For I know the plans I have for you...

About a month ago, while heading out of the dispensary, I spotted a very ill woman waiting to get her vital signs taken. When I returned, she was sitting outside the doctor's office, head propped on the doorway, obviously exhausted.

Not wanting her to wait long, I found her medical chart and brought her to my office. Her abdomen was hugely swollen, greater than that of a 9 month pregnant woman, her belly was tight and she had difficulty breathing. The rest of her body was skin and bones, and I was amazed that she could still walk upright.

She had visited the hospital a few months previous and her condition had improved with medications, but she did not return for her follow-up visit and subsequently ran out of meds. She stated she simply did not have the money to return.

This swollen-belly condition is called ascites. There are different causes, but in her case the cause was liver failure. Her liver was no longer making the protein needed to keep the body's fluids in check, and consequently, all the fluids pooled into her abdomen.

I wanted to hospitalize her but learned in amazement that she had come completely alone. I had no idea how she had made it on her own. I asked her to call her family and have them come and wrote up admission orders in her chart, hoping to put her in the women's ward the next day.

That week her teenage son arrived, and she was admitted. She was still extremely fragile and the doctor in charge of her set about the task of draining the ascites. When I arrived the following Monday to start rounds on the women's ward, they had already removed eight liters of fluid from her belly.

Most relatives staying with a sick person are responsible for caring for the patient's practical needs such as bathing, doing laundry and preparing food. However this woman's young son didn't have a clue how to perform these tasks. So the patient wore the same outfit for two weeks, slept on a plastic mattress without sheets and ate food from the restaurant out in front of the hospital. When his sister finally arrived, I gently prodded both of them to help wash their mother, change her clothes, make her bed etc.

At one point, I asked the son not to give his mother salt, as this causes water retention and worsens the problem of ascites. He proceeded to stop feeding her, as food from the restaurant had salt in it! When I found out I was quick to clarify, stating that salted food was better than no food at all and that she needed to eat!

During that week, she developed a very high fever. I was concerned that perhaps the liquid in her abdomen had become infected. We ran a few tests, started her on some antibiotics and I lifted her in prayer to God. At this point in her recovery, fever and infection was a very serious threat.

Shortly thereafter, when she had barely enough strength to walk to the bathroom, she started vomiting and stopped eating.

Her son then came to me and said he didn't have enough money to continue his mother's treatment. I had just prescribed a few more days of the antibiotic she had been taking, and this news was heartbreaking. I knew that she was nowhere near ready to go home, and I urged the young man to speak with hospital administration about their financial difficulty.

He did and received credit, a buy-now-pay-later system, but quickly became nervous when the bill exceeded what he thought he could realistically repay. He came to me again, and I suggested he speak with the hospital chaplains to be placed on the “poor fund” which means the hospital would then assume financial responsibility for his mother's care.

The finances were finally sorted, her fever broke, the vomiting stopped and her abdominal swelling had been greatly reduced by the second and third week of her hospitalization. Her eyes were brighter and I could tell she was feeling better. She was out of the woods.

However, perhaps the biggest victory was her salvation.

The chaplains, who were now in relationship with this family informed me that she had accepted Jesus during her stay with us. Her face had changed from a mask of exhaustion and pain to one of joy. Her transformation was truly amazing, and I am privileged to have witnessed it. By our standards, her body is still weak, and there is little else that we can do other than pray.

But now she has hope.

Today, while passing by the pharmacy, she called to me, stating she was going home and would be back for a follow up in 1 month. Her face was so lovely, her smile so warm and she asked me to wait while she went and fetched her younger daughter so we could meet. I shook the timid girl's hand and greeted her, and said goodbye to this sweet woman, praising God for his faithfulness, asking him to bring her back to me in a month.

Her stay was long and grueling, her care was complicated by poverty, she and her family required much energy and effort, and there were times when it wasn't clear whether or not she would survive.

But God had plans for her, and the look on her face today was worth it all.

Update - Hamidou Goni

In a recent blog post on May 17th, I thanked Calvary Chapel of Battle Creek for their generosity in providing school supplies and multivitamins to our pediatric patients.

I also mentioned Hamidou Goni, a malnourished infant who was hospitalized at the time.

With the loving involvment of one of our missionaries, the boy's caretaker Amagaena was taught how to use formula to feed Hamidou Goni. Since this time he has plumped up considerably and is lovely, playful and alert.