July 25, What happened?

In the hospital, a young 2 ½ y/o boy had come in with sepsis. The story was that he had a swollen right leg and a blister on his right medial foot that the grandmother had tried to drain a week ago. He now had a taut, swollen right thigh, moist cough, and very distended abdomen with a heart rate of 144 and pox of 75%.  I wasn’t sure that he was going to make it through the night. His lungs were coarse and there is only one oxygen concentrator for all of the medical wards, which works when there is electricity, which is sporadic at night. His right upper arm was slightly swollen; we couldn’t feel any abscesses in his swollen thigh; his abdomen was distended and he hadn’t passed stools for the past week; he also had an altered level of consciousness in which he would not focus his vision on you or anything, just kind of stared off into space, and had a sardonic-like smile.  Over the next few days, with antibiotic therapy, nursing care, and a lot of prayers, he is getting better. The swelling in his arm has dissipated, his cough is less (pox 93%), his belly has softened after enemas and paraffin tx, and the swelling of his thigh has reduced enough to reveal multiple abscesses. Probably for an incision and drainage soon. Thank you for your prayers.
 

Just a little FYI: The language they speak here are Pigeon, Kom, and English. Pigeon has many English words in it with different organization of expressions. For example: If you’d like for the patient to sit on the examining table, the term is, “Climb for bed”. If you’d like for them to lay down for an abdominal examination, you say, “Sleep for bed”.  Have you lost any weight is “Is your body small for skin?” If you’d like them to take deep breaths, you say “Breathe deep.”  Diarrhea is “posh”, vomit is vomit, cough is cough. Tuberculosis is “Strong cough”. Fever is fever, or “Is your skin for hot?” Pain is “hot”. For example, when checking for dysuria - “Is it hot when de piss?”  And by the way, just when you think you have the pronunciation down right, you’ll say it in your best American Pigeon, and they still won’t understand you. Our translator still has to sometimes repeat exactly what we’ve said, but with familiar accent and then they understand.

In Kom, it is a little more foreign. “Lay down” is “Ninyi”. “Sit up” is “Lolli”. “Deep breathe” is “Z’usa”.  “Say ahhh” is “Zese ahhh”.  “Where is the pain?” is “Fos ia de hot?”.  “Goodmorning” is “Tulima,” the response is “Aye, Wulime”. Or, “How did you sleep?” is “Aye wachima junga?” and the response is “Aye, machime”, which means you slept fine. And I always sleep fine because if I didn’t sleep fine then that would lead to a whole explanation that I am nowhere near translating!! “I’m sorry” is “Asha.”

This morning, a young lady came in comatose, pupils fixed and dilated, no doll’s eyes. The story was that she was fine yesterday, had some had not been ill, no history of headache. Last night she had some problems sleeping (unclear why) and this morning she awoke and told her mother that her head hurt, and collapsed.  They tried to give her some traditional medicine to wake her, but it did not help and so they brought her to us.  We placed an NG, oral suction, and placed her in what they call “cardiac position” (HOB elevated).  Within a couple of hours, she passed. SAH? Ruptured aneurysm? I suppose we’ll never know. God rest her soul and be with her family…

Today Milan felt the pain of teaching. The usual instructor that teaches grammer and reading was not there as he had a funeral, so Milan taught math (division of fractions) for 4 periods today and was exhausted. The children seem to be catching on to the concepts, but it has taken time. And of course on their break, Milan plays a mean game of futbol with them.  He says that they are really good, especially one young boy is superfast.