Roger Update

Roger is the young man who impaled himself on his hunting spear and had the sucking chest wound over his heart.  The last 3 days he had increasing abdominal distention but denied pain and was quite upset that he was not being allowed to eat.  

Yesterday, he finally admitted to some abdominal pain.  Dr. Lazare took him to the theater last evening.  The spear had managed to enter his left chest, slide by his heart, pierce the diaphragm and then put a 1 inch hole in his stomach.  He is a very sick young man but will hopefully survive to hunt another  day.

Roger with distended belly in the operating room--spear wound upper dressing

Cholera

Friday I received and email from the US Embassy warning that 22 cases of Cholera had been confirmed in Yaoundé, the capital.  

I returned to work on Saturday to find that a 21 year old man had arrived at our hospital on Tuesday suffering fro profuse diarrhea.  Dr. Eugene had suspected Cholera and ordered the appropriate culture which  confirmed it.  

The patient is getting better and we are hopeful he did not share this with family, friends, fellow patients or staff.  I was pleasantly surprised that the government sent a response team to track down all possible contacts that the patient may have exposed.

Hunting Accident

Roger is a 17 year male who came to the hospital yesterday morning after suffering a hunting accident.  He apparently tripped and fell unto the spear he was carrying. 

When I examined him he had a 3 inch gash in his left anterior chest wall and air was sucking through the wound.  I was able to put my finger between his ribs and feel his heart, not something I have routinely done in the past.  I placed a chest tube then sutured his wound closed. 

Today, he resting comfortably but his abdomen is distended.  I am concerned about his abdomen and hope things improve overnight.

Beldine

A new HIV patient is a daily occurrence here but today's caught me off guard.  

Mom brought in 5 month old Beldine who was smiling and the rolls of thigh fat indicated she had not missed any feeding opportunities.  Mom apparently is HIV positive and took prophylactic medicine only the last month of the pregnancy and for whatever reason Beldine was not placed on medication for the first month of life to further reduce her chance of contracting HIV.  She fortunately did get tested recently and her HIV PCR test was positive.  She was started immediately on medication and will hopefully keep the HIV virus under control.  

If current protocols are followed the chance of mom's passing HIV on to their children can be reduced from 20-25% to 2 %.  Prevention is the only way out of this crisis.

Slims Disease

Sera, all 70 pounds of her

Sera is a new patient on the TB ward this week.  She has the classic history of months of weight loss, fever, cough, night sweats and diarrhea.  Her sputum was positive for TB.  Patients with HIV have a 10-15% chance of acquiring active TB each year accounting for the large amount of TB that we see.  To no ones surprise Sera's HIV test was positive.  

She illustrates why when HIV was first recognized as an illness here in Africa it was called Slims Disease.  She was also extremely anemic and after a blood transfusion and a couple days of TB medications she is feeling better with no fever.  We will start her HIV medications in another 10 days.

Chastibelle

There are stretches here when disease seems to be winning the war.  Then someone like Chastibelle walks through the door and we are reminded that our efforts do pay off.   

Chastibelle is a smiling 8 year old girl who has been on medication for her HIV for 6 years.  She is doing well and today her CD4 count was 2139, the highest one I have ever seen.  We place people on medication when their CD4 falls below 350.  She is leading an absolutely normal life other than she must remember to take her medications daily and come into the clinic monthly for her refills.  

Her smile is thanking you for your support of our mission.

This week

The government is sponsoring a 4 day conference on HIV this week at our hospital.  I was pleasantly surprised today when the presenter today was an Internist from the USA with a PowerPoint presentation.  It was a first rate presentation and a nice diversion from the OPD (Out Patient Department).  I am looking forward to the remainder of the conference.
 
The Dutch Orthopedic Surgeons finished up their Surgeries today and over 50 children and a dozen adults benefited from their mission.  We are lucky to have these happy children and their families around the hospital until their discharges in 3 months.  We pray for safe travels for this marvelous team of Doctors, Nurses and Technicians.

Dutch Treat

The Othopedic team from Holland is back.  They straighten crooked legs which occur here very frequently.  In November they operated on 80 children, more often than not doing both legs.

Not only do they provide the medical care but The Lillian Foundation from Holland footed the bill.  Do to economics they were unable to provide the same amount of funding so it looks like there will only be 35 children having surgery this time.

This has been a tremendous program which has been going on for at least 12 years.  The children and families usually spend 3 months here in casts then go to Bafut, a rehabilitation hospital for another 3 months.

The rainy season brings friends and signs of hope...

The rainy season is knocking on the door here.  We got caught at mass last evening without umbrellas and the sky let loose.  During the rainy season you rarely forget to leave home without an umbrella but after 3-4 months of dry season we were unprepared.
 
Bill and Kate Walsh spent the last 3 days here visiting.  Bill is the Surgeon from Chicago who spent last August with us.  He and his wife Kate were at Shisong, another hospital run by the Franciscan Sisters, the last 2 months.  They left today to visit their daughter and grandchildren in Dublin.  We had an enjoyable visit with them.
 
Today, Emanuella's father came in to refill her medications.  She is the young lady with HIV and TB  who had a stroke.  You helped provide the wheelchair that enabled her to go home.  She is doing well, speaking a few words and signing more.  She is able to navigate some on her own once she is in her wheelchair.  It is gratifying to get a report like this, especially considering there were many days when it did not look like she would survive.

Before Christ and Good News

Before Christ with Mom

Frequently children are named after virtues such as Patience, Mercy, Faith or Prudence.  Today, there was a child on the ward with a name I had never seen before, Before Christ.  He is a cute little guy and I decided to just call him BC.  I can only assume that mom plans on having another son and I think I know what he will be named.

Good news arrived this week at the TB and HIV treatment center.  We have a good supply of both drugs now.  I will actually have to make a clinical decision about starting HIV or TB drugs first rather than going with which ever is available.  We are all thrilled that our patients can get the drugs they need for these life threatening illnesses.