Bread Alone

He came in very thin and looking very weak and several months younger than he actually was.  He had a rash over his whole body. After a few moments of questioning “mom” a very different life-picture emerged. The real mother had abandoned the baby shortly after birth because she was upset with the two other wives that the husband had. This was actually the sister of the husband who had been looking after the baby. She was single and unmarried and so didn’t have breast milk and the family couldn’t afford to buy powdered milk/formula and so they had been boiling biscuits in water and then feeding the baby the boiled concoction since birth.

I happened to be spending some extra time with the pediatrician when this little guy came in. My first reaction was shock at the situation and then anger and confusion at the family situation not fully understanding the cultural dynamics and saga that had taken place here. The diagnosis was actually relatively simple: severe malnutrition with kwashiorkor (swelling in the feet) along with a skin infection.

The complicating matter in this situation was how to treat –it needed to be done very carefully! If we fed him too fast he could die. Fifty percent of deaths in children in Africa between 6 months and 5 years is related to malnutrition and complicated by infection that can cause a quick spiral downward. Effects of the malnutrition affect everything in the body from brain development to kidney function (not being able to excrete sodium well or excess fluid) to poor intestinal digestion and absorption, electrolyte imbalances, decreased immune system, and more. The first step in this situation was to initially stabilize him the first few days with IV fluids, antibiotics, and then gradually adding in milk and then possibly other food sources.

The big question was if his little body would be able to handle it or had it gone too far in damages? One of the first things we needed to do was to warm him up –his body temperature was registering at 34-35˚C –this was because he literally had no fat insulation and a large body surface area with very little weight. After ordering labs, our next responsibility was to determine what type of fluid and how much should we give him, and what electrolytes (Potassium, Magnesium, etc.) did we need to get him and when. Then using a special formula put out by WHO (World Health Organization) we started him on some slow oral feedings with plans to transition him to formula sometime over the next few days depending on how he tolerated it all.

Initially things were concerning, his skin began to peal all over his body, and the edema was getting worse, now extending up his lower legs, into his upper legs, and into his lower abdomen. His aunt was very concerned the first few days that he was actually getting worse. It is in this time that we had done everything we could –followed all the known directions that we could down to the smallest calculation of electrolytes and such –and now just step back, pray and allow the body to heal and praying that it wasn’t too late and that God would allow this little guy to survive.

Each day we had a chance to interact with the surrogate mother and to pray with her for the health and healing of this little one. Then all of a sudden one day there was a sudden and dramatic change that seemed to turn the corner for this little guy –his swelling was all of a sudden gone, he was taking in good amounts of formula and he started interacting and playing a little! It is not every child that comes in that we pray with that survives, and I often wonder what is it about one child that God calls home versus another that he allows to stay on this earth longer?

Now the big question is to what kind of a life will this little guy go home to? The family had initially come in because of some workers from an community outreach group, YWAM, had encouraged them to come –so we are hoping that YWAM will continue to have interaction with them and support this little boy and family during the next few months as he grows –there is no governmental system to follow-them once they leave our care. But we also hope and pray there will be a true change in the life of this family as a result of the interactions that they had here at HBB –that is his only hope.

After fasting forty days and forty nights, he was hungry. The tempter came to him and said, “If you are the Son of God, tell these stones to become bread.” Jesus answered, “It is written: ‘Man shall not live on bread alone, but on every word that comes from the mouth of God.’” Matthew 4:2-4

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