Day 3: Eye surgery; recognizing the need for support & counselling; and the anticipated arrival of a Medcan dermatologist

 Patients being screened for cataract surgery

Patients being screened for cataract surgery

Jumbo!

Another great day at Fluorspar.  Dr. Sidiqa and Vanessa arrived early at the clinic in order to set up for the cataract surgeries.   16 surgeries were completed and the patients will stay overnight to be monitored and administered drops in order to optimize results.

A challenge we are now dealing with is that the public has heard that we are providing free cataract surgeries and are showing up literally as walk-ins asking if they are able to have their cataracts removed.  The issue is that we have planned for 25 to 30 surgeries in total over the two day period as that is a reasonable number of surgeries to perform safely by one surgeon.   We’ve promised them that we’ll be back in January and they can participate in the program then.

As well, in order to mitigate the risks of doing surgeries in such a remote setting, we conducted a 2 part screening process so as to ensure that the patients we were undertaking were low risk and had a high chance of success. 

 Jemimah and Sidiqa doing an eye exam

Jemimah and Sidiqa doing an eye exam

 Cataract surgery. Vanessa helping

Cataract surgery. Vanessa helping

One of our goals is to have zero cases whereby the surgery actually made their eyesight worse due to secondary conditions to the cataracts!  Those patients we advised to go to another cataract surgery initiative being conducted at Moi University in Eldoret next week where they actually have the resources to deal with difficult cases and complications.

A very sad case involved a woman who tried to commit suicide and was rushed to the clinic by a neighbour who found her unconscious. Apparently she had an argument with a relative with regard to her positive HIV status, which resulted in her ingesting some sort of toxin.  The challenge was trying to determine what toxin she actually ingested so that she could be treated properly. 

Dr. Michael, Dr. Ed and Julius (the clinic manager) were quickly researching online what the possible substance could have been given her presenting symptoms and what she would have available to her.  They deduced that it was likely a tick pesticide used for cattle.  They treated her with that assumption and she has improved but is not out of the woods yet.  She is still experiencing respiratory distress, which is the leading cause of death with this particular substance. 

This case is yet another example of the need for a support and counselling in the community.   Drug and alcohol use as well as depression are common here and there is no apparent program available to them.  We are considering bringing with us a mental health expert on the next trip in order to help give the staff strategies on how to deal with stress, anxiety and depression.

 Dr. Paul with Dr. Michael and Dr. Ed with Julius, the clinic manager, and a dermatology patient

Dr. Paul with Dr. Michael and Dr. Ed with Julius, the clinic manager, and a dermatology patient

I’m happy to report that Dr. Paul our dermatologist has arrived safely!  He had a great afternoon working alongside Dr. Michael and Dr. Ed, Julius and Samuel (another clinical officer).  They saw several patients with skin ailments who were brought in specially because Dr. Paul was here.  They saw a myriad of issues including scabies in an adult, severe hair loss in a woman and a woman with keloids from piercing her ears.

Each patient provides a great learning opportunity resulting in a rich discussion on treatment strategies and protocols for proper diagnosis.

Tomorrow we will do the second half of cataract surgeries with another 10 planned.  We will also assess the patients who received their surgeries today.  It is always an incredible experience to witness when someone who hasn’t been able to see for years finally regains their eyesight.  We will be sure to share many photos!

Dr. Paul will be conducting a lumps and bumps clinic and continue educating and training the clinical officers.

And of course we’ll begin with checking on the woman who ingested the poison.  Her vitals were all much better before we left this evening and we are very hopeful she will make a recovery. 

Until tomorrow...thanks for reading and lala salama from Kenya.

Stacy