Saturday, Saturday....

Good Morning everyone,
It is Saturday morning, and we are already finished for the day (it is just before 11AM here). Quick updates: Still no snake venom available and still no x-ray film available. We are not sure when any of either will be available, but this certainly limits some of our treatment options.

At the hospital it has been a difficult week on the pediatric ward. We have had at least 1 death each day, and several days had 2 deaths each. It seems that several of the children with GI problems, whether they were gastroenteritis or typhoid related were all unable to overcome their illness. A couple of them I really had thought were improving, but then quickly passed away. We had 2 malnourished children with multiple problems also pass and last night we lost a little boy with what was likely bronchiolitis and pneumonia, who we just didn't have anything more than bulb suction to help with his secretions and mucus. He had looked in less distress yesterday on rounds, but I wasn't sure if he was truly less distressed or becoming more sick and just unable to mount an appropriate response. Meanwhile, there are two children (a newborn, and a 2 year old) on the ward who may have Hirschprung's disease (where the nerves of the colon do not develop normally so they cannot pass stool). The newborn presented with a very large, hard abdomen, having never passed stool in the first few days of life. We were able to find on exam that his anus is not completely open and he has formed a fistula tract where stool leaks from just under his scrotum. He is passing stool through the fistula, however, his belly is much softer, and he is eating well. We are going to let this continue until monday when a new surgeon arrives and let him help us determine the best course for the child. He will ultimately need some kind of anal surgery to help him, but since he is OK for now, we felt it best to do no more harm than already exists. The 2 year old is a child who also presented with a hard abdomen and having difficulty passing stool. it was very difficult to get a good history from the mother with the language barrier. Initially she reported the child had normal stools until recently. While the child has been in the hospital, he has not had a single stool in several days. On further questioning with a different nurse doing the interpreting, I was able to learn that the child has never had a stool on his own since birth. They have always "mixed up" enemas to give him when is belly became hard to help him stool. So, I think this child may for sure have Hirschprung's. We are doing small enemas daily now to help him stool and the surgeon will also evaluate him on Monday. Otherwise he is doing well. One last child to talk about is a little 2 year old boy who came in overnight with a femur fracture. The parents took him home today because they wanted "Local treatment" not casting or traction. Local treatment here varies by illness or problem, but usually is not a very good option from a medical standpoint. For skin wounds, the medicine man creates some liquid, which contains who knows what, some have said snake parts among other things, and then pours it on the skin. usually we see them a week or so later because the solution causes the skin to peel off and then it gets infected. They also have a similar concoction for internal problems that the people drink, and many others for a variety of different illnesses.

On a more positive note, Majeed, the young boy whose pictures you saw a few days back after all the suturing, returned yesterday for suture removal. After multiple attempts to be sure we had them all out, he looks great. He has a little area from the wound next to his right eye that is still healing, but otherwise all the other areas have healed very well and hopefully won't scar too badly. He is a very polite young man, very loving and grateful, and just makes your heart bleed for the suffering he has endured the past week and a half. I really pray for blessings for he and his family as they are all very loving and compassionate. I am surprised how attached to him I became in just a few days, but there is definnitely a special bond there. I guess he is just one of those patients who touches your heart in a special way, a blessing sent from Heaven.

Outside the hospital, the past few days have also been fun. We bought some fabric from the local market and are having some African clothes made. The wife of one of the caretakers of our guesthouse is making them for us, for a very cheap price. She tailored everything on Thursday, and Friday we tried them on, but let's just say that my butt is a little bigger than she perceived or measured. She came by in the evening yesterday and is going to alter them with the extra fabric to make it possible for me to get the pants above my lower thighs! Jeremy and I also got some of the Ghana Health Service fabric from the hospital, and are having shirts made from this. Hopefully they will be done in time for us to wear them to the hospital and get some pictures made before we leave. The clothing here is very colorful, and very simple in they way it is tailored, but seems to be very durable. Michelle (the pediatrician from Kansas City) has made the observation that it is amazing how many layers of clothing some of the people wear, even in this hot weather. It reminds me a lot of our experience in South America with some of the women wearing many layers and bundling their babies in many layers also.

As you are probably aware, the World Cup competition is officially underway. The Ghana National television is carrying every game, so we are hoping to see the US play tonight. Yesterday, as we were returning from the local market I saw a few groups of people gathered around TVs watching very intently. I can't wait to see the local energy and activities when Ghana plays tomorrow!

As most of you know, my sister Danielle graduated from high school last night. I hated to miss the ceremony, but I did have the chance to call and talk to her for a while yesterday before the graduation. I am very proud of her and excited she is going to attend Northern Kentucky University, which is only about 5 miles from my house in Fort Thomas. I am sure there will be plenty of photo and video coverage from our family. Pray for her as she goes through this big period of transition in her life.

It is hard to believe this time in 1 week we will be getting back into the USA. Jim one of the other docs here reminded me today. Our time is going by so quickly. I just hope our work and efforts are a good example to the local people. We know the hospital is going through transition and some serious financial struggles currently for multiple reasons (not being paid by the goverment insurance for 6 months now, having difficulty purchasing medications, searching for more long-term physicians to help staff the hospital). I just hope God blesses them to be able to continue the good work that is happening here so the local people can continue to receive good care and spiritual nourishment. A large part of the community's life is due in part to the hospital at some point, past or present.

My goal for the coming week is to begin putting together some of our photos into a slide show, or a printable format, so that we can have them ready pretty quickly to share with everyone when we are back. It is always frustrating to try to tell people about the trip and not have the pictures ready to show when we return. Pray that I would get this done or at least a good start. We have a lot of pictures to sort through, and many more we will acquire/share with some of the others here with us.

I will stop for now. I hope you are all having a great weekend. We will post again soon, and maybe even try to get a few more pictures on here in the next couple of days.

Love always,
Steve