Monday, 15 April 2013

Let's play spot the fracture

Today's my last day in Yei before I leave for a two-month break (I'll return at the end of June). It was going pretty well until 3pm where I returned to the hospital after lunch and was greeted with the sight of a 9-month-old boy in extremis, complete with agonal gasps and all. He had been admitted to the ward by the clinical officer with a working diagnosis of gastroenteritis (one-day history of vomitting and diarrhoea). I got a call from the head nurse 10 minutes before I arrived, letting me know that no one had managed to gain IV access and to ask if I could come put in an IO (intraosseous) line - which I've never done before other than on practice mannequins. Anyway, I dropped by my senior colleague's house to request some supervision and trotted on to the hospital. And yup, there was a big crowd surrounding the bed, some wailing from the boy's relatives, and the little one deceased. Apparently, he went into cardiac arrest shortly before, presumably from hypovolaemic shock.

That wasn't the end of it, though. From that time up till the time I left (7.30pm), there were six new admissions, including:
- An 11-year-old boy who had fallen out of a mango tree earlier that afternoon (his right femur XR is displayed on the right),
- A 1-year-old boy with gross macroencephaly (literally three times the normal size of a child's head) secondary to hydrocephalus 8 months post ETV who presented with new-onset seizures, fevers, vomitting and a fixed, dilated left pupil (possible meningitis +/- stoma occlusion),
- A 30-year-old lady with threatened miscarriage (which became a complete miscarriage by the time I left),
- A middle-aged man with symptoms of subacute pulmonary oedema secondary to congestive cardiac failure, and last but not least,
- Two others kids with malaria, one of whom needed blood transfusion for a Hb of 4.5

Well, at least you can never accuse the work here of being mundane or boring! We do what we can, refer where we can, and hopefully most of our patients are better off because of it. Outcomes may never reach the standards to which we are accustomed in the West (for the foreseeable future, at least), but God willing, I believe we do make some difference.

On a lighter note, I somehow got roped in to be part of a mini choir on Sunday! It boggles the mind of anyone who's familiar with my singing prowess (or rather, lack of); to my left is our pastor and the second person to my right is the lovely wife of our American missionary doc while the others comprised the older girls from our orphanage. We presented a song during offering time at church service ("Presence Beautiful" by Daniel Thornton), which was followed by a special dance presentation - thankfully not including yours truly this time!

One of the advantages (some may call it a disadvantage?) of living in such a close-knit community is that we see one another almost literally all the time. We share our meals, work together, go to town together, serve in church together, etc. Sometimes, that means friction as we rub each other the wrong way. It'll mean disagreements from time to time, hopefully settled amicably. But overall, I guess it's practice for heaven, where we are one body in Christ:
Romans 12:3-8 For I say, through the grace given to me, to everyone who is among you, not to think of himself more highly than he ought to think, but to think soberly, as God has dealt to each one a measure of faith. For as we have many members in one body, but all the members do not have the same function, so we, being many, are one body in Christ, and individually members of one another. Having then gifts differing according to the grace that is given to us, let us use them: if prophecy, let us prophesy in proportion to our faith; or ministry, let us use it in our ministering; he who teaches, in teaching; he who exhorts, in exhortation; he who gives, with liberality; he who leads, with diligence; he who shows mercy, with cheerfulness.
Sadly, the current state of the church worldwide leaves much to be desired. Our saving grace is that our good Shepherd is very much aware of our failings, both as individuals and as a group, and yet loves us still.

If you could pray for my safe return to both Malaysia and Australia, it'll be much appreciated :)

1 comment:

  1. I am interested obviously in the young child who had macroencephaly. How are ETVs done in Sudan? Who does them and what sort of follow-up is afforded to them?