Paediatric Quiz - CLUE TIME

Some need a clue to the diagnosis in this case for a bolus point:

A scar is the solution, it all comes to the helm in the end!

Draining...

Brain drain...

Occasionally we are disappointed when one of our Staff decides to leave for a higher-paid job in a big city rather than staying to help care for our desperately poor community... but on the other hand it makes us really appreciate the Staff who faithfully serve even though they could earn so much more elsewhere for less work.  One such is Dr. Gabriel, our Consultant Surgeon, who has now returned safely from a trip to Geneva to the World Health Organisation and this all went very well.

One other factor in a couple of Staff leaving is that we discovered some were holding full-time government jobs as well as their Kisiizi appointments and were trying to do them in their days off from here... but of course this could mean compromising on both sides.

Chest drain...

this youngster is an example of a child being brought to us late in a disease progression.

He was very breathless and had a large amount of fluid accumulating in his left chest.

The x-rays show the difference before and after a chest drain was inserted to relieve his distress.

The first film shows his heart pushed across to the right by all the fluid [which looks white on the x-ray].  In the second film the right lung looks more normal and the tube of the chest drain can be seen in the lower left chest.

We were able to remove the drain after about 3 days and he went home a few days later.

Tank drain....

Kisiizi has 360 beds and sometimes the number of patients exceeds this.  Then patients all have attendants who help them with washing, food etc [the nurses concentrate on observations, dressings, medication etc] so that adds another group of people.  Add a couple of hundred student nurses/midwives, about 430 pupils in the primary school and a few hundred out-patients every week and you will understand that there is quite a demand for basic water and sanitation.  We are blessed with a capped spring and gravity flow water system that has served Kisiizi for its 55 years.  The pipes will need replacing but happily there still seems to be adequate water for our needs at present. Sanitation is provided by a range of different facilities ranging from extremely basic pit latrines to western-style flush systems and anything inbetween.  Only problem is that a lot of these facilities drain into septic tanks and with time these fill.  So one joy to anticipate is draining some of these tanks in the next week or so.  Moses, our senior hospital administrator, assures us that it will be fine and not an assault on our olfactory senses...

Ambassador

Dr. Gabriel lecturing on the Kisiizi APPS Amplification seminar

Dr. Gabriel Okumu, our Consultant Surgeon, is currently in Geneva at the invitation of the World Health Organisation to represent Church of Uganda Kisiizi Hospital at a strategic planning meeting relating to the Surgical Unit-based Safety Programme.  This is a new initiative from WHO supported by a team from John Hopkins university, USA.  Kisiizi has been asked to participate following the recent successful amplification work as part of our role as the only first-wave hospital in Uganda on the WHO African Partnerships for Patient Safety programme. We will continue to liaise with our partners at Countess of Chester NHS Trust as the programme develops.

Kisiizi has also been asked to act as one of five worldwide WHO "Learning Laboratories" researching the ways to link Patient Safety to the Universal Health Coverage targets.  Other sites are in places like Bangledesh, Gambia and Dominica so hopefully we can all learn from one another.

Our large community Health Insurance Scheme, with over 35,000 members in 177 groups, will help us interact with our communities, sharing health promotion messages and listening to key issues raised.  In addition, as part of the North Kigezi diocese of the Church of Uganda we have another network with around 320,000 members, again in a structure of parishes and archdeaconeries that will facilitate similar interactions.

Special guests...

We were delighted to welcome Sister Esther Kobusingye, our former Principal Nursing Officer, back for a visit to Kisiizi this weekend. 

She retired from Kisiizi about 18 months ago and now works part time in Mbarara, about 80 miles away.  It was a joy to see her again, accompanied by Oriki, seen here with Esther and his sister Gladys and her young baby.

Paediatric Quiz time...

for the medics amongst you, here is a case we admitted recently...  a previously well child of about 8 months presenting with intermittent severe abdominal cramping pain and this appearance...







What do you think is the cause?

We will give the answer in a week or so!