WORK:
Hanna has been busy on Maternity, and delivered one lady who had had 11 previous pregnancies but only 3 surviving. They had all been girls, but this time she had a boy who was healthy. The mum went home very happy.
Other details of Hanna's work are not suitable for a general public audience but represent the aftermath of picking up the pieces where women have been inappropriately cared for in the community prior to coming to Kisiizi.
Hanna, conveniently for others being O Negative blood group, gave blood again recently and probably has the record for duration of a bruise which is still prominent over 2 weeks after the event!
We have had some challenging cases in the
Children’s ward recently... as well as 3 children needing chest drains we have
had a wide range of patients.
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| Child with pneumothorax and right chest drain in situ |
We have
discharged one girl who had bad burns and has done well, but still have a young
boy who has developed tetanus secondary
to his burns and is quite unwell. We
have tried to access tetanus immunoglobulin [this is a preparation of body
defence protein specifically against the toxins produced in tetanus] but it
doesn’t appear to be available in Uganda and we are trying to access it from
Nairobi...
Then a one month infant came in with a
swollen everted lower eyelid related to infection... happily now responding to
treatment.
We have had a few cases of dysentery all
improving but tragically a little boy who had nephrotic syndrome [kidney
problem with big loss of protein in the urine causing body swelling] and who
had a background poor nutritional state died yesterday. I had a day off so wasn’t there but he
apparently collapsed having been out to a washroom. It highlights how limited our resources are
as we would have had a much greater insight into his diagnosis and guidance in
how to manage him optimally if we had been in UK with all the tests
available. Having said that, we are much
better off than many other places in Uganda having ultrasound, basic tests and
specialists around.
We have a 9 year old admitted unconscious,
it seems this is caused by very high blood pressure in turn due to kidney
problems.... not very common fortunately. I was pleased to hear today she has started eating and communicating.
Then we had a baby who had come in to the
hospital at the age of two weeks with infection of the tibia [bone in the lower
leg] sufficiently serious to expose the bone.
A couple of weeks later he had developed very unusual swellings of the
ends of his collar bones [as shown in the photo] where they join the breast bone. These were quite prominent and
symmetrical. I had never come across
this before but one of our visitors from Chester told us she had seen it in
older children at Alder Hey hospital in Liverpool. It is due to an overgrowth called hyperostosis. A quick look at the literature has not turned
up any cases younger than 3 years with this condition [Sapho syndrome] so we
might write up the case...
REST AND PLAY
so at last due for some days off...
but had
to go in the first day as the Primary School had arranged an end of year
concert and I had to give a speech...
then it turned out one of our medical
officers had also arranged another meeting for in-charges of health centres
that we are responsible for in our health sub-district so, yes you guessed,
another speech... [fortunately I managed to avoid mixing up the speeches!]...
...then in the evening after having a couple
of people for a meal we had a surprise birthday party here for Peter, one of
our two Australian medical students who have been with us for about six
weeks.
The guest house had produced a
good cake and someone brought roasted g-nuts [ = ground nuts, the local name
for peanuts which we more usually eat as g-nut sauce...] and Gloria Banya, aged 1, was of course present to share in the fun...
But yesterday was a proper day off, and we
needed it. Good to unwind a bit and
Kisiizi is a beautiful place to do this.
The sun was out, the sunbirds were out, the spray from the waterfall
picked up by shafts of sunlight through the trees,
the hospital cows chewing
the cud contentedly
[they provide milk for malnourished children on the ward
and for Staff]
and Hanna enjoying a break on the verandah.
I had a short game of badminton and paid the
price in the evening with stiff muscles not used often enough.
Last night we had a very enjoyable meal with Dr. Gabriel and his wife Sister Maureen and their 3 children, followed by a look at the night sky through a telescope... the moons of Jupiter were like tiny pinpricks next to the planet, the Seven Sisters beautifully clustered, and the almost full moon breathtaking. Today Herbert, one of our electricians, spoke in chapel for advent Sunday and, having been sidetracked to see review the child with tetanus, we had a number of friends for coffee... and later an enjoyable lunch with another group... so we thank God for the variety that is Kisiizi.
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| staff walking down towards chapel |
They arrived in Kisiizi on Sunday having flown to Entebbe via Nairobi. Ndola is a large teritary hospital with a medical school in a large town so it was quite a contrast coming to Kisiizi but they fitted in extremely well and enjoyed their time with us.
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