Rwanda Update #3 - My American Brain

I'm trying to write a quick blog post before getting ready for clinic this morning. I woke up to the rooster crowing which I oddly love. However, he starts his business at around 2:30 in the AM and if I knew where he lived, we would have some words. Yesterday was our first full day in country. We woke up, visited Africa New Life Bible Church where Dr. Charles preached. What really resonated with me is that our God is a God of miracles. Following church we went to lunch and headed to the genocide memorial. While they visited the genocide memorial, a few staff and myself went to visit one of our sponsored boys in the hospital.

Pause, the rest of this post might make a non-medical or sensitive stomach a little queasy.

His name is Daniel and he is 16 years old. As far as we can tell he has a primary squamous cell carcinoma that is rapidly growing. Early December he was seen at a government clinic for what was thought to be a small pimple on the inside of his nose, he was given some topical antibiotic. Early January, it has grown significantly but was still felt to be infectious vs. inflammatory in nature resulting in a severe sinus infection. However, at this second visit a biopsy was performed revealing cancer three weeks later. In that timeframe, the mass has grown so significantly it is now obstructing his airway. What the ENT physician told me was the mass is not only growing from his nose but involves the entire R maxillary sinus and growing inferiorly down the oropharynx/throat.1907943_10153069040994604_5375898849003256126_n

Daniel went home last week and taking a razor blade, attempted to cut off the part of the tumor that was visibly growing from his nose. He bled so much that he couldn't breathe and an emergency tracheotomy was performed. He has since been transferred to a Kigali hospital and waiting for a transfer to a private hospital for plastic surgery consultation.

Visiting him in the hospital is difficult to describe. Daniel is very malnourished and has the stature of approximately 8-9 years old. The hospital conditions are poor in comparison to the United States. Daniel tried to be polite and sit at the bedside to meet us. However, I quickly realized the tumor has caused so much obstruction, he has difficulty breathing in that position and cannot handle his secretions. We gestured for him to lay back down. It's clear he has an infection in that sinus cavity that is communicating with the venous drainage system of his eye. The physician states that the cancer is also spreading to his frontal bone area, unclear if this is frontal and ethmoid sinuses or if it is invading bone. We have asked to get images but the radiology department is not open on Sundays.

I am having a hard time processing his case because short of a miracle, his prognosis is not good. My American brain is wanting to fix this. I want to give him the best treatment available in the world. I see the disparity between what is available to Daniel in Rwanda and what would be available to him in the US. I want parenteral nutrition, IV antibiotics, a suction machine, a plastic surgeon and reconstructive surgery. The reality I am confronted with is that Daniel wouldn't be able to travel to the US, he is too ill. And I know that bringing every sick child to the US is not possible nor is it sustainable. My medical provider brain wants to heal him and I want to am struggling with the limitations of a third world medical health system. It doesn't seem fair, it doesn't seem right.

What we are attempting to do is expedite his transfer to the private hospital and an appointment with the only plastic surgeon in the country. And I am praying for a miracle. Short of a miracle, I am praying for halt of cancer growth, protection against an infection in his lungs or brain, praying that he can tolerate his secretions and that he doesn't aspirate. I am praying that he doesn't suffer. And if God isn't going to do a miracle; honestly, I pray that He takes away his suffering, receives a new body in heaven.

First day of clinic, have to run. Specific prayer requests:

1. Health, energy, and unity of the team

2. That God is glorified by what we do and see today.

3. That logistically, things run as smoothly as possible

Katie Fisher - Team Leader