Saturday, July 19, 2008

Leyna - A story from Dr. Leon Greene - Loma De Luz


Introduction: Dr. Leon Greene serves as a cardiologist with his wife Judy at Hospital Loma De Luz. This heart-rending story was included in his last newsletter. I reprint it here, with his permission, to give you a sense of the deep sadness that can visit the missionaries at Loma De Luz at any moment. Please be in prayer for the medical staff as they give aid (when they can) and Christ's compassion (always).


The Best-Dressed Child in the Neighborhood

Leyna came to the clinic on a Friday morning from the village of Rio Esteban, about 10 miles and two bridgeless rivers away from us. Tiny for her 3 months of age – slightly over 9 pounds, her mom had brought Leyna to us because she was having difficulty breathing. By the mom’s report, Leyna had been healthy until now. As a dark-skinned child of Garifuna extraction, her blue color had not attracted attention from anyone in the family. Being born in the government hospital in La Ceiba had not guaranteed that any such abnormality would have been detected. We were just about to go to town for groceries (Friday is not one of my clinic days), when Dr. Ted asked me to see her.
Leyna’s deeply blue fingers, toes, and lips were a stark contrast to the clean white of the tattered and ripped dress that covered her chest and abdomen. Her oxygen saturation was 62% (normal is 100%), and her breathing was labored, as though each breath was the last supreme effort of this infant to survive. A quick exam revealed that the child’s heart was on the right side of the chest. A tip-off for other congenital cardiac defects, a quick echocardiogram revealed that the abnormalities were almost countless (for you medical folks, she had almost every lesion in the texbook – VSD, ASD [actually a common atrium], dextrocardia, transposition, pulmonary stenosis, PDA, single AV valve with tricuspid atresia, and a slightly hypoplastic LV). She also had pneumonia, the reason the mom had been prompted to bring her to us. Immediately I knew that we could do little for her at Hospital Loma de Luz. The only chance for improving her hopes of survival was to go to the big city for a palliative shunt – a connection between her aorta and the small pulmonary artery – after recovering from her pneumonia. Such surgery would not cure her, but it would improve her condition. Forget the groceries, we needed to get her transferred to San Pedro Sula to Hospital Mario Catarina Rivas, one of only 2 or 3 hospitals in the country where someone might be able to do this surgery.
The next 2 hours were consumed by calls to the hospital in San Pedro Sula and attempts to connect Leyna’s mom with missionaries in San Pedro to help her navigate the difficult process of going to the city and finding not only the hospital but the right part of this huge complex. We were able to connect with Lynelle Fields, a missionary who worked part-time as a volunteer at this hospital. She promised to help this bewildered mom and her baby from the countryside. We hurriedly drove her to a bus in La Ceiba, and found that the connections were good. The next bus left in 10 minutes. In the states this scenario would have prompted an airlift transport, but we had to settle for a public bus.
Over the next few days, Lynelle called us a number of times. Yes, the mom and baby had arrived safely. Yes, they were admitted (a rarity over the weekend in the government hospital, but my talking to the director of the hospital had oiled a few doors). But the surgeons there were unwilling to operate. In the states the surgeons would have been able to do a shunt, but not here in Honduras. So she was returned to us on the same bus.
Leyna’s mom immediately brought her back to us in her tattered white dress. She still had a fever, difficulty breathing, diarrhea, and vomiting. So we admitted her for a few days, and she improved. But she still had an oxygen saturation of 72% on discharge, an ominous sign that she might not last very long. We drove them to their house in Rio Esteban. It was simple: a hard-packed dirt floor, measuring about 20 by 20 feet for the 6 people living there, dogs and chickens in the house, mud and dirt walls with pieces of cardboard for doors. Leyna’s father was a fisherman – he dove for lobsters on the ocean floor.
Indeed, 10 days later Leyna returned to the hospital with saturations in the 40’s. This time she wore only a diaper. Her breathing was labored, and I was forced to tell the mom – again – that her baby might not survive. Oxygen administration did not help, nor did the medicines. She died in her mother’s arms only hours after being admitted. Nurses Penny and Ritza found a new colorful pink and blue child’s sleeper that had been donated to the hospital, and they dressed the tiny body in it. We then drove the mom, the dad, and Leyna back to their village. Leyna’s mom’s sobs were the only sounds we heard on the trip. As we plunged through the last river to reach their house, I realized sadly that Leyna was now the best-dressed child in the neighborhood.

1 comment:

Anonymous said...

My heart goes out to this poor mother. My daughter was born in 1983 with tricuspid atresia and various other heart defects. Thank God that she was born in the US where she has continued to have the best medical care available in the world. She is now 25, has completed her Master's Degree, and lives life to the fullest. We can only guess what this precious baby may have accomplished if only she had the chance to survive her heart defects...