Paediatric Quiz solution...

Thanks to those of you who posted comments or sent emails suggesting a solution... it seems that my clues were too cryptic!Here is the clue again but with highlights...

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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!

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The answer is that the child had sub-acute obstruction caused by a bolus of ascaris roundworms, a type of helminth parasite infection.  Ascaris are quite common but usually only cause mild problems such as malabsorption with the risk of compromise of the child's nutrition.

This unfortunate child had hundreds of worms which were vomited or passed once we gave the child anti-helminth medication [mebendazole].

Re-generation...

Kisiizi Hospital Power Ltd, our hydro-electric power company, plays a vital role in keeping Kisiizi operational.  For many years we ran the Hospital on the 60kW Gilkes generator and then in 2008/9 the new 300kW generator was installed by Charles Swainson and the team.  This has allowed power to be transmitted to our community for domestic use or, in some cases, providing energy for small industrial concerns such as carpentry workshops.

Gideon inspects the alternator bearings

Now the main generator has been running for 4 years and we are grateful that Charles has returned to supervise the essential maintenance required to ensure the on-going smooth running of the turbine, alternator and whole system.