Friday, March 16, 2012

A battle for their lives

In the Highlands of Papua New Guinea, kids between the ages of 2-6 yo are fighting a battle for their lives and they don’t even know it.  For many, the odds are against them. 

The culture in the Highlands of PNG is one of subsistence farming where many eat what grows out of their garden and only occasionally enjoy protein at mumu celebrations.  As a result, the majority of kids are malnourished and don’t have enough of the enzyme needed to breakdown protein.  Kaukau (sweet potateo), their dietary staple, also serves to inhibit what enzymes they do have.  As a result, when they do eat meat, which is often undercooked, the bacteria (clostridium perfringens) found in the meat  produces a toxin that wages war on the child’s small intestine. 

The kids don’t know any of this, they run and play, eating meat and celebrating with their family one day and in a day or 2 they start to complain of abdominal pain.  Pain is usually just after eating, but sometimes drinking will cause pain too.  The pain is severe enough that they are miserable, crying, and writhing on the beds in pain.  Their abdomens start to swell and they have both diarrhea and vomiting, usually bloody or black. 

Early antibiotics are the key to treatment, but too often the kids don’t come in until they have been sick for 3-5 days.  We give them IVFs, antibiotics, put a tube in their nose to empty out what is in their stomach, get labs and xrays and we pray.  We watch them daily to see how they are or aren’t responding and Jim makes the tough decision of when and if they need surgery.  Occasionally, they get better without surgery, but often they need surgery, which brings no guarantee that they will survive. 

In the past 6 weeks, this disease, which for years had disappeared when the government was supplying the vaccine, has seemed to come back with a vengeance.  There have been at least 10 kids that I have known of who have had pigbel.  Some had extensive small bowel resections in surgery and survived, one child died in the ER before we could do anything but start an IV and give one dose of antibiotics, children have died in surgery and just after surgery – their bodies so sick from the toxins that even when we try and take out the diseased portion of bowel, it isn’t enough, but some have made it even without surgery.  

Pigbel is a killing off too many of our little kids, yet to stop it we need to change the only culture they have known their whole lives.  Pray for wisdom for all of us to know where to go from here.  Pray for Jim to know when and if to do surgery on these kids.  Pray for those working on educating the public about this and steps they can take to decrease the chance their kid may get pigbel.  Pray that the government make look into supplying the vaccine once again.