“This day is holy to our Lord. Do not grieve, for the joy of the Lord is your strength.” – Nehemiah 8:10
Birungi walked through Nyankunde Hospital in a pretty dress, a large smile spreading across her face. It was the day of her post-surgery follow-up, and she was looking for the people who had saved her life.
CHSC pediatrician Lindsey Cooper didn’t recognize the woman at first glance, now that she looked healthy and happy, but Birungi knew Lindsey. Just weeks before, Birungi was inches away from death and preparing to say goodbye to her two children.
Birungi’s story begins in Bunia, around 40km (~25 miles) away from Nyankunde. She had been vomiting blood at a local hospital and they were not able to stop the bleeding. The situation had become critical.
The physicians in Bunia worked quickly to shuttle Birungi to Nyankunde Hospital by car – a dangerous, two-hour drive at night. Upon arrival, CHSC General Surgeon Warren Cooper determined she had portal hypertension, usually caused by hepatitis, cirrhosis or parasitic diseases, which was now leading to her bleeding from her esophagus.
The rapid blood loss left Birungi confused as blood struggled to reach her vital organs. The team needed to act quickly to save her life. Dr. Cooper and his team found the source of internal bleeding with an endoscope, then applied several small rubber bands the size of a pencil eraser to create a tourniquet.
“As soon as she arrived, we mobilized the team and did an endoscopy,” Warren said.
“It’s quite a difficult procedure, because you’re trying to look down the scope at something, but at the same time, they’re coughing and vomiting blood on you.”
Warren wasn’t certain the operation would be a complete success. Birungi received around four and a half liters of blood – almost a complete body volume– before and during the procedure, but the blood loss continued into the next morning.
“We were doing everything that we could, but it just seemed like it wasn’t working,” Warren said. “No matter how we banded these varices, they kept bleeding. I started wondering, ‘Well, maybe we’re missing something.’”
They were missing something. Warren conducted an abdominal ultrasound scan on Birungi, locating a blood clot extending into her splenic vein. Her only chance seemed to be a splenectomy to decrease the pressure in this venous system.
Even in the best of settings a splenectomy is a big intervention, but especially for someone with portal hypertension and extreme blood loss. The operation would be something of a “Hail Mary” attempt, but Warren was willing to try.
“It became pretty clear that she was going to die if we didn’t try something,” Warren said.
Remarkably, Birungi survived the operation and made a recovery in the following week.
Warren began calling her “Lazarus” during rounds, because of her miraculous journey from near death to life. Her smiles indicated to Warren that she was making a true recovery.
Birungi’s smiles melted into tears of joy and relief. She later admitted that she never expected to see her children again. Warren was there to remind her that God had different plans.
“I said, ‘Even going home, when you see your kids, I want you to thank God and to think of His mercy, and to think of what he’s done in your life. Testify about this to other people,’” Warren said. “She was so overcome with emotion hearing that.”
Nyankunde offers plenty of opportunities and freedom for Drs. Warren and Lindsey Cooper to share the Gospel with the sick and suffering. When patients like Birungi make such great recoveries, they serve as a beautiful demonstration of God’s grace, His saving power, and ultimately, His love for humanity.
Birungi returned to Nyankunde almost unrecognizable – not just because of the beautiful dress she wore or her more healthy complexion, but rather because her suffering was replaced with joy, the joy of being re-united with the team who helped save her life.
“We still have a lot of questions about the etiology of this and why it happened,” Warren said. “But as far as I can tell, she seems to have recovered fully. She is one of the happiest patients I’ve seen in a long time.”
