medical post: joel

I haven't had a chance to write lately. The combination of having a newborn baby, malaria season and Dr. Failes departure have all led to being very busy. Rainy season is coming to a close soon. We were blessed with rains which helped the crops and hopefully give enough sustenance for the people to make it to next rainy season. With the rains come mosquitoes, with mosquitoes come malaria. The hospital has mostly been full the last few months. The pediatric unit has 40 beds and that is often not enough and at times there may be as many as twenty patients also on the floor. Unfortunately, it is not uncommon to have several pediatric deaths a day from malaria. We were blessed to have a visiting pediatrician, our first doctor to come from World Medical Mission (a branch of Samaritan's purse). He was a retired pediatrician from Delaware who spends time volunteering at mission hospitals. In addition, to the adults and children with malaria, medical patients we see may have pneumonia, hypertension, strokes, meningitis or asthma. Snakebites are also common. Some days we may have 5 or so patients admitted after having been bitten by poisonous snakes. Fortunately, the anti-venom is usually very effective. The most common bites are from a Cobra and a Carpet Viper. The Carpet Viper can be quite aggressive and has been known to bite people as they sleep outside of their huts. Fortunately, the watchmen on the hospital compound seem to do a good job of killing the snakes that wander into the compound. They also are good at killing the large rats that wander around at night, providing some much needed protein in a diet that consists mostly of carbohydrates from ground yams, corn and millet. One of our patients had a wound that needed healing. Matt, our surgery resident, counseled the patient's mother about sources of protein to help the wound heal. The mother was proud to say that the child did get protein in the form of one egg a day. The chickens here don't get as much to eat as American chickens, so I would guess he gets the equivalent protein of 1/2 american egg a day. Some patients of course, don't get that much.

Our most common surgeries are probably C'sections, hernia repairs (inguinal, incisional, umbilical and others), small bowel perforations from typhoid fever, and perforated peptic ulcers. We see a rare case of appendicitis. Two nights ago we did a Csection in a patient with failure to progress in labor and severe abdominal pain. She had a large amount of pus in her abdomen and some necrotic bowel requiring resection and anastomosis of small bowel. It's kind of like a box of chocolates here, you never know what you might find.
blessings, joel

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