"Water Guard Training" was reviewed, and eager caregivers competed for every available bottle of bleach. The simple solar solution works, as well: eight hours in the hot sun on a corrugated roof will render a clear plastic bottle of polluted cistern water potable. We also reviewed the recipe for ORS (Oral Rehydration Solution): 1 liter of clean water, 1 pinch of salt, 1 tablespoon of sugar, 1 pinch of baking soda -- and voila: a reasonably balanced electrolytic solution. The "mothers" and students who attended today's meeting were attentive: diarrhea and the resulting dehydration routinely kill children here.
The 42 sponsored secondary school students then received holiday goody bags and were invited to choose from a table full of used sports (mostly soccer) shoes which had been donated by previous visitors. Unfortunately, most of the shoes were too small, and the kids' disappointment was palpable. They were nonetheless polite when consoled, "We will be sure that your younger brothers and sisters get them."
We sang Christmas carols together before closing in prayer, and I felt honored to receive an invitation to a Mother's Union Leader's "ordination" service on Sunday. Truphena will officially become an Evangelist in the ACK that day... A "call and response" of yet another order.
Rounds this afternoon included an update on our cardiac patient, who remains conscious but clearly compromised by his aortic insufficiency, in spite of a now-normal sinus rhythm. Is he throwing pulmonary emboli? Or are we seeing the effects of a myocardial contusion/laceration related to the beating which sent him to Maseno Hospital last August? The mystery continues, but he is gaining strength. A new patient presented with abdominal pain and an enormous spleen; his platelets are too low for a splenectomy, and his WBC is greatly elevated with lymphocytic blasts: Shadrack will probably not make it through the night. Another patient who had been admitted with fever, stiff neck, palsy and cloudy CS fluid shows no improvement after three days of IV antibiotics. Could this be TB meningitis?
Meanwhile, Esther, who was scheduled for discharge today, will not be going home after all. A quantity of pus was removed from her chest this morning. She really needs a chest tube for her empyema and a week to recover, with antibiotics followed by AFB's. Andrew is still awaiting his endoscopic biopsy results from a far-away lab, but his family doesn't want to send him anywhere else. They trust Dr. Hardison and this hospital. We observed surgeries today for an undescended testicle, a testicular torsion and three circumcisions (of 13-year-old boys). Those operations elicited a conversation with the medical officer on duty about "female circumcision." Clitoridectomy (genital mutilation) is still legal in Kenya, and it is estimated that 50% of the women have undergone the surgery -- not in any hospital, of course.
This afternoon Zach brought a gospel singer to the hospital perform for the nursing students, who are in the midst of their exams. I trundled Ruth outside in a wheelchair to sit and listen through the open windows. More calls and responses... Amen.