Day 18 here in the Congo, and one week until I head back to Brazzaville and start working on getting a flight home. Yes, I have a flight, but it's scheduled for Monday, so I'm going to attempt to get an earlier flight out on Saturday. We shall see. Anyway, today we started the day with the usual Chapel service at 7am, but then we all headed out to open up the shipping container together. I got some cool videos/pictures from that, so you'll have to wait to see. They got a new truck in there too, which is going to be hugely beneficial. Jason was the "ribbon cutter," or the guy who yanked open the rusty metal shipping container door, which was entertaining. I think they were giving instructions to some people in French and then expecting Jason to open it by himself, or something, no one was really quite sure. But hey, it's open and we are getting the much needed supplies out for the hospital grounds. Solar panels and some radio tower stuff among other things. It was more or less a pretty big ceremony. They sung songs as we walked from the Chapel to the container, and each of the pastors prayed before opening it. I guess each time in the past they have had a container transported here it's been a huge ordeal. Like, it gets picked up and put down and up and down and up and down, roughly 27 or so times, and then they pay a few thousand US dollars to get it from Brazzaville to Impfondo, and it takes forever, and they have to be there. Well, this time it was a bit different. It's been sitting in Brazzaville for a while I guess, but this company picked it up once and drove it straight to the hospital, along with a crane, unloaded the container and also moved another container around for us. The people here didn't have to do anything. And I guess they didn't really charge them for it, just like $350 I think they said for the gas or something like that. Still, a few thousand less. Pretty crazy, God is good. Nice when things like that work out and surpass any expectations you have.
We then rounded with Dr. Wegner and Dr. Kiong. There was a little girl who had come in who had cut her foot while riding on the back of a motorcycle. Basically, her foot got caught in the motorcycle chain, and when I say cut, what I really mean is that her foot was split in half.....I also have sweet pictures. We wrapped it up and put a splint on it and are sending her to Brazzaville for treatment. When I first asked Dr. Wegner his plan he said, "we are going to evacuate." So I thought he meant, evacuate = cut off her foot. I was like, oh too bad, thought maybe we could salvage it. Then he clarified, we are evacuating her to Brazzaville. Ah, light bulb. Thank you, brain. So she gets to keep her foot at least for now. We were joking that now she needs a ride on the plane, Jason would have to give up his seat.....but so far so good and I think he's on his flight. He'll touch base in Brazzaville, so I'll know for sure. Anyway, I guess the family of this little girl is one of the richer families in the area and owns several pharmacies. So, Dr. Wegner told them that rather than paying for the treatment and such from the hospital, they could pay us with a large container of compresses (gauze) -- we ran out and it's hard to get large supplies I guess, so this will be a good trade for us. We'll see how these people come through, but the foot is pretty bad so I have a feeling it won't be a problem.
Otherwise, rounding was pretty good. We do have this one patient who we thought maybe had CNS toxoplasmosis, but his CDV (HIV) test came back negative, so now we are thinking Tuberculosis Meningitis. He was a rebel in the army and spent some time in prison afterwards, where he acquired TB. He had come in for some treatment a while back but never finished it (it's like a 6 month treatment course), and now he is having seizures, paralysis, and other CNS stuff. Today they were telling us how he was eating and drinking fine, which we didn't quite believe, so they wanted to demonstrate. They filled a cup of water and poured it down his throat.....to which he started gagging and kind of puking a bit....."swallow study failed," said Dr. Wegner. Exactly. We don't think he'll live through the weekend because he has been progressively getting more and more ill, but we shall see what happens.
The guy who had a tree fall on him yesterday is doing pretty well, though he is refusing for us to fix his broken radius and ulna. He wants to go to a traditional healer who will do "massage." Somehow I guess he thinks that if this guy massages his broken it will work normally again, which it will not obviously. We have another guy who did something similar, and yeah his arm doesn't move so well. This happened while he was working for someone too so it's a "workman's comp claim," and the one nurse was trying to tell him "dude, you're not even paying for it, just let the surgeons fix you." But, as of now, we still are not going to be able to fix him. He wasn't terribly happy with how his face looked either, but I don't think he realized just how bad the lacerations were until I showed him a picture of the before and after. So far he's healing up nice, so we'll see what happens. I spent more time than anyone else would have probably, so it's the best it's going to get without a real plastic surgeon. It's really one of the biggest problems they face here in my opinion -- the traditional healers. I've told you stories about the guy's leg who was filled with pus because they stabbed it to drain out the demons. Well, massaging a broken arm to fix it is a pretty terrible fix too. This is one of those circumstances where trying to change a cultural view isn't such a terrible idea, though how to do it I'm still not entirely sure. Hopefully we can convince this guy, maybe if he sees the other guy whose arm doesn't work post massage treatment, he'll change his mind.
Another guy came in today who hadn't urinated in a while because of an enlarged prostate. The nurse tried to place a foley but couldn't pass it, so Dr. Wegner tried and also couldn't get it to go through. So, suprapubic tap time, which in the Congo means cutting him open because we don't have the kit like in the states. So, we numbed him with local, made an incision, cut through the fascia, Dr. Wegner identifided the bladder and made an incision, and I put the foley in the bladder. We confirmed placement with the ultrasound. His urine was pretty bloody in the bladder, so that probably won't bode well for his prostatectomy that we plan to do. I don't know when we are planning that, but probably early next week.
Our chest tube lady from the other day has also been having some trouble breathing so we took another look at her. The chest tube was clotted up with blood, so Amanda tried to flush it out. The patient was complaining of more pain so we grabbed the ultrasound and took a look. Still some fluid in the pleural space, so we will leave the chest tube in and keep an eye on her. Chest tubes hurt, I hear, so it's understandable she's complaining of pain.
No other surgeries planned for today, since the guy didn't want his arm fixed, that was about it. We mentioned to Dr. Wegner that there hasn't been a cesarean section since we've been here, to which he responded that Dr. Kiong was for sure going to get one at 10pm on Saturday night now. I guess they usually have a fair share of c-sections, so it's kind of surprising that there hasn't been any. With the Hong Kong Team and Jason gone, my house is very empty. The house here is broken into 3 sections: Albany, Bethlehem, and Casablanca. Jason, Kiong and I lived in Albany. Bethlehem is the common area/kitchen. The HKT lived in Casablanca. So now with everyone gone, it's super quiet and really empty. Hopefully there ends up being a lot that goes on during the next week so I don't have a lot of down time. Though as I keep telling Anna, I'm sad and lonely so I'm just going to keep stopping by their house and hanging out. They let me come and eat their mango and chat with them, and so far they don't seem too annoyed by me. Jason said I was like a stray puppy that follows Anna home at night (mainly since last night she said she had mango and I just walked home with her and next thing you knew I was eating dinner with them and invited Jason to join). Everyone here is so nice though, I'm not too worried. Joyce and Henri still have their parents staying with them for a bit longer, though I'm sure I could drop by and bug them or the kids at any point too.
For the weekend there are a few things we have planned. I think tomorrow Dr. Syriac is taking the girls fishing on his canoe, so I'll probably tag along and see what that's like. Weekends are typically slow as far as the clinic goes because just the doctor on call rounds on some of the patients and only if there's an emergency will everyone get called in. Anyway, we'll see what happens. Sunday we are meeting at 7am to do some pill sorting (which is early.....so much for sleeping in haha) and then I'm helping out with the church service at 11am again. Sunday night live at 6pm, so we'll see what unfolds for the day between there. Then the following Monday through Thursday it'll just be me. The girls leave on Monday, so I'll have a full 4 days of working with the team here solo. I think there are some surgeries scheduled Monday and Tuesday, and Thursday Wegner is alone so I'll be joining with him, and then Wednesday I think the plan will be to go with Sarah Spear and do some home visits for her patients.
We are talking about going to the beach later tonight, I guess there are some sand dunes or something. We were trying to find a sled, lunch tray, or garbage can lid to use to slide down ("Later dudes."), but I haven't found anything good as of yet. It also kind of depends on the rain....it's one of those it's thundering a lot but only drizzling on and off days, so maybe a storm will hit and maybe not....who knows. So that's it for now, thanks as always for reading. Make sure to check out our main blog page and check on what Kyla is doing in the Philippines and Niti in India: www.makeachangeinternational.org/blogs
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