Tis' the rainy Season

Tis’ the season… the season for rain, and with rain comes illness and infections. The high humidity of Rurrenabaque, Bolivia creates the perfect environment for microorganism to grow. Many of the kids have developed pustules and rashes on their hands and feet. As much as we try to tell them to keep their shoes on and to wash well in the shower, going barefoot in the mud is just so much fun. One kid had an unknown infection that I was not able to treat with topical antibiotics, antifungals, or antihistamines, and it kept spreading. Eventually I had to take him to a clinic in town. The doctor prescribed something I now call the “magic cream” because it is an antifungal/antiallergy/antimicrobial/antiviral cream that took the rash away in a couple of days.

Aside from skin illnesses, we have had some illness going through campus that manifests with a low fever, nausea, and fatigue. Most SM’s and kids got through it within three or four days, however, one SM had an on-and-off fever for about 10 days. The disease process for this illness was strange because the fever did not follow any specific peak time and sometimes would skip days or nights. We ran every possible fever-illness test at the lab in town, but nothing was coming up. Along with those tests, I kept an eye on the SM’s electrolyte and blood counts. The blood counts stayed relatively normal other than a brief drop in WBCs. The electrolytes however did get a bit out-of-wack due to the prolonged fever leading to dehydration. We tried a bout of antibiotics, but it did not have a significant effect. I administered several liters of fluids to maintain electrolytes, fluid balance, and I added some vitamins to support the immune system. Throughout the days of fevers, the SM took acetaminophen to treat the fever, but it kept coming back. Eventually, we decided to target the inflammatory response with a dose of dexamethasone. This is what finally broke the fever and after that, the SM began to make a recovery.

During this very busy week, my parents were able to visit. They stayed with me in the clinic, and it was nice to have time to catch up without having a constantly disconnecting phone call. Having them at Familia Feliz was strange because it has become such a separate world from home. Seeing my parents made me remember home more, and I realized how privileged we are in the states. Overall, it was a good visit, and I was able to show them around Rurre and the work I have been doing for these last few months.

Another interesting case that I had was a girl who kept complaining of a stomach ache. Usually, stomach aches here are due to indigestion, parasites, or eating something bad. So, I gave her charcoal for the first couple of days and waited to see if the discomfort would pass. However, the girl developed shoulder pain. Then, one evening when I was hugging her goodnight, I tapped on her back near her kidneys to see if she would react. As soon as I applied pressure, she winced and exclaimed that it hurt. After that, I took her to get an ultrasound to rule out kidney stones. Now you may think that kidney stones in a young kid is highly improbable, but for some reason, people here in Rurre get them commonly and at very young ages. If you read my past blog, I recently had a two-year-old that developed kidney stones (who is now fully healed per a follow-up ultrasound). My hunch is that the water has a high amount of minerals and residue that builds up in the kidneys plus the insane heat makes frequent dehydration a problem. Her ultrasound did not show kidney stones, but did show dilated ureters proximal to the kidney which means that she probably had stones at some point. I have tried reminding her to drink plenty of fluids and promote a regular bathroom schedule.

I have gotten to learn so much about looking at the big picture in medical things which can be tiring for 70+ kids, but luckily my nursing work has slowed down a good bit due to the kids going on break. We only have about thirteen-ish kids left on campus, and us SMs are getting ready to go on break. All twelve of us are going on a trip through South America, hitting about 5 countries. Our first stop is Peru to be in Machu Picchu on Christmas day, then to Brazil, then to the Patagonia’s in Argentina, and stop in Chile and Colombia on the way to these locations (…sponsors welcome ;)). I have mixed feelings about leaving for break. I am very excited to travel, take a clean shower, and sleep in a real bed, but I am sad that we will not be here to celebrate the holidays with the kids on campus and share those memories with them. However, past SMs have told me that taking this break in the middle of the 9 months is very important in order to have energy for the kids when we get back.

Tomorrow is our departure date, and I have been reflecting on the time I have been here so far. 141 days ago, I arrived with a totally different mindset to life and different priorities, not necessarily bad, just different. It is amazing what God can do when you choose to give everything to God. I definitely have had ups and downs with my relationship with God here, honestly some days not even opening my Bible because I was “too tired’. However, days like that have made me see even more why I need God in my daily life.