Thursday, November 17, 2011

Our Princess

When I first arrived in Sierra Leone and found out that I would be taking care of both adults AND children on the wards, I was nervous. My last experience in pediatrics was my limited clinical time in college, and I was (and still am, to some extent) very insecure about my abilities as a peds nurse. One of my first little patients way back in June was Aminata, a baby with a big tumor growing underneath her jaw. She was severely malnourished and developmentally delayed when she came to us, so she was put on the infant feeding program to get her healthy enough for surgery. I remember when we were taking care of her in June, Ami was very lethargic and didn't even have the energy to cry or kick her legs. Her arms and legs were much too skinny in proportion to the rest of her body, and her hair was thin and pale.

After staying in the hospital for awhile on tube feedings, she and her mother were sent to live at the Hope Center while she continued to fatten up before surgery. Over the next few months, Ami slowly gained weight and began acting more and more like the 2-year-old she is. Finally she was healthy enough to undergo surgery! All the nurses were so excited to see her back in the hospital, and she quickly became the Princess of D Ward. I remember one day I looked over and saw a group of our day volunteers gathered around Ami's bed, playing the guitar and singing to her. She had the biggest smile on her face, and was waving her arms at them while they sang.

In the operating room, the surgeons found that the tumor was much bigger than they'd anticipated. They had to do quite a bit of "digging" to get it all out, and as a result Aminata had a lot of swelling around her throat after the procedure. She came back to us intubated and breathing on a ventilator, and took up residence in the ICU. She had one-on-one care from nurses with pediatric ICU experience, and lots of visitors over the next few weeks. One evening as I was getting ready for my shift, I heard an announcement come on the overhead speakers: "Emergency medical team to the ICU!" My heart sank when I heard that; I knew we only had one patient in the ICU at the time. When I showed up in the ward for work, a crowd was gathered around Ami's bed. Despite being sedated, she had pulled her breathing tube out and there was too much swelling around her throat to put a new one in. As the doctors and emergency medical team were working, all the D Ward nurses waited nervously next door. At one point our team leader, Natalie, looked up at us and said "Are you guys ok? I think I'm more worried about you than Aminata!" Several of us were close to tears, worried about our little princess. Ami was rushed down the hall to the operating room to have a tracheostomy placed, and she came back to us on the ventilator again.

It was a long, slow process, but eventually the swelling went down enough for Ami to start breathing on her own and come off the ventilator. Her trach site healed up, but she had a pretty nasty respiratory infection after that. Several more weeks on antibiotics and tube feedings had her slowly but surely feeling better. She's been going back and forth between the Hope Center and the hospital since getting her feeding tube out, and is brighter-eyed and happier than ever these days. It's really amazing to see the change in her, since having taken care of her back in June. She's definitely fattened up since then, loves to play with the nurses, and smiles all the time. Her hair is healthy, and her legs are strong enough for her to start learning how to walk!

Despite the improvements, Aminata's tumor may return, and her chest infection never quite went away. And the ship is leaving in December. Leaving Ami before she's completely healed is something we're all struggling with. It's hard to leave before the problem is fixed. It's hard to go home to a country where I have immediate access to whatever healthcare I need, when the people I leave behind don't have enough medicine or doctors or food or clean water. All of Ami's memories are here on the ship; what's she going to think when all of a sudden, we're gone? Her home is probably not a very clean environment; what if her infection gets worse? One of my coworkers reminded me the other day: God brought Aminata to us. He was with her all along, and He'll still be with her when we leave.


  1. This post really brought tears to my eyes. And you are so right in the end.

  2. Ah. Crying for you and your princess. Like, big ol' crocodile tears while I'm sitting here at a coffeeshop. Kind of worried the guy working is about to come ask me if I'm okay. Awkward. But yes, by God's healing hand alone, she will thrive. And what a joy to be reunited with her in heaven! Love you Baby Ruth.