Monday, January 16, 2012

Hit the ground running...

Got back from our whirlwind trip to Michigan, very happy to have seen our family and help out with the care of our parents, and already are going full speed.  Apparently in the month of December, many people in the community have decided that our hospital provides better care than the regional referral hospital and our numbers have sky rocketed. 


From Jan 1st through the 9th we provided care for over 800 outpatients and numerous inpatients.  Mondays have gone from 80-90 patients in OPD to 130-150.  Not to brag but I've treated 420 patients in OPD over the past 9 days.  Part of the increase in patients is because it is malaria season here.  Every day we admit children with high temperatures (often over 103F) because of serious malaria infections.  Almost all families have insecticide treated mosquito bed nets but still kids get bit in the evening before sleeping and so problems of malaria continue.


I thank God that our good reputation continues to grow in the community. We hope sometime this year to reopen the maternity ward to provide even more services to the community.


Sally and I are excited that next week Dr. Justin will arrive from Mississippi.  He will be teaching many of us ultrasound skills and doing as many scans as I can convince him to do with us.  We are so grateful for his willingness to come and help us as it is a big cost in many ways to him and his family.  We have numerous patients booked for scans.  In addition to myself there are 4 other doctors who will be trained and at least one nurse.  Five days of intense teaching will give us a taste of U/S scanning and hopefully will improve greatly my self-taught skills.  We are using an old machine but it is working for now.  We hope someday to get a newer one that will allow us to do cardiac scans as well.  If you happen to know someone with a spare U/S machine to donate to the hospital let me know.


The other thing I am excited about it to have gotten a really cool teaching set of MP3 files from cardiologist, Dr. Michael Barrett.  He graciously gave us permission through the American College of Cardiology to have these training files that teach about heart sounds.  The files called HeartSongs 3 are his brainchild (www.cardiosource.org).  He has a passion for teaching and has helped countless students, interns, and residents to gain the skillls necessary to recognize various normal and abnormal heart sounds.  When I was back in the USA I picked up two MP3 players and now our doctors are listening to the files to improve their skills.  Thank you again Dr. Barrett! 


Finally, I want to share with you about one young boy that I admitted today.  At 4-1/2 he began to have problems breathing in December.  He hasn't been able to play with other kids his age because of fatigue and breathlessness.  He got treated for malaria because of a fever but still hadn't gotten better.  His mom brought him to the hospital today.  He was breating at a rate of 70/min.  His heart was racing at 100.  Yet he was smiling.  One of the other doctors had examined him and asked me to see him too.  We discovered he had a very loud heart murmer and early signs of pulmonary edema (water on the lungs).  We checked his oxygen saturation and it was only 33% (normal >95%).  We admitted him and got him on oxygen that is provided by a machine called an oxygen concentrator.  It takes room air oxygen and concentrates to a higher percentage.  After some medications and the oxygen his saturation had risen to 65%.  By the time I left the ward his breathing rate had slowed down a bit, and his saturation was now 80%.  The challenge now is to get him stablized and then find a way for he and his mom to travel to another hospital for echocardiography (heart ultrasound) and most likely surgery.  Just to share with you what the social challenges are here, the mom has one other child.  The dad is studying in a city about two days away and they don't have the money to take the child to the other hospital.  We will begin tomorrow to encourage them to hold a family meeting so they can determine the way to get the funds to take him to the referral hospital.  The extended family will be asked to contribute. It is the way that things are done here.  I would ask you to pray for this little boy (Kambugwe) and his family. 


Will write more and post some pictures once Dr. Justin arrives and the fun begins.  Meanwhile, I would ask you to pray for all of us at the hospital as we continue to provide compassionate quality care for very needy and sick people. 


Daily by the grace of God...

2 comments:

  1. Uncle Larry - how do you go about dictating on all your patients-paper charts? Voice recorder? Just wondering.

    Isn't it great how families take care of one another--"The extended family will be asked to contribute. It is the way that things are done here."

    We could learn from them eh?

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  2. We do all our charting on paper, no dictation. Very true, family takes care of one another. As Americans, we have many things to learn from our African friends...

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