This blog is about my dad and I taking a trip to Niger this August in 2012. My dad, Brad, is a family doc who specializes in obstetrics. I'm a pre-med student with clinic experience. We'll be volunteering at a hospital in Galmi, Niger for 10 days.
Showing posts with label medicine. Show all posts
Showing posts with label medicine. Show all posts
Wednesday, August 15, 2012
Malaria in Galmi
This 16-month-old has malaria. He needs a blood transfusion, but he has O-negative, a rare blood type that is in short supply at the hospital. The blood bank here survives by asking for a blood donation, usually by a relative, when a patient receives a blood donation. But any number of blood payments will not help this little boy because we have no O-neg to give him.
Blood is so precious here that transfusions cannot be approved unless the patient has a hematocrit of 18% or below. (Hematocrits are a measure of the percentage of red blood cells in the blood. Normal levels are 35-50.) Even a patient hovering around 19-20, which is less than half the normal amount already, cannot receive a transfusion. This little boy has a hematocrit of 10.
His exhaustion, which is obvious from this photo, is a symptom of his low RBC count and oxygen, and malnutrition. Niger has a heavy load of malaria cases. It is the leading cause of death in this country, and a major contributor to the fact that nearly 2 in 5 children will die before the age of five.
EDIT: A donor was found for this boy!
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Tuesday, August 14, 2012
Katy's First Day
Yesterday I started work at the hospital's pharmacy in the morning. Dr. Starke gave my dad and I a tour earlier and warned us that sometimes people get woozy walking around the hospital. I understood why. There are only 100 beds in the hospital, but they are admitting 20-25 people a day with the disease. They are lining up mattresses end to end down a hallway where patients lay, splayed out, too weak to move.
I cut and counted pills yesterday morning for several hours. The powder of medication being cut sort of hangs in the air and there's a certain scent of it that is familiar to me because of the Dominican. I felt right at home there. Then I shadowed Dr. Starke, who was working in the surgery exam rooms.
The first patient was a man who had a serious head injury five or six inches long up his forehead into his hair. Nothing had grown back together again, although he had two sutures. He had gauze plugs in the wound, which was not necrotic and did not bleed much. That was the first case I saw. There was a man with swollen fingers - possibly a tumor. Then a girl I thought must be pregnant. Couldn’t have been more than 13 or 14. When she lifted her dress I saw that she was pregnant not with child, but with a large tumor that made her appear as though she could be ready to deliver a baby any day. After that was a man with one leg. Then a man who’d broken his arm nine months ago, but the bones had never knit back together. His arm above the elbow was all noodly…like a joint that could move any direction.
I cut and counted pills yesterday morning for several hours. The powder of medication being cut sort of hangs in the air and there's a certain scent of it that is familiar to me because of the Dominican. I felt right at home there. Then I shadowed Dr. Starke, who was working in the surgery exam rooms.
The first patient was a man who had a serious head injury five or six inches long up his forehead into his hair. Nothing had grown back together again, although he had two sutures. He had gauze plugs in the wound, which was not necrotic and did not bleed much. That was the first case I saw. There was a man with swollen fingers - possibly a tumor. Then a girl I thought must be pregnant. Couldn’t have been more than 13 or 14. When she lifted her dress I saw that she was pregnant not with child, but with a large tumor that made her appear as though she could be ready to deliver a baby any day. After that was a man with one leg. Then a man who’d broken his arm nine months ago, but the bones had never knit back together. His arm above the elbow was all noodly…like a joint that could move any direction.
After that was a patient, maybe 10 years old, with a swollen chest and abdomen. An ultrasound showed massive cysts throughout his abdomen, eating up his liver. The doctors discussed whether or not the boy had cancer or a parasite, and how to treat him. They were all pouring over medical textbooks and discussing possible treatment plans. They finally decided to treat with antiparasitic meds and then drain the cysts as well.
Then a woman with a wide, wobbly 12-inch scar down her belly. She had had cysts drained too and was there for a post-op exam. Then an elderly man with open wounds on his foot. His foot was swollen, and his wound oozed blood and puss, which was smeared along the floor as he dragged himself to his seat. Dozens of flies followed him, feasting on the rotting foot. I got a paper fan and insisted on fanning his foot. Flies carry diseases. They shouldn’t be eating a man alive.
It took just an hour to see more serious injuries and sicknesses than I've ever seen in my life. I'll give you today's report later. Gotta get back to the hospital. Much love to you all
Katy
Brad's First Night On Call
Tues *AM Aug 14
Last night was my first nite of medical call.
I admitted four children with severe malaria. Three of them were having seizures and were critically ill with cerebral malaria, that is when the parasites are in the brain. One young man came in yesterday but before the meds could reverse things he had a stroke. It was a very sad case. I hope my patients made it through. We give blood transfusions, quinine and IV fluids. When I was at a hospital in Ghana in 1995 many times we didn't have any meds to help people it was unbearable so this is much better to have some very effective tools, not everything we would have in the States but still some great resources.
I am cutting this short because I am eager to go in do pre-rounds to see how my patients did.
Thank you for your prayers and support
I can feel Gods hand in what we are doing
blessings to you
Brad
Last night was my first nite of medical call.
I admitted four children with severe malaria. Three of them were having seizures and were critically ill with cerebral malaria, that is when the parasites are in the brain. One young man came in yesterday but before the meds could reverse things he had a stroke. It was a very sad case. I hope my patients made it through. We give blood transfusions, quinine and IV fluids. When I was at a hospital in Ghana in 1995 many times we didn't have any meds to help people it was unbearable so this is much better to have some very effective tools, not everything we would have in the States but still some great resources.
I am cutting this short because I am eager to go in do pre-rounds to see how my patients did.
Thank you for your prayers and support
I can feel Gods hand in what we are doing
blessings to you
Brad
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