Awanda

10 year old Awanda was admitted 2 weeks ago with Cerebral Malaria.  Terry and I had a 4 day holiday to Oceanside Kribi last week.  When we left Awanda was still in a coma.  The prior 3 days he suffered from recurrent seizures that did not stop until I added a Valium IV drip to his Phenobarbital.  

When we did rounds on Sunday Terry and I anxiously checked to see if Awanda was still on the ward.  He was there and was beginning to wake up.  Over the last 3 days he has improved to the point that he can sit and eat.  He walks with mom’s assistance.  He is trying to talk and a big smile returned to his face today.  Awanda still has a long way to go to get back to his prior self.  Since his Malaria treatment is now completed he is going home today to continue his recuperation.  Home for Christmas!  He will be in our thoughts until his follow up in 2 weeks. 

Remarkable

 John is a 45 year old man admitted 1 week ago.  He had been admitted to another hospital 1 week earlier with a stroke resulting in complete paralysis of his right arm and leg with almost a total aphasia.  He was extremely wasted so it was not surprising to find that he had HIV.  It was felt his stroke was from Toxoplasmosis and he was started on a second line treatment for it.  After no improvement after 1 week they asked for discharge from that hospital and presented here. 
 

I was not optimistic we could do much for him since he had shown absolutely no improvement in his paralysis after 1 week.  We fortunately have the combination of medications that are recommended for Toxoplasmosis.  Within a day John was speaking a few words.  By day 2 there was movement in his leg.  Day 3 he was walking with assistance.  Day 4 walking by himself with a cane.  Day 5 movement in his upper arm.
 

I had the pleasure of discharging John home today with full speech, walking with a cane and showing daily improvement in his arm strength.  I will see him back in 2 weeks and will then return to the Southwest Province to begin his HIV treatment.

Terry and I feel we got to witness a Miracle this Holiday Season.

The Good and the Bad

Marcel and Magnus

Sunday afternoon there was a knock on our door.  The hospital guard announced there was someone who wanted to see us.  In February I did a Blog about 8 year old Marcel who had Cerebral Malaria.  He had non-stop seizures and remained in a coma for days.  He slowly recovered and eventually was discharged functioning at about 80% of his prior level.  Our visitors were Marcel, his twin brother Magnus and their Grandmother.  They had stopped by to thank us for the care he had received and to show us he was now fully recovered.  They brought us a basket of eggs and a bag of dried beans in appreciation.  Despite difficulties speaking a common language we had a nice visit.

Today was a reminder that Malaria can be devastating.  I was called to the OPD shortly after I began Hospital rounds to see a sick child.  Grant was nearly 3 years old and been ill for 3 days with fever.  He was seen at a distant Health Center yesterday and referred to our hospital.  Due to distance and transportation issues Grant and his family did not arrive until this AM.  He was obtunded and had rapid respirations from acidosis.  He was extremely pale and his Hemoglobin was less than 6.0.  I started 2 anti-malarial medications, steroids and antibiotics.  Unfortunately Grant expired 3 hours later.  His parents had to suffer what nearly 1 million other parents experience yearly, the loss of a child to Malaria.

Last month there was news of a Malaria Vaccine that will likely be released next year.  It is not a perfect vaccine but will likely reduce the death rate in half, sparing 500,000 children and families annually.  Keep Grant and his family in your prayers.