Tuesday, October 30, 2012


25 year old Beltha was diagnosed with HIV 2 months ago and was started on HIV medications.  She was doing well until she started developing severe headaches and fever last week.  She was admitted and a spinal tap revealed that she had Cryptococcal Meningitis.  Fortunately when Dr Laura was here last month she gave us nearly 3000 fluconazole tablets for our HIV patients.  This will literally save lives as most of our Crypto patients could not afford the medication once they left the hospital.

2 days later Beltha’s headache was no better and her vision was not clear.  This is caused from the pressure in her head affecting the vision area of the brain.  I did a spinal tap and released nearly 2 ounces of fluid which greatly helped her headache and completely restored her vision to normal.  She was even able to read the screen on her cell phone.  This morning Terry and I could tell her headache was back to full strength.  She tried to minimize it as I am sure she preferred not having another spinal tap.  It took little to convince her that another spinal tap was necessary and we took off another 2 ounces of spinal fluid after rounds.  She was still rather miserable when we finished at the hospital this afternoon but I am sure she will be better by tomorrow morning.

Wednesday, October 17, 2012


I was called last evening to evaluate a man who had been electrocuted.  39 year old Sylvester was working on a 240 volt electrical line that he thought was inactivated.  He wrapped his hand with a very thin plastic bag to protect himself from the current in case he was wrong about the circuit being live.  Unfortunately the circuit was very alive and the thin plastic did nothing to protect him.  He was thrown into the air and landed face down.  He was further unlucky that the wire remained in his hand and the current continued to travel thru his body until a passerby used a stick to dislodge the wire from his hand.

Sylvester had second and third degree burns the entire length of his right arm and then on his lower legs and feet where the current exited to the ground.  He was quite uncomfortable with his pain but was able to communicate well.  I was extremely concerned about Sylvester’s overnight prognosis.  To my pleasant surprise Sylvester was doing much better than expected today.  He was able to get up to go to the bathroom on his own.  His burns were cleansed and debrided today.  There was no sign of compartment syndrome in his arms or legs and his kidneys were working well.  Sylvester still has a long recovery road ahead of him but he is very lucky just to be on that road today.

Monday, October 8, 2012

Whittier Rerun

Dr. Laura and Germar rounding
Dr. Paula on ward
Last year Dr Laura Dooley from Whittier, California spent a month here in Njinikom.  Laura supervises the Tropical Medicine component of the Family Practice Residency Program at Presbyterian Intercommunity Hospital.  The experience was good for the 2 residents who accompanied her so Dr Laura is back, this time with Dr Paula.  They are managing all the inpatients on the medical wards.  This has freed Terry and I up to spend more time in the OPD.  It is always nice to have American colleague available to discuss the more difficult cases that we manage.

Dr Laura’s husband Mike has been busy helping with the never ending maintenance problems.  I am am especially happy that Mike was able to devise and install a snake guard for the front door of our house.

Wednesday, October 3, 2012


Last week 5 year old Lawretta was admitted to the hospital with a 3 day history of fever and headache.  She was in a semi-conscious state on admission and could only moan in obvious pain.  She was diagnosed with Cerebral Malaria with severe anemia.  After 2 days of IV malaria treatment and blood transfusions she showed no improvement.  The entire time her Grandmother remained at her side stroking her forehead trying to comfort her.  Cerebral Malaria kills 25% of its victims and those who recover usually are slow to show improvement.  Terry and I were pleased to see Lawretta was resting comfortably Monday morning when we started rounds.  We were further delighted to hear that Lawretta had woken up earlier in the morning and asked for food.  Over the last 3 days Lawretta has made a miraculous recovery.  Her Grandmother was all smiles today as Lawretta was discharged home.