It was Monday afternoon and I had finished with the afternoon clinic and decided to stop by Dr Ivan Dueña's office. He was the attending physician on call and it had been a relatively quiet day. When asked if he had had any new admissions, he just said that he was awaiting a patient transfer from the community of Macas, which is about 1 1/2 hours from here. Apparently a 9 year old girl had been bitten by a "serpiente" and was not doing well. The snake bite had occurred 4 days previously. Knowing that it had already been 4 days I figured she was probably septic (sick with an often overwhelming systemic infection) or she was in need of surgery.
This morning her case was presented in 'morning report'.
Near Macas is a large Shuar community that is predominantly indigenous and most of the inhabitants live in the jungle. Rosa had been working outside with her dad when she was bitten on the ankle. Her father had killed the snake and taken her to the nearby clinic. She was at some point given the anti-venin and admitted to the Macas hospital. Her condition worsened and she was presented to Hospital Vozandes del Oriente (HVO), our hospital. She was found to be fighting a serious leg infection that extended from her foot all the way to her groin of her left leg.
Snake bites will often cause significant tissue destruction and swelling that will jeopardize the limb. In order to relieve that pressure an incision is made over the area to relieve that pressure and it's then left open. In her case, that operation had to be performed by Dr Eckehart Wolff (our missionary surgeon) as well as removal of a lot of dead muscle tissue. All of this was performed in order to give her any immediate chance to improve.
Because of the extent of her infection and the dying muscle tissue of her lower leg she was also going to need an amputation of her leg, below her knee, if she was going to have any chance of improving. Without it she would most certainly die. It is a difficult decision to make and especially so if you live in the jungle. After having agreed to the procedure last night her father withdrew his consent this morning. It was all too clear, in his mind, what kind of a future she would have in the jungle with only one leg.
I had a chance to visit with both Rosa and her dad this afternoon. She was in and out of sleep but told me that her name was Rosa and that she was 9. When I told her that the rose was my favorite flower she just smiled and then told me that the red ones were her favorites. She then went to sleep. She was sick and receiving morphine for her pain. Her father told me that he was a believer in Christ but was a 'bad man' and had sinned. I found out that he had 4 other children who had all died in the jungle. Since that time he had promised God that if he were blessed with others that he would give them to Him. Thus came Rosa's 3 older brothers and then Rosa, all of whom are living. He seemed to have a relationship with the Lord but had strayed at some point in the past. We prayed together about his relationship with the Lord as well as grace to help him make a tough choice. By the time we were finished we were both in tears as I can't imagine going through what he's going through. As I write this Rosa has had her amputation and hopefully will be on the road to recovery. Please pray for her as she tries to fight this infection and adjust to the many obstacles she'll have in her future. Please also pray for her father as he struggles with this decision and also pray that he may open up his heart to the Lord again.