Friday, April 10, 2009

TIGF and TIA

(This is Good Friday, and This is Africa.)

And this is a hospital. Although ours is a mission hospital, we did not get to church this morning, best intentions notwithstanding. Most of Kenya celebrates a four-day Easter weekend, but our patients don't have the privilege of determining when to be sick.

After rounds last night, we admitted a three-year-old with a snake bite. Dettrick's mama had killed the snake, but she hadn't brought it with her to the hospital. That was worrisome since we couldn't be sure it was non-poisonous, based upon description alone, and since we have no (expensive) anti-venoms at Maseno Hospital. "It was a green snake, about a meter long," Mama reported. That was somewhat reassuring, since the only poisonous green snake in Kenya is the green mamba.

Frankly, Dettrick would not be alive two hours after a green mamba strike. (It was a long walk to the hospital for Mama with a three-year-old on her back.) Since the boy was not in obvious distress, we decided to simply keep him for observation. A banana leaf had been tied as a tourniquet above his swollen ankle. The bite marks on his heel were visible. We removed the tourniquet, cleansed the wound, administered an antibiotic, then paracetamol for pain and a precautionary tetanus shot. Dettrick was discharged today. (Travel at night, via foot or vehicle, is dangerous in Kenya. Our patients sometimes stay 12 hours just for safety's sake if they present in the evening.)

This morning, we were greeted by several new admissions, a second crop (sorry) of kids for circumcision, and a skeleton crew of staff members. On Ward I we saw Mark, an underdeveloped 15-year-old who was described by his mother as "sickly all his life." Diagnosed with "malaria" multiple times at multiple clinics over the years, Mark arrived at Maseno Hospital feverish, in a coma and in respiratory distress. We began treatment and tested him for HIV in the process. Mark is positive.

Sadly, "Mama Mark" has since been tested and is also positive. She has been counseled and is heartsick because her son needs a blood transfusion, but she cannot donate. Four other patients are currently awaiting blood transfusions, as well, and we have no supply. There was none to be had in Kisumu all week, and the relatives of our patients are often sick or unavailable. Because of the holiday weekend, the blood bank will not re-open until Tuesday, and there is no guarantee anything will be available then.

Rotary House residents made Easter donations today. Five pints of blood seemed more sensible than a dozen marshmallow peeps.

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