Kellers in Africa

our life in Zambia

Tag: health

A list of things that you shouldn’t do…

during a cholera outbreak:

Wait… what is cholera? If you need to ask this question, you should send up a little prayer of thanks for God’s grace in modern civilization and sanitation! Cholera is a disease of poverty, filth, and ignorance.

Oh yeah, and bacteria. But it LOVES poverty, filth, and ignorance.

 

Photo by MicrobiologyOnline.org

It spreads rapidly through any water-based medium.

Water is everywhere…

Photo by Open.edu

The infection is horrible.

Not. Fun.

Photo by EMS-Solution Inc

 

Which brings us back to…. a list of things you should NOT do in a cholera outbreak:

Shake hands

Cholera is a bacterial disease spread by contact with infected human waste and body fluids… which have a tendency to come in contact with hands. (EW.)

This is a cultural issue in Zambia as greeting one another and shaking hands goes beyond courtesy here- it is vital to maintaining relationships. People often hold hands (even if they are not much more than strangers) as they talk as a means of establishing connection in the conversation. After a church service, as you walk out the door, everyone forms a line and shakes hands with everyone else. 

 

Eat raw vegetables

Most vegetables in market places here are washed in… the latrine area. Not even kidding. You know where that water has been?! If you buy fruits or vegetables for cooking they have to be sanitized first. And sanitize them well.

There are no “facilities” so vegetables are washed  in whatever water is available.

So if you take these veggies home:

 

 

Eat fast food/street food

There are no public toilet areas, no sinks, no sanitation. No hair nets, no hand sanitizer, no food-safe containers. If that guy is carrying cholera… so are his snacks.

Hand washing and food handling… not a “thing” with street food

Drink water that hasn’t been boiled or treated

Even bottled water isn’t safe if you aren’t certain that the bottling company isn’t just “purifying” it (as opposed to treating it). And in Africa all bets are off on that one!

Boil it or bleach it. (Yes, we drink bleach water. Lovely.)

 

Go to church/school/public meetings

For now, all public meetings have been suspended in outbreak areas. This is mostly due to ignorance about how cholera spreads. Most people in compounds don’t realize that not washing hands,  sharing food, shaking hands, sharing toilets, etc can spread this disease. It isn’t a strictly necessary measure to stop the disease… but it helps people realize how serious and necessary the sanitation measures are.

An infected person who hasn’t washed their hands and then shakes hands, hugs, handles food, washes/drinks with communal water can infect a whole community.

Some of these areas are already affected by dirty drinking water, infected latrines, etc. You know what that means?

Stop Helping Others

(remember these are things you shouldn’t do!) The time to help is NOW. Time to educate on health and sanitation, to install proper water pumps on boreholes (deep wells with pumps instead of shallow hand-dugs that are easily infected), to help families with infected bread-winners, teach children about microbes, to encourage and support clean up in the slums. Can’t do that from where you are sitting because you live in a country NOT affected by cholera? Educate your kids about this disease and how it impacts third world countries. Support people engaged in dealing with the situation (we need short term solutions like clean up and long term solutions like education and water pumps).

PRAY FOR THE AFFECTED FAMILIES.

Education

Empowerment & Aid

Panic

Think Ebola Zombie Apocalypse 2014. No don’t. Don’t even go there! This is a simple bacterial infection. It is so easy to treat that WHO and the CDC don’t even hand out antibiotics for it. That’s right: electrolytes (in treated water) and rest take care of this disease almost without exception. Extreme cases occur when the sick person continues to be exposed (got sick from infected water and continues drinking the same water).

Soooo… you don’t have to worry that cholera zombies are going to be arriving at your local airport.

However… this disease is impacting the lives of millions of people across the world. Without education and empowerment to change their lives, cholera will continue to kill hundreds of thousands of people (most of them children) every year.

 

Vindicate the weak and fatherless; Do justice to the afflicted and destitute.
Psalm 82:3

 

Is Ian okay? What Just Happened???

Well, we are still figuring that out ourselves. And it isn’t over yet, but it is past time for me to acknowledge God’s amazing grace and provision…. And put together some kind of update before my mother stops speaking to me. That’s right. This has all happened so quickly and intensely that some of our family is still trying to figure out what is going on. (Sorry Mom!!)

The feeding tube made a huge difference

 

We have received so much support, many questions, and a variety of potential solutions from everyone who has been praying for us. We read and appreciated every single message- and replied to very few. (Blame stress?) But the encouragement meant So Much. In the interest of answering a broad swathe of questions, I am making this quite detailed. Please feel free to comment or message me if you have something to add!

Ian was born in Johannesburg, South Africa on July 26th. He was full term and did not have the potential abdominal complication that was a concern throughout the pregnancy. We will never know if it was bad radiology or God’s healing… Either way we are just so thankful. I know a lot of people were praying and let me tell you- we felt it. (So no, this issue is not related to the pregnancy concerns. Ian is just working on his Prayer Baby merit badge!!)

  

“I finally have my own brother.” And that is how Freddy sees Ian: HIS brother! 😛

 

After his birth we waited in South Africa just long enough for his travel documentation and returned to Zambia. Everything seemed to be going well. He was an interactive, perky little boy. He had a love/fear relationship with his siblings. He fed regularly, hated baths, and had an infatuation with 2am. Normal baby. Except that he wasn’t growing. We kept coming up with reasons like “It has been crazy hot, he is sweating out all his fluids” or “He is just a long, skinny, noodle baby.” However, people stopped saying “what a cute, tiny baby” and instead gave us scared looks when they heard his age. We knew it was time to see a doctor. So why hadn’t we taken him in? Well…. The problem was: in where? I was pretty sure it was a calorie problem but realized he needed to have some blood work done. And if there is one thing you don’t rely on in Zambia it is the lab work and the diagnostic ability of the doctors in the hospitals. Since Timothy needed to go back to South Africa anyway to get 4×4 kit done for the newly purchased field truck, we decided to go as a family and get a check up for Ian. From that point our entire life revolved around feeding him. We encouraged him to eat every 2 hours. I ate more calories and drank buckets of water. We were convinced that by the time we reached Cape Town he would pick up weight and we would feel like fools for worrying too much and feeding too little. (Why I thought that when we were feeding him every 2 hours…. Hey sleep deprivation is a dangerous thing!)

I didn’t know a pediatrician in Cape Town so I asked our friends Charl & Sonja if they could recommend one. I booked an appointment for the day after we arrived. We walked into the doctor’s office unsure of what to expect. Mostly I thought that I was going to get seriously told off for underfeeding him (naive much??) When the doctor saw us he was very kind and very thorough. Upon examination he told us that Ian weighed 7lbs 8oz. At 15 weeks of age. From that point on, our world started spinning at a whole new, horrible angle. We were whisked off to the lab for tests. I was referred to (a completely amazing) dietician who specializes in infants and breastfeeding. We spent most of that week talking to doctors, getting lab work done, and waiting. The biggest concern was determining if he has a genetic/metabolic disease. Apparently those can progress rapidly and cause permanent brain damage due to nutrient issues. Because he was feeding well and often but not growing this was a very real possibility.

 

3 months old- beginning to look physically wasted. His bones were so TINY.

 

By the end of the week (the longest week in my life) nothing conclusive had been found. In a last ditch effort to find a reasonable diagnosis (before all the scary genetic testing) the two doctors that were helping us decided to put in a feeding tube (breastmilk supplementaion plus extra nutrients). It was an experiment attempting to narrow down the possibilities. To everyone’s astonishment, Ian immediately started to gain weight- at an incredible rate. The doctors put him on a heavy feeding plan and began trying to work out what was causing the problem. Unfortunately, without a lot of testing- most of which is invasive and expensive- they couldn’t come up with anything definitive. After a few more referrals the best all around idea was to go in for corrective oral surgery and release his tongue tie. It was a small tie- really too small to worry about. But it was the only simple solution available. We had the weekend to weigh the pros and cons, deciding whether or not it was in the best interest of our drastically underweight baby to anesthetize him and start cutting up his tongue. We got advice from a lot of people and finally decided to go ahead with the surgery.

 

a very nervous and worried Daddy

 

That made Tuesday the longest day in my life. Ian wasn’t allowed food after 2am. You can imagine how that went down! Checking him in and handing him over to the surgeon was the hardest thing I have ever done. The relief when they brought him out was intense and helping him cope as he surfaced from the anesthesia and became aware of the pain…. agony. The whole situation is something I hope never to repeat. His extremely low weight and emaciated state made every moment of that surgery and recovery absolutely terrifying.

Amazing how quickly they recover – mama is still traumatized!!!

 

We had follow ups the next day and all looked well enough. They left the feeding tube in as we can’t risk him losing any weight in recovery.

Complicating the situation, our visas were due to expire within the week. Ian had the surgery Tuesday, follow up appointments on Wednesday, and we headed north on Thursday! We stayed just inside the country (with the Le Roux family- some amazing people!) until our last day on the visa. Then the long road home.

As of this writing I would say that Ian has made a good recovery from surgery and it is just too early to say if this is the solution or not. We chose not to stay in South Africa on a medical visa because Ian would just be fed and monitored for a few weeks anyway. We might as well do that from home. If (please Lord no) this is not the solution…. We move on to the genetic testing. That would be expensive, potentially invasive, and none of the options are nice at all.

In the 5 weeks following his surgery he gained another pound. We are extremely grateful for that growth! It is a very good sign! As of today Ian is up to 9lbs 6oz!

 

He hates the feeding tube. HATES it.

 

We want to thank so many people-

The amazing doctors and dietician who have helped us so much

The van Wyk family for giving up a whole week to watch our other kids while we went in and out of hospital

The families who put us up with all our kids in tow

The many people who encouraged, prayed for, and supported us through this

God’s amazing grace, without which my brain would have stopped functioning from stress weeks ago.

 

 

FAQs:

Does he need to go on a special formula?

– No, at this point they are still figuring out if he has a metabolic problem. The supplementer tube with breastmilk worked well and eventually we were able to switch to bottle supplementation of breastmilk. Pumping and feeding is extremely draining… but it is the best solution for him right now.

Will you be bringing him to the USA?

– No, we are very, very happy with the doctors who are helping us in South Africa. At this point there is nothing else that can be done. It is wait, watch, and feed for a while.

Have you done any genetic testing?

– Yes. We had the most common/best fitting tests run. They came back negative. He doesn’t have enough symptoms to justify the cost of any further genetic tests at this time. The doctors have advised that until/unless he develops more symptoms, it would be like shooting in the dark.

Is there anything you need?

– Yes. Lots of prayer. We received financial help with the surgery expenses and that was a huge blessing. If we are able to do any of the blood tests here in Zambia it will be very costly… but cheaper than flying to Cape Town. We will have to see how that works out. But the main thing is definitely prayer for strength and growth and health.

Is his development on track?

– Yes. He is a bit behind in some areas.. and ahead in others. Pretty much a normal baby (which is very good!!)

IMG_3104

I might be skinny, but I have big plans!

 

Please feel free to comment or message me! We have been SO BLESSED with all the prayers and support!

 

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