Gertrude's Children's Hospital

Today is Thursday March 29 and not much has changed.  Cole feels like an 8/10 most of the time, but continues to spike fevers in the afternoon at 5pm.  I could set my watch to it.  We are approved to travel home via commercial flight with a nurse escort, and finally travel arrangements have been made.  We fly home beginning Saturday night and will be in Grand Rapids Sunday afternoon.  We will have a nurse escort to help with Cole.  I think I'll take care of Cole, and have the nurse take care of Ivey.  

Life in a hospital.  For those of you who are asking (and will ask) what the hospital is like.  

1.  Wake up at 6 to rounds by the plastic surgeon (who is managing the wound VAC dressing).  Surgeons round very early for two reasons: First, to get it done before your surgeries or office starts.  Secondly, so that the patient and his/her family are too tired to ask a million questions.  So true.  From the parents perspective, I just want him to leave so I can go back to sleep.

2.  Up at 7am.  A true blessing is that I have an actual bed in the room next to Cole.  A second blessing is that every night I am reminded to be thankful for my bed at home.

3.  We then do the normal morning activities like brushing teeth, bath, am dose of antibiotics, and putting up the mosquito nets.  There aren't nurses assistants, so yours truly helps Cole to the bathroom etc.  Excellent father son bonding time.  I keep reminding him that one day our roles will be reversed.  

4.  Breakfast:  Chai, mandazi, sausage, a fried egg, a yogurt. 

5.  Various other morning activities:  More doctors rounding, entertaining visitors, going to surgery, etc.

6.  Get some math homework done before the afternoon fever/blah feeling.

7.  Play some games, read etc.

8.  Lunch at 2.  Kenyans love a late lunch.

9.  Screen time starts at 4.  We both have a new love for YouTube videos of Britain's Got Talent.  

10.  Dinner while watching the only Kenyan TV channel we can stand...English Premier League. 

11.  Bedtime.

Pictures from around the hospital:

Stairs leading up to Cole's Ward.  We had the option of a private ward or an open ward with 10 other patients.  Easy choice.  

Mural outside Cole's ward. 

Hallway to Jean Ward, our home for the week.  I love how all the hallways are outside.  Easy to get fresh air.  

Jean Ward.  Why it is called Jean Ward?  I have no idea.  The nurses don't either. 

Nurses Station.

Playground in the hospital courtyard.

 Thanks for praying.

This Time It's Cole UPDATE

We have been in the hospital now for 6 days, and Cole continues to make slow improvement.   He has been to the operating room a total of four times now, and the surgeon tells me his wound is now clean.  His treatment now consists of IV antibiotics three times a day and patience.  The antibiotics are for him, and the patience is for me.  I think I'm under dosing myself.

Positives: his leg doesn't hurt as long as it not dangled low for too long; his energy is slowly improving and he now can hop to the bathroom on one leg; he is eating slightly more; and there are no more concerns about his needing ICU care.

Negatives: Over the past 4 days, he has spiked a fever between 4:30 and 5:30pm like clockwork.  How the immune system can tell time is beyond me.  The maximum temperature is slowly getting lower, but that may be because of the Tylenol.  Also, we checked some blood work today and his WBC remains high at 16.  In a perfect world it would be normal by now.  Perhaps we will need more tests done when we get home...to see how that bone looks.  There is no MRI here at this hospital so we will have to wait.

So far, we are trying to arrange to come back to the US Friday or this weekend.  Depending on how the next few days go, Cole with either go home or directly to Helen Devos Children's hospital in Grand Rapids.  I think we will check him in under a fake name now that he is an international celebrity.

Thank you all for your prayers, emails, notes, offers to come to Nairobi and help, cookies, and mercy regarding the completion homework (Mr. K).

For those of you who we have never met, here is the family last summer.  Cole is the one in the black shirt.

This Time Its Cole Part III

Day 7 Friday March 23

After surgery, Cole had an uneventful night, and I was able to get some sleep.  He awoke the next morning happy and was making jokes.  Things were on the upswing, and therefore I finally had an appetite.  By this time Erin and the family had settled into a guesthouse about 20 minutes from the hospital, and they came over for a visit.  We enjoyed the Kenyan sunshine outside, with Cole in a wheelchair. 

Cole the morning after his second surgery.

Day 8 Saturday March 24

Like sailors caught in a storm, extreme highs and lows make you want to puke and cry out to God for mercy.  Friday was such a good day and I went to bed optimistic.  However, Cole woke up on Saturday feeling blah.  He didn’t have a temperature but he wasn’t hungry.  If anyone knows Cole, if he isn’t hungry something is wrong.  I knew he was going to have a rough day so I immediately became nervous.  Just when I thought things were under control, the roller coaster that is our trip crested a hill and started downward.  Cole wasn’t hungry…and therefore neither was I.  Erin and the kids came up to see him for about an hour before they headed off to a more comfortable place to stay for the next week or so (we hope its only that).  Our friends Kevin and Danielle Foster offered to host the crew, as a guesthouse can get cramped after 2 days. During Erin’s visit Cole was exhausted and just wanted to sleep.

Throughout the morning and early afternoon, his temperature slowly climbed to 39.3, the highest it has been.  He was hot.  He went for a second washout of his leg infection at 4:30, and thankfully his temperature had started coming down, to 38.1. 

Throughout the day my anxiety level was rising.  Why this high fever?  I thought we had him on the correct antibiotics…the one I advocated for.  Now I had to advocate again for a stronger antibiotic, vancomycin.  The doctor/Dad in me didn’t have a good history of calmly interacting with the doctors.  I had become the annoying family member that I always dread interacting with on rounds.  So many questions, and what if’s, and needs.  I realized I needed another ally by my side to help and calm my anxiety. 

I had thumbed through the Psalms that day, looking for encouraging words.  I came upon Psalm 62.  It reminded me that God was my rock, my fortress and that I could find rest in him.  It wasn’t working.  I really had to cry out that I can’t do anything else, that He has to work.  God took me to my edge and made me step off… to trust that He would provide me a way forward.   

Mike Ganey had come to stay with me through the first surgery but he traveled home the next day.  I was anticipating waiting by myself during surgery, deep in thought about how I would advocate for the antibiotics I thought should be started.  I didn’t want to be alone, but new it was inevitable.  However, 30 minutes before surgery, God came through with a HUGE answer to prayer.  I took a step off the cliff, and He carried me to the other side.  The absolute BEST doctor in all of Kenya, and our former next-door neighbor, walked through Cole’s door.  Matilda Ongondi, a Kenyan Tenwek alumni, fellowship trained hematologist, and all around wonderful person was the perfect answer to my prayers.  God orchestrated her presence…not me.   I thought she was still in Australia doing her fellowship, so I never contacted her.  Three days ago Mike Davis had notified her of our situation but she didn’t have time to come until this very moment.  I went over, gave her a hug and started crying.  Just when my anxieties were peaking, and I needed a Kenyan colleague to help navigate the medical system, God sent an angel. 

Dr. Matilda, an answer to my prayer that day.

Cole was nervous about the surgery, even though he knew what to expect.  I think that his fever exacerbated his anxiety.  I can tell when he doesn’t feel well because he gets teary when stressful things come his way…like blood draws, needing to go to the bathroom, IV infusions etc.  I told him that I was proud of him and that he was being tough.  He wished that I could come back into the OR with him, but I reminded him that I was now his Dad, and Dad’s weren’t allowed back.  I told him to look around and remember as many details as he could… so that he can have a good idea of what my place of work looks like. 

Surgery went well and the doctor said his leg looked clean with no pus.  They put a V.A.C. (fancy vacuum dressing I was impressed they had) on it, with plans to change it in three days.

Matilda and I sat and chatted during Cole’s case, catching up on the past 4 years since we last saw each other at Tenwek.  She now works at the large public referral hospital in Nairobi, Kenyatta National Hospital.  It is her mission hospital.  The sickest of the poor people get referred there, if they don’t die first in the district hospitals.  She read Psalm 107 to me, and reminded me that when I am weak, He is strong.  God loves us and will take care of us.  Cry out to the Lord and he will deliver you from your distress.   My anxieties calmed.  God spoke to me.  Then, out of nowhere, this elderly lady came up and introduced herself, saying that she gets in trouble by her family for talking to everyone.  After showing us the coin that was just removed from her grandson’s esophagus, she began preaching the SAME message that Matilda had just told me.  I had this eerie thought that she was an angel who came to deliver God’s message to me (like in the movies when the homeless disheveled lady speaks some truth into the main characters life, and then disappears).  She wasn’t disheveled, and she didn’t disappear, she just let her light shine and I happened to be in the path. 

Day 9  Sunday March 25.

Day 9?  I feels just like yesterday that this all started.  A whirlwind for sure.  Today, the hard part begins... waiting.  The cultures from Cole’s leg came back with results today.  The verdict is out.  Cole is more American than he is Burundian.  He grew Staphylococcus aureus that was resistance to a few penicillin type antibiotics.  Burundian’s don’t have drug resistant bacteria, American’s do.  It all made perfect sense now.  Cole didn’t get better after his first surgery because he didn’t have the right antibiotics.  We drained the pus, but he was resistant to the drugs needed to sterilize his blood and bone marrow.  He rallied after the dose of expired Vancomycin we gave him the morning of the evacuation. Vancomycin was the antibiotic Cole needed all along.  (Upon admission I did bring this up with both the ortho doctor and the ID doctor.  They wanted to treat him like a Kenyan/Burundian first and if he failed standard penicillin, then they would treat him with the Vancomycin.)

So now Cole has no obvious pus around his bone and muscle, and he is on the correct antibiotic.  It becomes a waiting game.  God will now give Erin and I a lesson in patience and trusting Him for the next one step forward.  The light on the path will illuminate only a few feet in front of us instead of several yards or miles.  If anyone knows Erin and I, this is hard for us.  We must wait day by day to see how Cole’s fevers trend.  Will they go down and then go away?  Or will they spike back up again?  Only time will tell.

So, hopefully no more drama for social media in the next week or so, just simple posts about fevers and when we will make the decision to come home.  Pray for us to have wisdom with this decision.  Pray for our stamina and sanity…as I live in a hospital room with Cole, and Erin lives an hour away with four tired kids who have been yanked all around East Africa.  Pray prayers of thanks for the body of Christ and how it can rise to the occasion. 

God Bless,

Eric

This time it's Cole Part II

Part II

By the grace of God another missionary, a seasoned pediatric ER doctor, was awaiting us in Bujumbura.  He had prepared a spot for Cole at the primary teaching hospital for Hope Africa University.  Cole wouldn’t officially be admitted, but would have a bed to use as a waiting area until the medi-evac plan arrived.  It was amazing how many doctors were available to participate in Cole’s care.  Brain power was not the limiting factor.  It was resources.  Even at this university teaching hospital, there was no ICU, no ventilators, one tank of oxygen, and very basic lab tests.  By going to Nairobi we were trading control of Cole’s care for better resources in case he got worse.  I was ok with that, but knew it would be hard to give up the ability to order the drugs/tests/surgeries that I thought were best.

In good African time, the plane arrived a little later than expected, around 10:00pm Burundi time.  It had been a little more than twelve hours since we made the decision to evacuate, and the plane was finally here.  Erin and I realized how American we are, and that we are spoiled.  In the US, a quick 911 phone call gets you an ambulance within 10 minutes.  It took me at least 20 phone calls and we were frustrated there wasn’t a plane there for us immediately.  “What if Cole had continued to get worse and was dying?” she asked.  “How would the evacuation people explain their delay?” 

I responded by saying, “Well, they would say, ‘You shouldn’t travel to such a remote area.  That’s a risk you take.’”  In all honesty, mobilizing all these resources within twelve hours is pretty good.

A Kenyan nurse, and a young British Doctor staffed our winged ambulance ride.  By this point, Cole had not gotten worse like we thought might happen.  His oxygen level was better, and his pulse had returned to 100.  Therefore, he might have been the healthiest patient this ambulance had transported.  All he needed was some oxygen in his nose.  I was ok with this.  Better to be safe than sorry.  Without the Vancomycin and the prayers, he could have been struggling.  The airplane could fit two patients, the two staff, and one passenger.  It was my first international travel without having to go through luggage XRAY, security and/or pat downs.  I could take my 1L water bottle with me!! I wanted to sit in the cockpit, but it was filled with two Kenyan pilots.  Instead I got my sleep for the night, two hours.

Upon arrival at Kenyatta airport in Nairobi we were met by an ambulance that took us straight to the ER of Gertrude’s Children’s Hospital, the only children’s hospital in East Africa. 

Day 6 Thursday March 22

At 5:30am we found ourselves half awake and in the “ER” of the children’s hospital.  We didn’t see any doctors, just a nurse who asked, “Who is your doctor?”  I wanted to say, “Whoever YOUR attending doctor is for this shift.”  But, I quickly realized that this was not an American emergency room ready to triage everyone who walks into the door.  It was more like an outpatient clinic that did intake for the hospital.  Thankfully, my support system from the days in Kenya at Tenwek Hospital had made me a recommendation for an orthopedic surgeon in Nairobi.  I told the nurse his name, Dr. Murilla, and it worked.  She said she would call him. 

We got admitted with some verbal orders, and by that time Cole had started to feel ill again.  His fever started coming back and he was teary that they wanted to draw blood from him.  He was complaining of more pain in his leg and I could see some redness.  I knew it needed opened, but I couldn’t do it.  I had the nurse call the doctor, and she said he was in surgery…at another hospital…an hour across town.  “He will come in about four hours.”  I knew what that meant.  I’d see him in six or eight.  There are three lies that surgeons tell all the time.  “This won’t hurt, I’m almost done, and I’ll be there in ____ amount of time.”  I got pretty anxious as I felt helpless. 

Small miracle…the doctor actually came in four hours.  Dr. Murilla was tall, thin, well dressed, and confident.  A true Nairobi surgeon.  After examining Cole’s leg, he wanted to give it more time and see what it looked like the next morning.  I strongly disagreed as he had all the markers of continued infection.  Fever, pain, redness, elevated WBC count.  I “calmly” stated my case…which in reality wasn’t very calm.  He told me I was acting like a father and not like a surgeon.  It was true, my sleep deprived emotions were that of a father…but my judgment was the same as if Cole were a strangers child.  We compromised that he would come back after his day of surgeries and wash him out at 10:00pm.  Deal.  Now I just had to sit back and wait nine hours. 

Meanwhile, Erin and the kids had just arrived in Nairobi and were met by a friend from Tenwek named Theresa.  Theresa was an answer to prayer. As soon as she heard about our situation she immediately decided to come help, and arrange the logistics of lodging and transportation for the family.  She was the perfect Ying to Erin’s Yang.  Erin was an emotional basket case, and Theresa was a familiar face who could provide comfort as well as take charge. 

If you have ever waited for a loved one during surgery, you know that it is not fun to wait alone.  While I waited, God had provided for me the perfect companion to wait with.  Dr. Mike Ganey, a pediatric surgeon who had arrived to Tenwek just after we left in 2015, was not only an expert I could run things by, but he was also a calm presence that was the Ying to my Yang.  He didn’t have to come, as we didn’t even know each other that well.  Later, he told me that he and his wife were having their morning devotions on the back porch when God told both of them that Mike should come to Nairobi to support me while I cared for Cole.  Thankfully he obeyed and we had a great evening together. 

There were two things that had to happen that night (in my mind) for Cole to get better.  First, the surgeon had to keep his word and actually show up for the 10:00 surgery.  I had a suspicion that he would delay it until the next morning.  Secondly, I was on a mission to get Cole on the proper antibiotics, recommended by several textbooks and one of my best friends Mike Davis, an expert trained in infectious diseases.  Cole was on clindamycin, but I thought he needed to be on a penicillin like cloxacillin or flucloxacillin.  In my sleepless anxiety ridden state, I was pressuring everyone I could find to give him the proper antibiotics.  Finally I found a loophole in the system.  If ever a nurse was “concerned” about a patient, the ICU doctor could leave the ICU and come evaluate the patient.  I convinced the nurse to call the ICU doctor.  My friend Mike Davis texted me that he was fervently praying about how Cole could get the right antibiotics.  At the exact moment he sent the text, the ICU doctor walked in and agreed what the first line antibiotics should be.  I was thankful.  In retrospect, I was probably a little overzealous about the antibiotics issue, but I saw it as being “an advocate.”  The whole time Mike Ganey just calmly watched Cole and his breathing pattern.  Without the emotional attachment of being his father, he knew that Cole would survive to the washout with the antibiotics he was on. 

Ten o’clock came and went, and still no surgeon.  I didn’t get more worried, because almost none of my surgeries start exactly on time.  Eventually Dr. Murilla showed up and Cole went back for his second surgery.  He was nervous but bravely left me at the door this time.  No longer was I his surgeon...I was a only a father now who had to wait in the waiting room.  The ortho doctor opened up our stitches, washed out the wound, and put on a dressing.  Cole did well and in recovery room, his fever had gone away.  Now, I could sleep. 

Another Mitchell Adventure...This time its Cole.

Erin told Cole the other day that he is famous.  I told him that you don’t want to be famous, and definitely not because you are sick and in one of the poorest countries in the world.  Social media is a powerful tool and we are thankful that it can spread the word to PRAY.  If fame brings prayer support…we’ll take it.  Because of your love, Cole has people on several continents praying for him and for that we are forever grateful. 

Our family has used a blog before, first when Erin tried to die in 2012, then while we were in Kenya from 2013-2015.  I’ll resurrect it as I try to summarize our ordeal in several posts. 

Day 1  Saturday March 17.

Saturday morning, Cole, Alex and I went out for a 15 minute jog so the boys could get ready for a 5K running race that was taking place soon after we returned home from Burundi.  Our family (all 7 of us) was in Burundi to help for a month at a mission hospital staffed by our dear friends.  Just before heading to Burundi, we had spent a week at Tenwek Hospital catching up with friends.  (We used to live there from 2013-2015).   So, on this Saturday, we had been in Burundi for the first week of four and I didn’t have any responsibilities at the hospital, so we went out for a jog.  I joked with Cole that he was the only sixth grader doing “elevation training,” since we were at about 6,000 feet.  He kept a good pace without any pain or issues.

That night Cole complained of a pain on the outside of his right leg, but we just thought it was from the running that day.  It was probably something typical like shin splints or a pulled muscle.  Later, he had a fever of 101.5F, which seemed odd. 

Day 2  Sunday March 18

On Sunday he continued to feel poor, and his leg really started hurting.  He was limping and hopping around the house.  I had a diagnostic dilemma.  Were the fever and leg pain from the same problem?  Or were they from two things…leg injury AND Malaria?  In retrospect, the signs and symptoms were classic for acute osteomyelitis, but that wasn’t on my radar being a general surgeon.  Plus, the kids who usually get acute osteo are malnourished African kids.  If anyone knows Cole, he is NOT malnourished.  Our children eat us out of house and home. 

Day 3 Monday March 19

Monday morning we got some labs and an XRAY of his leg, since he was not getting better.  His white blood cell count was elevated with evidence that there was a bacterial source of the fever.  The XRAY was normal.  I asked Dr. Alyssa Pfister, Kibuye Hospital’s missionary pediatrician what she thought, and we started him on some antibiotics by mouth, not knowing what we were treating. 

Day 4 Tuesday March 20

By Tuesday morning, Cole still didn’t feel well, and he had to be carried from the bed out to the living room.  I decided to do an ultrasound of his leg, seeing as how we didn’t have an MRI…the test he would have gotten if we were in the US.  I saw a fluid collection around the small bone of his lower leg, the fibula.  I told Dr. Joel Post, a visiting orthopedic surgeon from the US, and we decided to explore the area, with the concern for osteomyelitis or pyomyositis.  Dr. Post had also examined Cole over the past few days and had been just as baffled as I was.  Now our diagnosis was clear.  Either osteomyelitis or pyomyositis.  Pus in the bone, or pus in the muscle.  Unfortunately, I was familiar with the prospect of operating on one of my kids.  The last time we were in Burundi I had to fix up Alex’s foot in the operating room when a huge piece of glass went through his shoe and into his foot.  Per the missionaries at the hospital, AJ’s incident was the last time a missionary had to be operated on.  Go figure.  I was very thankful this time for Dr. Joel, as he would lead the charge and I would assist him. 

I went up to prepare the OR, and as Erin carried Cole on her back from the car to the operating room they acquired a lot of strange looks.  “Why was a Muzungu (white person) having surgery here?”

Once we were in the OR, the Burundian staff was awesome to Cole.  The Burundian nurse anesthetist did a great job with the Ketamine, as Cole was understandably nervous.  I gently bent down next to his head and asked him, “Do you trust me.”  Without hesitation, with tears in his eyes, he said, “YES.”  A moment I will never forget.  Soon we had opened Cole’s leg and found the culprit.  He did have osteomyelitis of the fibula, and it had elevated the periostium (covering of the bone) of 2/3 of the fibula.  If only we had recognized things sooner, there wouldn’t have been as much extension.  But again, why would a healthy kid like Cole get acute osteo?  We don’t have a microbiology lab at Kibuye so we couldn’t see what the specific bacteria was that caused all this problem.  Usually not an issue, as almost none of the Burundians have drug resistant bacteria.  But, Cole was just in the states two weeks ago.  Do we treat him as a Burundian boy, or an American Boy?  Burundian bacteria, or likely antibiotic resistant American bugs?  Time would tell.

 Cole during surgery in Burundi at Kibuye Hope Hospital.  If we had written up a consent form, I would have signed his it twice.

Easy rule to remember in surgery...you have to get the pus out.

Dr. Alyssa Pfister wearing the hat of recovery room nurse

After a time in recovery, with Cole trying to get his eyes to line back up and stop seeing double, we returned to the house with plans for IV antibiotics (cloxacillin) until he felt better.  Thankfully, Dr. Alyssa had arranged for a Burundian nurse to come to the house to administer Cole’s antibiotics.  That way, Cole didn’t have to remain in the hospital ward…with 39 new potential Burundian friends. 

Tuesday night was pretty uneventful except for a drenching sweat that soaked his clothes. 

Day 5 Wednesday March 21

By Wednesday morning, Cole was feeling ok so I went to work and started making rounds.  Around 8:30am I returned home so the nurse could show me how to administer the IV antibiotics…since he would need a dose each evening as well.  Dr. Alyssa was there “making rounds.”  Cole looked a little off…not as good as I would have hoped.  He had a slight fever, and the burning pain he felt with the antibiotic injection magnified his discomfort.  (Ask Cole about this!  He HATED the IV abx.  No longer does he want a career in surgery.  Instead he wants to be a computer engineer.  No needles or cuts in computer engineering. )

About 30 minutes later, Dr. Alyssa checked some vital signs.  He had a fever of 102, an elevated heart rate to 130, and his pulse ox (level of oxygen in the blood) was 89% without oxygen.  He had also developed some crackles in his lungs, possibly from a developing pneumonia.  Dr. Alyssa and I met eyes, and we were both thinking the same thing…Kibuye Hope Hospital is not the place you want to get into respiratory trouble or septic shock.  There is oxygen, but no ventilators, and being in the ICU means that you are in the ward bed closest to the nurse’s station. 

Since Sunday, when Cole started having the fevers, I began to ask myself on a regular basis…what would be the trigger to evacuate the country in pursuit of higher-level care?  We could do a decent amount of surgical care at Kibuye, and we had plenty of amazing doctors.  But, at this moment on Tuesday morning, Dr. Alyssa and I both knew that this was the trigger.  We had the people at Kibuye, and the control of his care, but we didn’t have the resources to take care of someone developing ARDS, a bad pneumonia, or septic shock.  Plus, we figured that Cole had bacteria in his blood and that this was the cause of the bone infection.

Erin and the other non-medical people in the room sensed our anxiety, and immediately everyone knew that we had to start planning to get somewhere quick.  We didn’t know if this was Kenya, Europe, or the U.S.  Everyone went into crisis mode, and for the next 4 hours our house was a flurry of activity.  Alyssa started focusing on taking care of Cole as well as writing up a transfer summary we would need to get approval for an air ambulance ride out.  As she attended to Cole, one drug she had in her back pocket was some expired Vancomycin, a powerful antibiotic that most Burundians don’t need because their bacteria are susceptible to normal antibiotics.  It had expired in 2016, since no one ever needed it.  Hmmm.  Give an expired med to your kid or risk him getting worse?  They don’t teach you this in medical school.  We decided the benefits outweighed the risk, and Cole started getting the antibiotic.  He tolerated it pretty well, until the end when he told me his head was itchy.  I told Alyssa that we probably infused it too fast and he had gotten a common response called Red Man’s Syndrome.  Maybe expired vanco makes Red Man’s syndrome worse.  (I will not be submitting this case to a journal as a case report.)  He got some Benadryl and Alyssa watched him closely.   

I started making phone calls to our travel agent and emergency evacuation insurance carrier, looking to see what our options were.  Erin, and several other friends started packing as well as arranging for our transportation to Bujumbura, the capital of Burundi.  It was amazing to see how this tight knit community of missionaries dropped everything and came to our aid.  We were sad that our time with them had to be cut so short. 

Just after lunch, (which only the kids ate) we all hopped into two vehicles and started the three hour trip to Bujumbura.  Susan (a missionary at Kibuye) drove the “ambulance” staffed by Alyssa and I;  George (Susan’s husband), Rachel (an intern who volunteered to come to help with the kids) and the family were in the other vehicle.  Cole and I had been approved for a medical airlift to Kenya and the rest of the family would spend the night in Bujumbura before catching a 10:00am Kenya Airways flight to Nairobi. 

Miraculously Cole improved after the Vancomycin and had an uneventful car ride.  Our anxieties calmed.   I looked at my watch and it was around 2pm our time, 8am EST.  America (and Facebook) was waking up to Wednesday morning and our story started getting shared.  In a matter of an hour Erin’s initial post pleading for prayer had 144 comments.  I then knew it was more than the expired vanco that was helping Cole get better.   to be continued.