Our Weekend

Terry and I spent the weekend in Shisong which is a 4 hour drive from here. The same Franciscan Sisters run St. Elizabeth Hospital there. We stayed with Bill and Kate Walsh. Bill is the Surgeon who spent last August with us in Njinikom. Bill is working for 2 months while their surgeon is on vacation. We had a wonderful time and it was good to have a break after working everyday the last 5 months.

Dr. Ellen

The best part of the weekend was touring the Cardiac Center. It is an absolutely incredible state of the art Cardiac Center has been built there and they are doing cardiac surgery. They have 2 full time Cardiologists who do Heart Catheterizations and Stents. They are looking for a full time Cardiac Surgeon but in the interim Teams of Cardiac Surgeons have been coming every 1-2 months from Europe. 106 Cardiac surgeries were done last year! It is one of the few centers in all of Sub-Saharan Africa offering these services. The idea of this center originated with an Italian priest 9 years ago and with God's Goodness it has become a reality.

Shortages

Shortages are part of life practicing medicine in a resource limited setting.  The last month we have experienced critical shortages of TB and HIV medications which are both supplied by the government.  Both these illnesses require daily dosing of medications to achieve success and avoid development of resistant strains.  We have no medications to start a new TB patient with.  We are sending them home with instructions to return in 2 weeks with the hope that we will have medications then and hope they will not infect family and friends in the meantime. 

Many of our HIV patients come from quite a distance to get their medications every 1-2 months.  Due to the shortages we can now give them only 7 days of medication and most are receiving whatever combination of drugs we have that day as opposed to the 3 drugs that they had been taking.  I hope that this situation will be rectified soon.

Abdou and Evette

Abdou after a blood transfusion

Abdou after a blood transfusion

Many of our patients consult with the Native Doctors before ever coming to see us.  One has to accept this as a cultural thing and not get upset about it.

Evette

 2 nights ago I was called to see a child bleeding after a tonsillectomy.  As I walked up to the hospital I wondered why the nurse had called me rather than the surgeon.  When I arrived at the hospital it became clear.  The tonsillectomy was a uvulectomy (remove the hangy down thing in the back of your throat) and it was performed at home by one of the Traditionalists.  It appears many of the Moslem children are subjected to this procedure done at home without anesthesia.  After a blood transfusion this child is doing well.  I hope this practice dies out soon.
 
Yesterday, I had the pleasure of seeing Evette.  She left the hospital 4 months after a stormy course of abdominal TB and HIV.  Today she is doing well and has only 1 more month of TB treatment.  She has gained 42 pounds since discharge, proving Slim's disease can be controlled.

Busy

My days at the hospital remain busy.  Dr. Eugene, a General Practitioner began working last week.  He is fresh out of his training program so he does not have a large amount of experience with direct patient care.  I am therefore doing a fair amount of teaching everyday which has been enjoyable.  He has a lot of enthusiasm which makes it fun.  He grew up near here so he speaks Kom (the local dialect), French, English and the dialect the Moslems speak.  This will certainly enhance the patient care we can deliver.
 
There is a 10 year old boy in the pediatric ward with cerebral malaria.  Keep him in your prayers today as he struggles to recover.

Good Things

Victorine was back for a routine check today.  She was the lady with HIV-TB who 5 months ago had a Hemoglobin of 2.5 and weighed 30 kilos(66 pounds).  She continues to do well and today weighed 56 kilos.  A weight gain of 56 pounds.  I threatened to give her back her TB if she continues gaining at this rate.
 
There are 3 visiting Orthopedic Surgeons from Italy this week so the Hospital and OPD have been very busy.  These surgeons have been operating on poorly healed fractures giving people another chance to regain function and their lives.  God continues to send good things to St Martin de Porres Hospital.

12 New Patients on HIV Medications

Today was unusual as I started 12 patients on HIV medications.  That is depressing in the sense that there continue to be so many new cases of HIV.  On the other had it is exciting to be involved in their care as I know the vast majority of them will get better.

This afternoon I saw Peter who was finishing his fourth month of TB treatment and also has HIV.  He was very happy with his progress.  Not only had his cough cleared but he gained 25 pounds in the last month. 

Evelyn, happy with progress

Evelyn, happy with progress

A few minutes later I saw Evelyn who also for follow-up on her HIV and TB.  She too was excited about her progress and was happy that the very swollen lymph nodes in her neck where melting away.  These encounters remind me that we are making a difference at St. Martin de Porres Hospital.

Florence

Florence Happy with Recovery

Florence was admitted last week.  She is 32 and came in with Headache, hearing loss and loss of movement in her foot.  She unfortunately was HIV positive and her Spinal Tap indicated TB.  After 3 days of TB medications and steroids her headache resolved, her hearing returned to normal and her foot movement has recovered by 75 %.

She will get her CD4 count this week which will dictate when we start her ARV's.  She has 2 bad illnesses but is making an unbelievable recovery.

Christmas

Terry and I in Native Garb

Kids enjoying Christmas Treats

Terry and I certainly had a different Christmas from years past but a very comfortable one.  We attended 8 PM Christmas Eve Mass.  It was a full house and Father carried in Baby Jesus in his arms, played by a baby born by C-section that same day.  We wore our new native dresses given to us by Sister Xaveria.
 
Christmas Day we did our normal Hospital rounds and then returned and delivered candy treats to the nearly 200 patients in the hospital and their families.  We spent additional time in our favorite ward with 8 young children all recovering from leg surgery.  They additionally received balloons made from exam gloves and all got special stickers for their casts.
 
Christmas evening we had an enjoyable dinner with the Sisters.  Terry made 2 trays of Christmas treats which they all enjoyed.
 
We remain thankful for your support of MDA and our mission as this year draws to a close.