“Andy, we need you, now!” These words are common to hear as a team leader of medical missions. I have served in the poorest countries, where there is little or no access to medical care. You never knew what emergency would suddenly appear at the clinic. This one I would not forget.
It was hot and equally humid in the tiny Honduran village. The human need was great. Hundreds came daily by any means possible – foot, horseback, mule, oxen, motorbike – often traveling many hours to be seen. Each succeeding day was busier as word of our presence spread. The people, as always, were loving, appreciative, and thankful.
She was in her 20’s, the mother of 4, her last baby was born the day before. However, later that night, she developed fever and abdominal pain. Within hours she rapidly deteriorated. The nearest hospital was a day’s walk as she lived far in the mountains. Late that night, her husband and 5 other men placed her on a blanket and began a 6 hour journey over treacherous mountain trails to see the American doctors they had heard about.
Septic, in fulminate pulmonary edema, she was seizing every few minutes. IV fluids and antibiotics were started, an oral airway placed, and, remembering a long ago intervention for pulmonary edema, I began rotating tourniquets. We had no IV Lasix, endotracheal tube, Ambu bag, or oxygen. The lack of basic infrastructure and the logistics of carrying our medicines, supplies, and equipment with us from the States, limit what we can bring and do.
There was a small hospital an hour away. The local pastor called for an “ambulance”. On arrival, I opened the rear doors to find a shell of an ambulance. We lifted her into the back while, Wendy, a third year medical student, and I climbed in beside her. She began vomiting in between her seizures. We continued rotating tourniquets and clearing her airway as her lungs filled further with fluid. The temperature inside was well over 100 and we struggled in the suffocating heat - no air conditioning, no windows to open, and the smell of vomitus permeating the air. We prayed. On arrival, she was immediately taken to the OR where a D&C was performed. She died a few hours later.
To most of the world, you and I live and work in “paradise”. May this story be a reminder of how fortunate we are and what a privilege it is to do what we do. Most of all, though, I am thankful for you!
Andy Lamb, MD