The Worst of the Worst

It’s crazy when you’re gone for a while that you forget how severe and how bad things get here in Africa.  Things that never make it that bad/involved in America.  Day One in the clinic started with a bang.  Patient after patient with severe spine deformities, and it continued throughout the day.  They had 72 patients waiting to be seen on Monday (both spine and general ortho)

We surprisingly got through 72 people and a few surgeries before 3:00.  It’s amazing when you chart only for the bare necessities how rapid you can move patients in need.  As I have said in the past, it is crazy that their lives often come to a halt, travel here for days, wait on the lawn to be called, and then wait some more, just to be seen. 

General Ortho Trauma hasn’t disappointed either, worst of the worst.  It’s always hearting to see the healing power of the human body and the resilience and perseverance of the human spirit.  Huge volumes of “Moto” (Motorcycle) accidents.  There were three thoracolumbar fractures and a cervical spine fracture waiting on me, but based on several things none that really needed surgical care, either too far out, or not surgical in nature.  Several Open tibia fractures just make you gulp and say, “Holy Crap”, but thankfully there is a plastic surgeon here now to give a glimmer of hope of saving these legs with flap coverage.  First picture is of a patient who had been treated Elsewhere since November and finally came to Mbingo for care, and still a mess.  The second had been treated here, had coverage over the bone, but the local witch healers had taken over care when he left, and returned with a wound that looked like this because of the concoction they had been rubbing on his wound, with severe tissue loss now.

The following pictures shows the Orthopaedic “A Ward” which moved from my last visit and is split between men on one side and women/children on the other side with a nursing desk in the middle.  Everything is similar on the wards, other than they now do electronic x-rays and have a PACS system and have to look at x-rays on the computer.  They also just launched their own electronic medical record this week which will be a huge advance, as previously patients were responsible for carrying their own charts (Little pink, blue, rainbow  Notebooks) everywhere, which acted as a medical record, anywhere in the country, and often lost.  They have truly advanced themselves which such a significant endeavor, and will really improve patient care by being able to keep track of previous labs, diagnoses, treatments and care.

Day 2 started slower than I hoped, you come here hoping to do as much as you can, knowing the need is great, and the time is ever enough, but as Mama Cindy says, WAWA (West Africa Wins Again) and you must roll with the punches. My instruments were delayed in arriving to Mbingo so I was unable to do any surgery today, so spent part of the morning organizing the spine sets here and getting them ready for our first big operation tomorrow.  I think it’s because they don’t store/save as much crap as we do in Western civilizations, but it can be a challenge to get them to understand keeping a certain number of and a certain amount of screws ready, available and then replaced with the same sizes so they are ready for the next day.

There were more severe scoliosis patients waiting for me in clinic this afternoon hoping to get onto the “Program” (be fixed) before I leave, but it is already filling fast.  This young lady had been being treated by a local witch doctor who had been practicing what my wife calls “Chicken Scratching” cutting to try to let the “evil” that is causing the bump in her back which is actually severe scoliosis.  It can be seen in the picture all the little scars in her low back from the cutting.

Made it by the prosthetics shop where they were making a leg prosthesis and gave some donated children’s AFO braces they were super excited to receive.

The boys and I have been able to get some hiking in the last two afternoon/evenings, and is gorgeous as always, this is later in the year than several of our previous visits, so is rainier than before, so its muddier, slicker and trickier to try to miss the pop up rain showers.  We hiked up to top of the hill, Joe helped fix some fence and saw some local Cameroonian cows.  Today we hiked up Mt. Mbingo, which the last time I did, Toby was 3 or 4 years old, cried most of the time and I had to carry him both ways.

Joe and I are again amazed at the beautiful color of even the dirt roads you walk up.

Joe also thinks they know how to grow corn, but their cows are too skinny.

By the time we made it to the top, the clouds rolled in and was hard to see or get good picture of hospital, but parts can be seen in the photo.  Joe was excited because he became the “Goat Whisperer” as he tamed the goats who let  him pet them.  For those who haven’t climbed Mt Mbingo, it’s a legit hike, and steep/slippery.  I’m really proud of the boys who are already asking where we are hiking to tomorrow.  I’m just happy with how much easier it was not to have to lug Toby up, and that he did it all on his own.

To bed I go, surgery in the morning, and I keep waking up at 1:30 in the morning for a few hours for no reason.