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Morbidity and Mortality

This is my fourth attempt to write this blog.  My previous attempts have been abandoned out of emotional exhaustion.  I have always been a crier.  I almost cried watching Beverly Hills Chihuahua (I was with twin 8-year old boys and had to pinch myself to prevent myself from tearing up.)  I am not ashamed.  Jesus wept (although probably not at Beverly Hills Chihuahua).  

My first week here was particularly challenging:  six children died.   Towards the end of the week, I thought to myself, “Ethan, you have the worst job in the world. Your job is to bury children.”  Then the Holy Spirit opened my eyes to the reality that I do not worship a God who does not understand suffering, but instead, a God who chose to suffer on the cross for me.  He was perfect, innocent, and lovely, and he was tortured so I could be reconciled to God.   He has invited me to take part in His mission on Earth:  to help his beloved creation be restored to Him by proclaiming the Good News of Jesus Christ. He is alive. He has called me to a job where I can weep with mourning parents, pray with them and for them, and suffer alongside them. 

Jesus suffered for me.  He has called me to preach and heal.  He has not left me.  He suffers with me now.  And through cancer, He allowed me to suffer so I could better understand the tears of the sick and afflicted.  He has equipped me for this.  I am thankful, and I love what I do here, even if I am often broken.  In fact, just hours ago another of my patients died.  As I returned from church, I found the mother weeping at the loss of her child.  I embraced her.  Elizabeth and the kids were with me.  Josiah looked concerned and walked over.  When I told him to hug the mother, he did not hesitate, and he wrapped his tiny arms around the grieving mother.  We told her that we were sorry, that we love her, and we will be praying for her.

I do not want our blog to become a morbidity and mortality report.  Every blog cannot be about death.   If I allowed this to happen, I would give death too much power.  Nor do I want our blog to be strictly about poverty (most here make less than $100 a month).  I do, however, want to write at least one post about the overwhelming miracles and tragedies that I see frequently. 

With this, I want to give a DISCLAIMER.  The rest of this post will describe many, but not all, of the heart breaking moments I have had here thus far.  If you struggle when you hear about children dying, you should probably not read on.

I bagged (ventilated) one kid for over an hour, praying to God that the child might start breathing.  I wept with the grandmother as the child died.

I cried with a mother, whose only child died from sickle cell anemia complicated by parasitic infection.  Her wails will forever be etched into my memory.  I did not think death would come so quickly.  I was wrong.  I knew the girl for only an hour before she died.

Another child, likely with leukemia, died as soon as he arrived on our ward.  I walked over to see the new patient, only to find that he had died.  I hugged the grandfather and wept with him.

I dared hope that 28-week gestational age twins might survive.  I planned all that I would do for the children.  I was excited.  Maybe we could save them.  We could not.  They died in rapid succession, just as I started dreaming.

A child with HIV and severe toxoplasmosis was transferred to us.  He had gotten good treatment, but it was clear that his brain was destroyed.  Survival seemed unlikely, and indeed, he also was too good for this world.

They called me about a 22-week gestational age baby who weighed just over 500 grams.  They knew we could not save the baby, but the nurses were surprised that the child was breathing at all.  I was, too.  I wish the surprise lasted.

I watched a seizing toddler with meningitis, as infection destroyed her brain.  I wept and wept as she died, and almost felt relief when I heard the child’s suffering was over.

A toddler with burns unexpectedly became worse.  Still, I anticipated she would survive.  But that is not my decision to make. Then something happened, and she died. I have no idea why.

A child with Wilm’s could barely breathe.  The tumor was pushing on his lungs, preventing them from properly expanding.  We tried chemotherapy knowing that odds were slim.  It did not help.

The baby with recurrent intussusception came in too late.  After experiencing extreme abdominal pain for three days, his bowel was dead.  He made it through surgery, but did not last long afterward.  

The infant with a GI bleed, HIV, and severe malnutrition died faster than I anticipated.  I went to check on him in the evening.  He seemed okay.  He died a few hours later.

A young girl presented with fever and pancytopenia, likely from leukemia.  I begged her father to stay.  He said he couldn’t.  He said he would return.  My residents seemed certain he would not.  We never saw her again.  I pray that God healed her, because only a miracle could have saved her.

Another young girl had anaplastic Wilm’s tumor.  Her prognosis was poor before she started seizing.  Then she seized and seized and seized.  We finally were able to control the seizures.  We have free chemotherapy, but we had little confidence it would work for her advanced disease.  Her dad decided to bring her home.  We loaded another seizure drug before she left, hoping she could make it home to see her mother before she died.

A young boy showed up with a huge mass in his mouth: rhabdomyosarcoma, with extensive metastases.  He was bleeding.  I talked to the mom. I told her we could try treatment, but that it likely would not be curative.  The treatment is free, but potentially could hurt him and not provide any benefit. She decided to go home so they could be with their family.

All of my patients’ stories are not bad.  Some are amazing.

A small baby with sepsis was on high settings of bubble CPAP and looked horrific.  Yet God spared the baby, despite my unbelief.

Another small baby with medical necrotizing enterocolitis also was on high settings of bubble CPAP.  Blood returned from his OG (decompression tube to his stomach).  Inexplicably, the Lord healed the child. 

A baby with thick meconium and a poor start to life started having seizures and respiratory distress.   The term baby went apneic (stopped breathing) several times.  Then, suddenly and without warning, the neuro exam and baby improved.  Praise the Lord.

A child with Burkitt’s lymphoma developed a large pleural effusion.  She lost consciousness and was breathing faster than most newborns (and she was almost 10 years old).  We started chemotherapy.  I cried as I prayed with the family, begging the Lord to save the girl.  The Lord did.   She left the hospital smiling. 

A baby girl had been given more than twice the dose of a drug that is toxic to the kidneys at an outside hospital.  She had renal failure.  We did peritoneal dialysis, and she improved.

At the age of one year, one child was the size of a large newborn.  She had trouble breathing and fever.  She looked wasted and lethargic.  We started her on antiretrovirals (her mother had HIV) and fed her.  At times, it seemed as if she would not grow, no matter how much food we gave her.  But gradually, things changed, and she started to grow.  Then one day I looked at her, and she was sitting up smiling.  She left smiling! 

I asked a little girl if she believed in Jesus (most here say yes).  She said, “no.”  I asked her what she believed.  She responded, “I am Muslim.”  We spoke to the father and asked him if he would like to learn more about Isa (the name of Jesus in the Quran).  He said, “Yes!”  We gave him the Bible in French and turned to the book of John, which he eagerly read.  After reading 3 chapters, he ran up to me and said, “I want this book!  I like this book.  Please let me have it,” in French.  Our chaplain met with him, and after two hour long sessions the man declared, “I believe this Jesus is true.  I reject what I used to believe.” 

A 13 year old boy did not know about Jesus.  We told him about Jesus and gave him a Bible.  By the time he left the hospital, he had read all four gospels and the book of Acts.  Every day I would sit and talk with him and pray with him.  I asked, “What do you think about Jesus?”  He said, “I love Him.”

We have been working to expand our multimedia ministry by downloading the Bible in different languages and putting them on the memory cards of the patients’ cell phones.   We have loaded the Bible and the Jesus Film onto many patients’ phones.  Frequently I see children in the wards watching the film on their parents’ phones. If only we had SD cards to hand out to everyone!

So here is a look into my first 2 months in Cameroon.  It is long and overwhelming. Trust me, it has felt that way, too.  In the middle of writing this, one child died (as detailed above).  Before posting it, yet another died.  Death here is real.  I struggle with it daily, and I am so thankful for your prayers and support.  


  1. Praying God's strength and wisdom and comfort for you as you continue to allow Him to work in and through you. Thank you for being a vessel God can use. Prayers for you and your family. Julie

  2. Praying God's strength and wisdom and comfort for you as you continue to allow Him to work in and through you. Thank you for being a vessel God can use. Prayers for you and your family. Julie

  3. Ethan thanks for sharing. I am thankful you are seeing God in the midst of the tragedy you are surrounded by. unfortunately these are the experiences of far too many in our world. they very much mirror my experience at Tenwek. May God's grace continue to carry you through and keep your heart soft for these patients and their families. At a particularly low point for me a visiting doc reminded me of how many of those we saw and treated and God healed. We continue to pray for you! Dino

  4. We are of one accord. Praying for you, brother.

  5. His Spirit is upon you. Our Lord is using you to transform lives in more ways than one!

  6. His Spirit is upon you. Our Lord is using you to transform lives in more ways than one!

  7. Ethan, I am so glad you are able to use your training for this! - Anna Bottar


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