There are many things in life that cannot be conveyed in words, but I will do my best. Saturday, I was hoping to give Dr. Mark Karnes a “day off.” I could be first call and see the patients and he could get a call on updates, but since I still do not have license I cannot do surgery without him or care of patients outside of his supervision. We were in the process of inducing a patient that is a friend and physician at the hospital here, so he wanted to participate in that part of the day. The patient was quite complicated. She had severe preeclampsia and we were using a medication that is not available in Ethiopia to prevent seizures. The medication can be dangerous and the nurses are unfamiliar with it, so I spent most of my day sitting by her bed counting the two IV drips she had going. We don’t have any IV pumps, so you have to count how many drips go in in a minute to know how much medicine the patient is getting.
As soon as I finished seeing the patients in the ward, I was called concerning a patient that had been referred from the government hospital, a woman with twins…the first one breech. When I got her chart there was a note in it from the government hospital saying that there anesthesia equipment was broken (they only have one machine and have been using it the last 19 years). She is HIV positive and her body is wasting away. She has only been on HIV treatment for about 2 months. She needed a c-section so the ringing of Dr. Mark’s phone began. Dr. Mark and one of the general surgery residents did her surgery and two beautiful boys were born. She has two kids at home and these babies will be number 3 and 4. I am not sure if her emaciated body with many sores will be able to provide the milk these babies need or how much longer she will survive.
Then, I got our second referral from the government hospital. A laboring mother with fevers. I placed her on IV antibiotics and watched to see if she would make cervical changes. She had been in “labor” for about 12 hours with no cervical change, but wasn’t contracting very often and the baby looked good. As I was planning her care, Mark informed me we had a woman with a ruptured uterus had just been admitted to the ICU. I will let Mark tell the story, as I wasn’t there.
This was her fifth pregnancy. She had one 7 year old girl and the rest had died. She was acutely ill having travelled over 150 kilometers to get to Soddo. Her dead baby was coming “face first,” and she could not deliver it. Her abdomen was rock hard, filled with blood and her breathing was shallow and rapid. She asked me, “Can you save my life?” I told her there is only one Savior, Jesus Christ. After praying for her we got her ready to go to the OR. As she lay on the operating table, I held her hand and our eyes locked upon each other. As the nurse anesthetist was putting her to sleep, she started vomiting and I could see bile in the endotracheal tube. I yelled, “Suction her!” The anesthetist could not ventilate her lungs and she died right before our eyes. Just a few short minutes before we had been looking at each other. Now she was gone. She had told me earlier, “I came here for you to save me.
The patient with the high fever had initially made progress and then stalled and the baby was no longer tolerating labor, so we decided to do a vaginal bypass. Mark and the resident delivered a live, big baby girl. While they were still in the operating room Mark received news that another mother had arrived with a ruptured uterus. She had been to three hospitals before arriving here, but they all referred her on because they were unable to do surgeries. This was her fourth pregnancy and she was pregnant with twins. She had delivered one baby the day before (it was afternoon now). She could not deliver the second twin and in the process had ruptured her uterus. Her bare feet were caked in mud, amniotic fluid and blood from squatting on her dirt floor trying to deliver her babies at home. Her blood count was extremely low (the next morning after 3 units of blood her hemoglobin was 5.9) and she was working on dying. She desperately needed blood and surgery to survive. Mark brought her to the OR and I peeked in to see if they needed any assistance. A stillborn boy was sitting in the trash can by the operating table. They said all was under control, so I returned to our friend. A few minutes later the electricity went out and it was dark, so all I could think was I hope the bleeding is still under control. In the hospital we have a generator that kicks on after 90 seconds, but in surgery, in the dark, 90 seconds feels like a lifetime in a critical situation.
The highlight of the day was the delivery of our friend’s tiny baby boy, Ephraim. I was so impressed with her. I have never seen a laboring mom do so well. If the contraction was strong, when it was over she would say, “Oh, this is good. He is coming.” If it was short or not strong she was disappointed because it probably didn’t do much.
Shortly after her delivery we had a women come in who didn’t know how far along she was but was having heavy vaginal bleeding. We did an ultrasound and the baby wass only 32 weeks, but she had to be delivered. Since Mark and I are not only the obstetrician/gynecologists, but also the pediatricians Mark did the surgery and I took care of a little baby boy that was just under 4 pounds. Initially, he did well, but was having a hard time keeping oxygenated if he wasn’t warm. We have one incubator that does not work and heaters like you would use in your house to keep the baby warm. I sat in the ICU and held the baby on my chest with a heater at my side. As long as he was warm he kept up his oxygenation. A sister of the patient volunteered to stay on the couch by the heater with the baby. I went home and read to see what I needed to do to help this baby. When I got back to the ICU the one nurse that was in charge of the ten to fourteen ICU patients was sleeping on the one empty bed. I gave my orders, made my displeasure with his sleeping known and hesitantly returned home.
I slept for about fours hours. Another day had started. I went to the ICU first to see our patients. I found the little baby next to the mom and blue. I immediately grabbed him and put him on my chest and went to the heater. It was no longer working. The only oxygen in the ICU was being used by other patients. I then ran with him to OB because I knew we had another heater there. I ripped of my shirt and held him against my skin while the nurses went to find the heater and oxygen. He was slowly improving, but then stopped breathing. I did mouth to mouth on him until we had a bag and oxygen, but by that time he didn’t need it.
We then began to set up our own little neonatal ICU. I had a non-functioning incubator, a heater and an oxygen tank that only worked sometimes. I had to write out a prescription for the family to get and IV, IV
fluids antibiotics and medicine to help the baby to remember to breath. As the family was getting those things he started seizing. They returned from the pharmacy empty handed because they couldn’t afford the $4.50. I went to the pharmacy and told them to start a tab for me. I was not going to let $4.50 be the deciding factor for this baby. I now needed seizure meds, but the only seizure medications here are pills.
The baby doesn’t suck well, so I also had to get a tube to put down his nose into his stomach to deliver the crushed pills (1/8 of a pill) dissolved in water. Sophie, an expatriate nurse that works in a nearby village, was spending the day with me in the hospital. We spent the next 25 hours by this babies bedside caring for him. Neither of us felt comfortable leaving the baby with the nurses because he had stopped breathing about 5 times and we have no alarms to notify you. You just have to watch. Every time I have gone to the ward at night the nurses are sleeping on the couch or beds. Sophie stayed up all night and worked with one of the nurses to teach her everything on the baby and I slept off and on, but was available for emergencies. We also had another delivery last night.
This morning I had a fabulous nurse, so I felt I could leave her with baby to go to surgery. Mark and I removed a volleyball sized ovary from a woman that was filled with hair and teeth (dermoid), then we did a hysterectomy on a woman with a molar pregnancy and then the plastic surgeon and I removed a squamous cell carcinoma from a woman’s vulva (we removed the outside of the vagina near the urethra to the anus and the lower 1/3 of the vagina) and then took skin from her leg and swung it around to cover the hole.
I just got home and my mind won’t stop, so I am writing. I realized that I offered to donate blood to one of the patients and haven’t had a chance to (she got blood I just haven’t replaced it), I have a lecture to put together for Thursday, I haven’t paid the pharmacy bill… the list goes on. They are also appealing my medical license today. This may determine if I get to stay in Ethiopia. Thank you all for your prayers and support!
You are so amazing! I know all those people are blessed to have you there. Please take care of yourself and stay safe.
Thank you Sariah. I am doing my best to take care of myself and I have others helping too. When I was at the hospital the other missionaries brought up meals, snacks, drinks, donated blood, watched baby when I was too tired… the list goes on. I am not doing this alone. I know God has me here for a purpose.
I cried through your blog. I am praying for you for godly wisdom, emotional strength, physical stamina, and blessed times of rest too. Love, Mary
Thanks Mary! And keep praying for sleep when I get away. Yesterday, I came home after work and couldn’t sleep. I home to sleep from 4pm on, but didn’t actually fall asleep until after midnight. It is so hard to slow your mind when things are still up in the air and you don’t feel comfortable with the care that is being provided. The nurses are learning and are eager to improve, it is just teaching them everything.
OH, Steph! I cried and cried as I read your blog. WOW!!! What great needs! Praying for God to give you strength, wisdom, endurance, and peace. Love you!
You are stronger than I could ever imagine being. Your post was moving and I thank God everyday that you are there, sharing His love and your love with those around you. Love, Lauren
It is a gift from God. He has made me to where I cannot walk away. I do not know how to. And in those times He gives me the strength to go on. Love you too!
Oh Stephanie…I know you heard about days like this before you went, but to live through them must be incredibly challenging. Isn’t it great though, that in the midst of so much, God never leaves our side. And He gives you amazing physical and emotional stamina for whatever you face. You continue in our thoughts and prayers. Love you, Cheryl
I know that things will improve. Everyone has their role here at the hospital Mark and I are just working on expanding the role of the nurses.
I sit here teary and feel “Tummy” wiggle around, secure in our medical future. Peace and courage to you. Thank you.
I hear about you and your family all the time. I find it funny that I have met your mom, but not you yet. I hope your “tummy” continues to grow and give you much joy. Thanks for you prayers.
Gracious, lady. Praying for the LORD to work His hand with your license and for Him to sustain you. Hugs from Kansas.
Where is the like button? Thanks for the prayer and hugs. I am so thankful we serve the God that we have!
On my goodness Stephanie! I cannot imagine how frustrating it must be to not have the equipment you need to help all your patients. Since we have always had the luxury of equipment or a center to refer to here in America it would be very daunting to not have access for immediate needs. I will be adding you to our dinner prayer tonight with Kyle and Anothony. Of course you will remain in my thoughts and prayers as well. Love you hun!
Thank you Bonnie! How is your practice going? I hope the kinks are all getting worked out. hugs!
Steph – I want to send a working isolette filled with ped. meds, bags, masks, IV pumps, and tubing stretching from there to here with an endless supply of O2. And Mag(with the accompanying little red boxes) and everything else under the sun for your mommas. The frustration you must feel – not having the equipment you need……
Your stories are truly “bittersweet” – but they are filled with such compassion and hope.
Praying for you and Dr. Mark – that the Lord continues to lay his hands upon yours as you do his work.
God Bless,
Deb
Thanks Deb. I am hoping to get some sort of woman and babies fund started, so that people can donate or send supplies that are needed. I will keep everyone updated!
“when i am weak, then He is strong…” walk in His strength and peace sweet lady,sherron wendt
As I wipe my tears and try to convey my great admiration for you and feel your frustration with improvising in any way possible to save lives I am humbled for being frustrated with with our move to the BrithCenter. You are an amazing woman and I love you for all you are doing. My prayers are with you and Mark and I hope the board will understand what an asset you are to the women and children of Etheopia. God willing you will continue your work. Take care of your self and know that you have many prayers being sent your way. Keep me posted
Linda
Through all of this I never cried. There wasn’t time and then I was too tired emotionally and physically. I think writing these stories is a bit of therapy for me. It lets me share my joys and frustrations.
I finally started crying when I started reading all of the responses. So many people with beautiful hearts that want to help in so many ways. Thank you for your words of encouragement!
My heart cries at the lack of medical things in Etheopia. Us Americans are SO spoiled! To not have $4.50 to save the child – I simply cannot imagine. In fact, I cried at all the various things that you wrote about. My God, in His greatest mercies, bless you and all the other people who try so very hard there. Please take care of yourself too – for without you, the world would be at a huge loss.
Everywhere in the world people go with and without different things. Here there is a definite lack of medical needs, but they are rich in many other areas of life. I have to remind myself of that when I get frustrated. And I have felt very blessed. God uses us all in different ways to bless each other. And the patients and families are all very thankful. No matter the outcome they are grateful that you did all you knew to do to help.
Wow, I just keep thinking of pictures of all of these things – but to see them in real life, and all in one weekend must be amazing in so many ways. Continuing to pray!
I have been praying for you. May God continue to be your strength and may you feel the prayers of others.
I wish I could get on a plane right now and come help you! I would stay up all night for you! I will pray extra extra hard for you, all the caregivers and patients I know you are giving your all for- God Bless!!!
Steph, what amazes me is the strength God has given u to do ur work. Remember to take care of yourself, I am not very good at this either but it will be vitals to ur work. I trust gods plan for u. In my thoughts and prayers daily
Steph. I can’t even begin to imagine what all of that must look like, feel like, sound like…I am praying for you. You help remind me to be thankful. Thank you. Love you, Em
Steph…I am at a loss for words!!! I feel embarrassed for ever complaining about our nursing shortage on our new unit. I can’t imagine going through what you just went through. You are truly an angel for these people in Ethiopia! I pray everyday that they approve your medical license. We also are gathering up quite a collection for Michelle to bring over in the spring. We don’t throw any expired thing away! Maybe I can send over some of Evan’s oxygen tanks that he is rarely using:) Hang in there and keep up the good work!
Lindsey
I don’t know how you do it but they certainly are lucky to have you. Also makes me realize how much we take for granted. Take good care of you.
Steph,
Ditto everything everyone else has said here! I’m praying for you, especially that you get the rest you need for the work that you do. Love you.
Stephanie,
I pray every morning @ 5:00 am that God will guide your hands and your heart, and give you strength. Prayers have been answered, but my heart is breaking. I have never felt such admiration for you & Mark as I have after reading your blog. I pray that the Board will award your license. God has great plans for you, and He will not fail you.
How can we help you? What would be the best way?
Know that you are loved, and prayed for by so many of us who have had the privilege to know you.
God bless you & Mark, and all of your patients.
Jan
May you continue to feel the power of prayer as God works through you to show the love of Christ to these children of His.
Steph~
W.O.W.!!!
I can’t imagine how exhausted you were! I loved your very politically correct statement of ‘making my displeasure known’ – I wish I had been there to hear what you actually said. I can’t imagine how difficult it is to work with people that are from a culture that isn’t used to their patients surviving even one of the scenarios that you described.
I am so proud of you! You are doing amazing things and making a difference that will have a ripple effect farther than nyou will ever know.
Strong work!
corey
It is hard to figure out how to approach without offending. We are such a direct culture and they are not. I told him he was supposed to be working and I was keeping them in the ICU for closer care and if he wouldn’t provide it then to please call me, because I would. I know that is very direct, but it was the middle of the night and it was the best I could do.
Boy Steph…I really admire you for what you are doing. God has given you a big job and I think you’re doing all that you can. Keep up the good work and our prayers will always be with you.
you’re right steph….no words. and all i can do is pray for you and remind you that God is bigger than all of this and you do what you can do and you are amazing. my devo today challenged me to “expect” God in everything. I don’t have an answer for how you do that where you are. i do like what dr mark said about only God can save you. love you!
Hang in there. Praying for you. Peds….well, that’s one reason I went back for the ob/gyn program. Neonatology…..uh, yeah. But, you do what you gotta do.
Just a thought, could go with mag IM like they used to do at Parkland in TX.
Agree with the above about how totally spoiled we are here in the states. Every time I go over and come back I swear I won’t prescribe another pain pill. ( I still do, but have gotten more picky about it.)
Regarding those lectures. Let me know if I can help. Can email what I’ve got in bits and pieces if your internet connection isn’t too fast. If it’s good, can send powerpoints.
Stephanie and Dr. Karnes,
Praying for you and your work daily! You are both such a blessing to those you are serving. Reading your blog I feel so spoiled and my concerns feel ridiculous.
Thank you for sharing your experience with us,
Melissa
Stephanie,
Oh my goodness, your stories are amazing! Working in the medical field, I am astonished by the conditions in which you find yourself. God has truly placed a wonderful calling on your life.
My prayer will be that you will be strengthened and encouraged as you journey forward in this high calling that God has led you to.
The lives of all those you touch will never be the same; and that is truly what God intends.
Dr. Kanes has also answered a call that most would not venture into; I will be praying for those that come to you. God will definitely use you in a mighty mighty way.
Blessings to you; thank you so much for keeping us informed of your journey and experiences.
Pamela
Stephanie!
I mirror what everyone else has already said…you are an amazing disciple of God.
Is there anyway we can help? Can we send money to you so that you have a fund for the families that can’t afford medicine? Can we send you funds for medical supplies?
I am praying.
Katie Allison
We are working on figuring out how to put together an women’s health care and neonatal fund for those in need. We will be putting up a list of supplies that are needed and wanted. Thanks for you prayers
Stephanie,
Thank you for sharing your experience with all of us. I will continue to keep you guys in my prayers. May God continue to provide you with strength.
Tricia
Dr.Stephanie Hail. You are amazing. What you have decided to do with your life is… just astonishing. I knew there was something special about you all along.. i just didnt realize how special. I will keep you in my prayers…. hope you get approved for your license!!!
Goodness sakes!! Hard to get my brain wrapped around that kind of a day….. wow.
God’s blessings on you!!
Sophie’s sister in Idaho
Now I see why you sounded tired and didn’t know what day it was, when I talked to you the other day.
There is no father in the world that is more proud of his daughter than I am of you Stephanie.
Love,
Dad
Hi,
I have discovered your blog via Sophie.
I am amazed at the stories…What a blessing you will be to so many people in need there.
Cari G in MI
Dr. Hail,
I am a patient of Dr. Karnes. (Muskegon) You should ask him about me! He will have STORIES! I am also an RN at Hackley, I work 3rd shift. I would be happy to stay up for you! It just might take me a while to get there!
God’s plan is perfect! When & where we are weak, it is then we see He is strong! Your license is just an opportunity to see God! I pray for wisdom strength and sleep! God’s blessings! Tell Dr Karnes I love him dearly!
Also sending IV pumps…it will just take 6-9 months to ship!
Angie
praying for the work there
Mary (another of Sophie’s sisters)
Stephanie,
I just emailed your blog link to 250 friends who pray.
John Tanksley
Tenwek Hospital, Kenya
Thank you John.