By Melody Harrell

Karen Alford makes people well.  

As Cooperative Baptist Fellowship field personnel in Vogan, West Africa, Karen’s training as a nurse practitioner is not only a credential, it is a calling. As she dispenses medication, she also dispenses education about how our bodies work, how recovery happens, how patients can bring their own initiative to bear on their healing with good nutrition, good hygiene and best health practices. Karen’s favorite tool is relationship. And she does that well, engaging patients about their life circumstances, listening to their stories and providing compassionate care in good measure.  

But every now and then, Karen faces challenges that severely limit her options. That was the case recently with Bayi, a patient in her late 70s. Bayi had come to the clinic in Vogan with a wound on her ankle which had occurred after a fall and, as Karen put it, “really wasn’t that bad.” 

Still, she was unable to walk as evidenced by the fact the family had to carry her in. Karen recognized right away that the ankle wasn’t straight and advised they go to the local hospital for an x-ray to rule out a fracture, something her own clinic could not provide.  

A month later, Bayi returned to the clinic. Upon her examination, Karen was immediately alarmed. “At this point”, Karen said, “the ankle had necrosed (tissue had died) until the shattered ankle bone was sticking out on both sides and the entire foot was black.”  

The family said the hospital had not investigated a fracture, but had only wrapped the foot and told her to return in a few weeks. During that time, the infection had taken hold so deeply that, upon their follow up visit, it was evident to the hospital staff the infection was out of control. They advised her to go back to the wound clinic, have the wound treated, and then return to them once more to set the fracture. Karen was appalled. 

“That was misguided and terribly dangerous advice,” she said.  Karen could not clean the wound as it was now encompassing the whole foot and spreading up the lower leg. Bayi was in distress and any manipulation of the ankle caused excruciating pain. Karen suspected it was going to require amputation. The only option for the next course of care was to send her to a larger missionary hospital almost five hours to the north for assessment and surgery. At this point, there was little hope for a way forward in which the leg could be saved.

Bayi had her leg amputated above the knee. It was a devastating result from the inattention given to what should have been a fairly straight forward plan for care. Bayi returned to the wound clinic once again post-surgery for wound care management

Although Karen expected the family to be furious upon their return to the clinic, she was greeted with gratitude to her for helping them and grateful to the clinic for its care. They were also thankful that the circumstance had resulted in reuniting with Bayi’s eldest daughter who was now caring for her.

Karen had learned of their Christian faith during the process and was moved by their warm and spacious hearts. It was evident that rather than gathering their energy around blame and retribution, which they had every reason to do, their hearts overflowed instead with thanksgiving that Bayi was alive and still with them. They felt that Karen and the clinic staff had done the best they could under the circumstances and had been truly attentive to their needs.

Karen shares often that she is glad to be where she is. Bringing her medical expertise and love for people together gives her long (and very hot) days filled with meaning and purpose.  And even where there is so much need and sometimes deep heartache, being a point of her work as CBF field personnel is something to which she can joyfully give her life.

This article first appeared in the Fall 2021 issue of fellowship! magazine. Read online and subscribe at www.cbf.net/fellowship.