Burns

I once watched a movie that included a humorous line. “If you want to make God laugh, tell Him about your plans.” In October, 2002, during my fourth month of residency, I endured my burn rotation at Parkland Medical Center. It was easily the most miserable experience of my training. No offense intended to Parkland, of course, it’s just that taking care of burn patients is an emotionally exhausting and depressing endeavor to me. As I walked out of the burn unit on the last day, I was fairly certain I would never take of another burn patient again. God must have been chuckling.

I’m trying to inject some humor into this but it really is, as always, a depressing subject. When you look at trauma epidemiology, Africa is in the worst category concerning deaths per population from burns. What I’ve discovered here in Soddo is that a disproportionate number of those burns are in children. In rural Ethiopia, like much of Africa, there are lots of cooking fires and lots of unattended children. That is a dangerous combination. Several months ago I shared a tragic story of two children with severe burns that were caused maliciously. I am thankful to say that I haven’t seen any more of these intentional cases. What grieves my heart, and what I want share with this post, is the magnitude of suffering I’m seeing from unintentional burns involving babies and children.

As an update on the brother and sister that were burned earlier, the sister is nearly healed but she needs a lot of therapy and will likely require more surgeries in the future due to wound contractures. I’m sorry to report that the brother died at our hospital. I knew that learning to be a good missionary surgeon was going to be hard but it’s really difficult to watch it play out in real time. With this brother and sister, I tried to treat them “by the book”. Unfortunately, the textbooks don’t always apply to a resource-poor third-world hospital. I’m learning from mistakes and we seem to be doing better at taking care of these bad burns. It’s a long and tedious process of care that is difficult for us and terrible for the patients. But then again, as I alluded to in my comment about burn care at Parkland, that’s what burn care is.

We currently have five kids in the hospital with bad burns. I wanted to share the stories of three of them, all fairly similar. I’ll be perfectly forthright and honest… I’m writing this because I need your money. Disclaimer: I am deeply grateful for all those who have already given to us. This is directed at the general public reading this. The reality is that these families are usually the poorest in the community and the children require weeks of hospitalization with multiple surgeries. If we’re going to take care of them, and not bankrupt the hospital, we will need outside help. Though I have no love or desire to be a burn surgeon, God has placed this ball in my arms and I will try to run with it as best I can. As you read this post, please ask God if this is something He wants you to act upon. For some it will be ‘yes’ and for others it will be ‘no’. I’m not worried about the answer, please just be obedient to whatever your answer is.

(I’m not putting up clinical pictures because they’re even hard for me to look at.)

Mamush, two months old when he was burned, was the first of the three babies to arrive at the hospital. He was being carried by his older sibling and she accidently dropped him into a fire. In her fear, she left him and ran to find their parents. Obviously a two month old baby can’t crawl so he just cooked until the parents came to get him out. He had very deep burns involving some muscle and bone to both of his legs, his buttocks and his scrotum. I want to thank Dr. Gary Purdue, a burn surgeon at Parkland, and Drs. Michael Foreman and Matthew Lovitt, trauma surgeons at Baylor. They all gave helpful advice as I cared for this child. He ultimately required amputation of his right foot and two toes on his left foot and I had to give him a colostomy to divert stool away from his wounds. For those who don’t know what a colostomy is, that means we sewed his colon to the skin of his abdomen so that the stool can be collected in a bag from his abdomen. After a lot of wound care and skin grafts, he now only has open wounds around his anus. Eventually, once this heals and I feel confident he will be able to stool the normal way, I’ll reverse the colostomy.

I have to give full credit to God’s mercy and healing touch in this boy. The fact that he’s still alive is a miracle! I’m greatly encouraged. When he first arrived and we explained the situation to his family, the father wanted to take him home and let him die. Though it sounds harsh, I can’t imagine the choice a man has to make when he’s already struggling to support a family with meager earnings, with hunger always around the corner, and now he has to decide whether or not to spend basically everything on the care of a child that probably won’t survive. We convinced him to stay and the cost of care has been paid from the benevolent fund. The smile and hope on the mother’s face each morning when I see the boy helps keep me going.

Wudinesh is a seven month old girl that came to our hospital about a week ago. Her parents were down at the river when she rolled into the fire. By the time they got her out, her right leg looked like a piece of charcoal. She also had deep burns over her buttocks, groin and lower abdomen. Like Mamush, she has required a colostomy to protect her wounds. I had to amputate her right leg above the knee but her wounds are now clean and healthy. I hope to put skin grafts on her wounds next week. Her family is out of money and she has been placed on the benevolent fund. Her fevers have improved and she’s eating well. I think she will likely survive. God be praised!

Alimeyu is a six month old baby boy who presented to our hospital four days ago. His sister was carrying him and accidently dropped him in the fire. He has deep burns to both legs and buttocks. (The repetition of the stories is utterly depressing.) He too has a colostomy and is receiving wound care. We hope to skin graft him next week. He’ll probably lose one or two toes from each foot.

I’m seriously considering what it will take to develop a more formalized burn unit at Soddo Christian Hospital. That would mean a dedicated place with dedicated nursing staff to take care of these patients. The thought scares me because my responsibilities have already piled up above the level of real manageability. I’m learning more than ever to depend on God’s strength to accomplish His tasks because I frankly don’t have enough gas in the tank to get it done under my own strength. If God wants a burn unit at Soddo, though, I’m sure He can pull it off… and fund it.

In the mean time, though, the need is here and doesn’t seem to be going away. These kids just keep coming. I’m not interested in using guilt to coerce you into anything. There are lots of needs in the world and lots of needs in your own back yard. God will take care of these kids. Of that I’m confident. If you feel that God has decided to use you in that capacity, however, please know that it will be greatly appreciated. If you want to give to help in this matter, there are a couple of ways. The hospital has a web site, www.soddo.org. At this web site you can give money online or mail a check to the St. Luke’s Health Care Foundation, which runs the hospital. Just designate the funds to the “benevolent fund”. Alternatively, you can give to our mission agency, Global Outreach International, at www.globaloutreach.org. Just indicate our names and designate the money to the “benevolent fund”. We’ll get it to the right place. There are also mailing addresses for each.

St Luke’s Healthcare Foundation, 27W140 Roosevelt Road, Suite 201, Winfield, IL 60190

Global Outreach International, PO Box 1, Tupelo, MS, 38802

Thanks and God bless,

Paul