night prior and was in contact with our nurse in Iquitos via a solar powered laptop and internet.  The child was waxing and waning in alertness but we arrived to Santa Clotilde that afternoon without problem.  He had pneumonia by exam and we adjusted some of his medications. On physical exam we noted swelling to his L wrist and thigh/knee. I was very concerned about the infection being in his bloodstream and entering his joints. The next morning he went on our boat with one of our nurses another 6 hours down to the regional hospital in Iquitos. He had x rays and was diagnosed with a severe pneumonia and septic joints. He stayed in the hospital several weeks, but recovered.

I give thanks for the dedicated workers we have on our river and the resources to be able to continue the work Padre Jack, Padre Moe and all the workers who elevated the level of care to be able to respond to needs of the over 300km of river we cover. God is Good.

Brian

Harold

Harold is 42 years old, the youngest of three brothers. Their parents are no longer living. Harold also has 4 children: six-year-old twins girls, a four year old and an 18 month old. His wife died just over a year ago of malaria, so he raises his children on his own, with the help of his two brothers and sister-in-laws.

Harold has had high blood pressure for years, with fluctuating creatinine´s. His creatinine (a test to see how the kidneys are functioning) had been slowly increasing. He was admitted to our hospital twice with his whole body swollen and his lungs and abdomen full of fluid. His kidneys were not able to get rid of the excess fluids. His last admission, he had a creatinine of 6 (usually once you reach 5 you need dialysis). Luckily the diuretics worked and he was able to urinate out some of the excess water and breath easier. We sent him to Iquitos where he was hospitalized at our referral hospital. He was sent back with a creatinine of 4, on the all the right meds to keep his water balance stable.

So yesterday and today, I spent a lot of time talking to Harold and his brothers about dialysis and renal transplant. Progression of kidney disease is often inevitable. Dialysis requires that he live in Iquitos, where he has no family members who could support him. He doesn't want to live hooked up to a machine two days a week, far from his community. His brothers just make enough to scrape by, selling the fish they catch and meat they hunt to support their own kids through school. They are not in a position to support him to live in Iquitos, nor in a position to donate a kidney, being that they must travel to Lima and spend many months away from their own families who are so dependent on them.

Despite the gravity of the whole situation, Harold has a constant smile on his face and the most positive attitude. The family has an immensely strong faith in God, and finds solace knowing that He is in control. We are all hoping and praying for a miracle- an improvement in his health and the return to normal of his kidney function. As you could imagine, he wants to be back in his community with his family. Once he gets there, he will continue the medicines that his kidney doctor has prescribed and also utilize plants and other natural remedies to attempt to cure his condition. Keep Harold and his children and family in your prayers!