Anne - January 20, 2015

Ed. Note:  We had trouble posting for a variety of reasons, but failed not for lack of trying!  All fixed now and nearly up to date. kpo

This blog entry is a little late – pole! (sorry!)

We have had an exciting day on the medical end at the hospital.  The
Outpatient Department has been filled with interesting cases from
infants to the elderly.  Congenital urogenital malformation, cataracts
causing near complete blindness (that will be fixed) and an array of
tropical infectious skin diseases that we try to sort out as a group.
A dermatology atlas of skin conditions common to this region, with
LOTS of pictures, would be great. Today we had two workmen come in
emergently with carbon monoxide poisoning from running a gas-powered
engine in the bottom of a water-holding tank, where they passed out.
Luckily a couple of people were there and pulled them out but they are
still in the throes of a several hour resuscitation.  They should
recover completely.

We have a super team here.  There are at least two excellent
clinicians from the hospital patiently working with us.  Our American
team sits down every afternoon to generate differential diagnoses on
the mystery cases, which is a stimulating exercise.  We try to rank
most likely to least likely but admit to significant data gaps that
make it difficult to lock in on a diagnosis most of the time.
Sometimes we indulge in thinking about  lab or imaging studies we
would order at home, but not too much.

Our medical team includes 5 generalists (3 family medicine, 1
emergency medicine, 1 family medicine) and 2 heme-onc specialists
(although Randy is an honorary generalist after tropical medicine
training and many years coming to Ilula).  I hope the 2 medical
students (1 headed for internal medicine, 1 for gyn) realize clinic
won’t be quite so exciting when they get home.  My rough calculation
(based on ~9 days of inpatient rounds) is that ~50% of patients would
be in the ICU in MN.  I think it’s Medical Camp for Adults.  It’s hard
to imagine a more fun way to learn.

Has anyone written about the food on the blog yet??  Today’s breakfast
was special – samosas!  Also fried bread with a trace of egg!
Africafe!  Nutella! Peanut butter! Nutella! Nutella! Africafe!  Usual
breakfast is fried bread (in various shapes), hard-boiled egg.  Lunch
and dinner are quite similar to each other, and quite similar day to
day (a polite understatement). Common elements: rice, (pinto?) beans,
potatoes (mostly fried), ugali (sometimes), meat (beef/pork/goat),
shredded cabbage (cooked), and spinach (I think).  Sweet pineapple and
mango are intermittent treats.

The countryside is beautiful for walks, especially the farther you get
from Ilula.  The farmers and kids we meet on the dirt paths are all
friendly and tolerant of our laughable Swahili and Hehe.  We feel very
comfortable and welcome.

There are at least 20 times each day I see something I desperately
want to show to my colleagues at home in the Primary Care Center, and
perhaps just as many times a day I miss showing my 3 beautiful
children, Alice, Pavel and Claire, something extraordinary.  We’ll be
home before you know it, full of pictures.

Love to all, Anne