Saturday, February 6, 2010
scariest day at amani - mouth to mouth
Thursday was a really scary day. It started off great. We had a group of Canadians come visit Amani and donate over 60,000 dollars!! The children performed circus (acrobatics) for them and then the Canadians set up a bunch of games for the kids. All of the children loved it. They did rely races, tennis balls in spoons, etc.
Towards the end of the day just as I was getting ready to leave, one of the 15 year olds came into the health office complaining of a cold. We gave him some cold medicine and he came back a little later saying that his throat felt funny. It was hard to understand what was going on with him because of the language barrier (also the Amani nurse was out because she has malaria). We had a staff member translate and ask him what was going on and he complained that he smelled something weird whenever he breathed out. He smelled like eucalyptus, which is the main ingredient in the medication he was given. He said he wasn’t having trouble breathing and his tongue didn’t look swollen and he seemed to be breathing just fine. We decided to wait just in case something was wrong and about fifteen minutes later he was obviously in distress I walked him outside of the health room so that we could find a ride to a hospital. Unfortunately, Amani’s driver was in Arusha and there were no spare keys and the ambulances in Tanzania are slower than the taxis from what I have heard. He started to get worse and I gave him two benedryl but it did nothing. One of the staff members called a taxi and we were waiting for the taxi and I was getting more and more worried and he was getting worse and worse. The mama’s and other staff were trying to force him to swallow milk and I tried to tell them that they shouldn’t but they were convinced it was going to help him. About five minutes later (it felt more like 4 hours) we found someone with a car and one of the teachers carried him out to the car. Once he was in the backseat he was not breathing adequately and became unconscious. I started doing mouth to mouth without even thinking about using a barrier because we did not have any. Anna and I took turns giving him breaths and soon enough he was conscious but still breathing really really rapidly and shallow. When we got him to the hospital he started to go into convulsions. The doctors at the hospital were taking their time and finally told us to put him on a bed and open a file and pay for him…I went back into the room after paying to find the doctor massaging his chest while he was laying there convulsing and scratching at his throat. He started to get really agitated and ripped off his rosary beads and was still having trouble breathing. After about ten minutes they gave him a cortisone injection and then tried to funnel water down his throat and he started making gargling noises and I had to leave because it was upsetting for me to watch them do this. They had no oxygen for him, no sort of monitor, nothing except cortisone. And a nurse came in a put her hand on his neck and started yelling out, “jesus jesus something jesus”. The doctor than told us that we had to take him to another hospital KCMC which is a bigger and better hospital. We had to find another taxi and then the teacher carried his limp body out to the taxi. He was unconscious for most of the ride but toward the end started getting agitated again and convulsing a little bit. His breathing was doing better though. When we got him to the ‘emergency room’ they asked us to sit him a chair…he was obviously unable to do that and they realized that pretty quickly and had us bring him to a room with three other beds. We put him on a stretcher and he came back to and started thrashing around and acting possessed. The doctors sent me out to get more doctors which I did and they gave him valium which knocked him out. His breathing began to even out and became normal again. They were concerned about cerebral malaria but he tested negative. I initially thought he was going into anaphylactic shock but because he wasn’t wheezing and nothing seemed swollen and benadryl didn’t make a difference something seemed off. I felt so much better though having him at this hospital where I knew they had equipment if needed and where the doctors seemed good and concerned with him.
Anyway, they eventually moved him upstairs to the men’s medical ward 1 where he was on a stretcher in the hallway. Of course they were bringing a dead body out of a room with about 10 other people in it on our way in. The power was going on and off but mostly just stayed off. We were in a dark crowded hallway with tons of sick people around. The patients here were not like any I have seen at Overlook because not one of them was complaining and it seemed like very few were being seen in a timely manner. We left a few hours later and another boy that was there watching his father kept an eye on him and promised to call or text one of us if anything changed. He texted saying that he woke up and was able to talk and complained of a headache. We returned early the next morning as they were wheeling another body out. He woke up and was responsive but couldn’t speak more than a whisper and seemed super anxious. Rovina, amani’s nurse brought him tea and he was able to drink a little bit. Anna and I left and went back to Amani. All of the kids were very concerned and worried about him. At the end of the day Anna and I went back to check on him and he seemed sort of confused. He said he remembered us and he remembered Rovina but when we mentioned the names of his friends he said he couldn’t remember them. I was worried that something had happened to his brain but I made him tell me the names of animals in Swahili and I thumb wrestled with him and he seemed to be doing okay but occasionally he would zone out or start twitching. Something was going on neurologically, when Rovina got back Anna and I mentioned it to her and she said that they diagnosed him with seizure disorder and then it all kind of made sense. Maybe the smell he was complaining of was an aura and when he was unconscious in the car he was postdictal…I don’t know. They discharged him and he got back to Amani where according to Anna he recognized all of his friends and started smiling.
Hopefully he will be alright and he is doing so much better but I felt so bad for him he was so confused and I have no idea if Rovina explained anything to him or not but I hope he doesn’t remember Anna or I doing mouth to mouth because he would probably feel really awkward. Also there is no public display of affection in Tanzania and because he looks like a teenager…and so do I…I felt like I was getting weird looks because I was holding his hand but I didn’t care because he just needed someone to comfort him.
So this incident brought about a few ideas for the health clinic at Amani. First of all, we are going to try to get at least three barrier masks donated incase we are in another situation requiring mouth to mouth. We are also going to work on getting epipens or epinephrine injections because we do not know if these children have any allergies and we are giving them medications and antibiotics etc that they could have reactions to. Without a quick ride to the hospital or an ambulance service having an epi-pen would make a huge difference if needed. Rovina is also going to talk to the staff about first-aid and what to do and what not to do (i.e. funnel milk into someone’s throat) in these situations. If anyone wants to donate for this please let me know or feel free to send pocket masks etc.