July 12, 2011

This past week has been interesting. Milan has put his yo-yoing on hold for the moment to construct a bow and arrow from wood, electrical tape, and feathers of a bird. It worked very well, the arrow actually stabbed a hole in one of our curtains, until it broke.  Then I came to pick him up from the orphanage one day and he and Terrence looked like they were doing some complex Ninja/Karate dual with bamboo sticks…  And a few days ago, I heard about the “wet-towel snapping” game (thank you Uncle Johnny.) that he was teaching the boys.  There were all running around trying to escape him! Terrence is doing better with the spintop… he now has it spinning on his own hand.  We hope to have Terrence prepared for class 3 in September.  We are trying to get the school books so that he can have a headstart for him in math and english/reading.

Today Milan went with Sr. Hilda for a bit to play with the baby calves and watch the milking of cows. Then it was back to the orphanage where he taught Terrence, played “copycat” with Moses and Louise, and fed Moses lunch. Milan has been doing well. We stopped by to visit with Bet, one of the ladies that is working with Project Hope. She was sharing her experience of working with the children and using child psychology. She and Milan had a good conversation of ways to assist Terrence with school preparation.

At the clinic, there was a woman who came in, and probably had the same story that many others share. She is married and I suppose had some suspicions of her husband’s infidelity. She came in for an HIV test and found that she was positive. There was a long conversation that took place in which she shared her anger and was asking “why me?” My heart ached for her… I pray for her and for the many that share her suffering.  Another little 3 y/o boy came in with Ricketts and rectal prolapse.  A 4y/o girl with a history of snoring, sleep apnea, and adenoid facies in need of an ENT consult.  A 15 month old girl with inspiratory stridor.  A young girl with an 2cm fluctuant abscess on her posterior head that contained purulent matter and necrotic subq tissue. Numbed, incised, and sent home on antibiotics.  And an older gentleman with Parkinsons who had been paying 4,000 francs (8.00 US dollars) for 10 pills of Sinemet and needed to take 6pills per day for relief.  He had to cut down because he couldn’t afford the cost. Now he only gets 30 minutes of relief three times a day, otherwise shakes the rest of the time.  It is very frustrating for him. Can you imagine having to consolidate all that you needed to do with steady hands into 30 minute time slots, 3 times a day.  And he is a farmer.

We have a young gentleman with tetanus. About a week or so ago he stepped on his machete and obtained a wound on his foot that healed well. He presented with trismus and generalized muscle spasms.  We have him on a diazepam drip to help with the spasms and are vigilant over him for any autonomic dysfunction. So far he is able to swallow, but there is some constipation beginning.

Upon repeated oropharynx exams, I have learned that it is common for people who have a tonsillectomy, to also have their uvulas removed.

We had a young 8y/o boy with partial seizures and left hemiparesis. Finally after over 2 weeks we have been able to send him home. He was slapping me “five”; up high, on the side, down low, TOO SLOW!! It is a game that I learned growing up and shared with him. He had a good time with it and it helped encourage movement and coordination with his left arm/hand.  He has gained some gross motor movement and is walking with help.  On his last day he was smiling from ear to ear… It felt good to see him improve and I was thankful to God for His guidance and to Tim for his knowledge and watchful eye.

It is a Moslem custom here that when a woman gives birth, she leaves her husband and lives with her mother for the 1st 2 years of the baby’s life while the husband usually comes to visit frequently.  Well, we had one patient who had lost a significant amount of weight over a 3 year period, anorexia, nausea, vomiting, and fever.  Well, her H-pylori and typhoid came back positive and so we treated, however, the weight loss was very concerning. Later we discovered that this patient had stayed with her mother for the 1st years of her baby’s life, but the husband never came to visit, and hasn’t been heard of since. The child is now 3 y/o.  We tried Citalopram and it has made a world of difference.  I feel for her in these last 3 years that she’s suffered, and I was thankful to God… my heart overflowed to see her finally smiling and a light in her eyes.

And I had my first neonatal sepsis. A one-day old with a fever of 40.6, born 37 weeks gestation, with 2 days of prolonged labor (unknown time of ruptured membranes).  Ampicillin and gentamycin. She is taking the breast and her suck is strong. No further fever. Thank God.

So this evening we pray for a friend of ours in the States who is having a surgery today. God be with you.

God bless all of you back home…