June 30, 2011

Today was a good day in the clinic and orphanage. Milan got Camerika to smile a few times and he helped to feed Louis, although today I heard he was quite distractable and so this made it a very messy encounter.

I discharged a few from the hospital and followed up on some patients with Tim. One young lady consulted a “chemist” (one that sells drugs on the streets) for the herpes zoster pain on her right back. He gave her 3 shots in each anterior thigh which rendered her unable to ambulate, or even stand. Worst part is that we don’t know what she was injected with.  We started her on acyclovir for the shingles. As for the thighs, these were now another source of pain. Sensation was intact but movement was initially minimal. Over time with some watchful waiting, she is beginning to regain strength in her thigh muscles. Not standing or walking yet, but improving.  

Another lady came in with “dizziness for 9 months” and inability to walk.  Her neuro and HEENT exam was essentially negative with a conjugate gaze and no nystagmus, however her eyes could not follow our finger on the vertical and horizontal gaze. Over the past few days, her extra-ocular eye movements have improved but not completely and she still cannot walk without assistance.  We are wondering about a supranuclear lesion and have sent her to see the opthamalogist. Other patients have been admitted for issues such as uncontrolled hypertension, fever of unknown etiology (sometimes accompanied by nausea, vomitting, and/or diarrhea), stroke, esophageal candida, typhoid, meningitis, and malaria.

This evening was completed with a “Welcome” dinner hosted by the Sisters in their convent. It was lovely and the food was delicious. I think Milan had 3 helpings of their mashed potatoes!! Their hospitality was warm and affectionate. They shared pictures with us and told us stories of themselves. Father Dominic joined us as well and spoke of his hopes to start some sports groups within the congregation to help inspire the youth. He is so full of energy. This Sunday there is a futbol game from 2-4. Milan is planning to play… I am excited. But I didn’t bring him sneakers. L We’ll see if this will still be doable.

June 29, 2011

Today we had our 1^st death. A 25 y/o young lady with Stage 4 HIV, encephalopathy. She had presented to the clinic about a week earlier in a wheelchair, unable to walk. She was HIV+ but was not on ARTs, she would only use traditional medicine healers. She was a very pretty young lady. 

My heart aches for her and her family…

My first day in St Martin De Porres Catholic Mission Hospital

I followed Tim around and saw the pediatric ward first. This room had 7 or 8 little ones in there from maybe 5 months old to 5 years old. It was all very overwhelming… very, very overwhelming. 

There was a girl in the corner bed, with her grandmother at her bedside for the last 2 weeks. She came in with a fever that has not responded to anything… she is in a coma-like state… and she’s HIV +, now looking at a potential brain abscess. Looking around and seeing all these young little lives… it was like a punch in the gut.

Sr Natalia with Aday

Yesterday, in the orphanage, I had an opportunity to talk with Sr. Natalia at length about the orphans. When the mother of a baby/child dies, sometimes the family will be able to care for them. If this is not feasible, the baby/child comes to the orphanage. The father of the baby/child comes to spend time with them occasionally. There are 2 brothers who do not have a father or a mother. Terrence, who is 13y/o and his brother Moses who is 2 y/o. Sr. Natalia was encouraging some member of their family to visit with them and I believe that she has established some communication with an uncle. In Cameroon, when these boys get older and want to marry, as orphans, they have “no background”, no family. This is something that is very important in their culture. No one would want to marry someone who has no mother or father as it shows ‘who they are’, so this is why Sr. Natalia struggled to keep a relationship with some member of Terrence’s family.

Sr. Natalia would like to help the older girls gain a focus for what they would like to be when they grow up. She wants them to keep hope in their hearts. In the afternoon, we had a little fun discussion about what each of the girls wanted to be: Florence 22, a seamstress; Absetu 16, a surgeon, Shalot 8, a teacher, and Dzuran 11, a tailor. They were very shy and giggling about sharing these aspirations, and it was great to learn more about them.

There are 4 babies with HIV in the orphanage. It is a struggle at times, but they put a lot of effort to make sure that theses little ones eat well, bond, and play to help them thrive and fight the virus.