Bowel surgery for Brandina

Brandina and her twin sister Brenda were born on the third of November 2014. Their mother is only 18 years old and mentally unsound. The babies were born pre-term at 32 weeks. The father left the mother when she was 4 months pregnant. After the birth, I assisted the grandmother in taking care of the babies. Because the mother was refusing to breastfeed, I was supplying Lactogen formula. Brenda was doing well and quickly gained weight. Brandina however didn't gain because of frequent vomiting. After 6 weeks of Kangaroo care in Nkhoma hospital the family went home. But soon after discharge the grandmother came back to my house with Brandina because she couldn't manage to care for her. She now had to take care of two babies, look after her daughter, work on the field and do all the work of cooking and washing. Brandina was vomiting and crying very frequently which made the situation difficult. I decided to take Brandina into the Africare house.

I experienced the same problems as the grandmother, frequent vomiting and frequent crying. We started to observe her weight and she wasn't gaining much. We visited the pediatric doctor at Nkhoma Hospital several times and soon there was a diagnose: pyloric stenosis.
Now a surgeon had to be found who could do this operation on a very young baby. On Sunday February 22th there was a positive answer from a surgeon of Kamuzu central hospital in Lilongwe. The next day we were admitted in the peds department to be operated on Wednesday. Kamuzu Central Hospital is a government hospital, which means the resources are very limited. The pediatric emergency department is very small with only a few beds, the number of patients however is high. It is very difficult for the few nurses and doctors to oversee all patients as every bed has at least 5 patients and many others are on the floor. Sleeping, sitting and eating is all done on the floor.
Brandina wasn't allowed to eat for 6 hours before the operation. The operation was planned for  the next morning and we had a sleepless night. At 8am a nurse brought us to the main operating theatre and they informed me the operation was going to take about an hour. So I waited outside, and waited and waited. Brandina finally came back after 3 hours. During the operation it turned out Brandina did not had pyloric stenosis but bowel obstruction. A minor procedure turned into a major operation. The operation went well but the next few hours were critical. In the afternoon we were back at the pediatric emergency department. Back in the room with at least another 100 patients. Because of her critical condition Brandina was given a place on a bed and luckily not on the floor. I observed her closly for the next 24 hours. She wasn't allowed to eat and had a lot of pain. She cried for the entire 24 hours. I tried to give her some comfort by holding her in my arms. It looked like the day and night passed by very slowly. The next morning at 9am she passed stool which is a sign the bowels are working again. The doctor came at 10am and after examination he said she could start drinking some milk. I gave her half a bottle and finally she fell asleep. We agreed with the doctors to be discharged and monitored at Nkhoma Hospital. Right now she still has a lot of pain and is only able to drink small amounts of milk. But she is improving and we thank and praise God for that!


Love,
Nicole