Day 8 - Complex care patients, cataract surgeries, and maternal health challenges


Well, I’m not sure how your day started but mine was watching a gheko run into my bathroom from the hallway and me searching everywhere to find him.  Not so much to do anything with him really, just wanted to know where he was.  I mean, I certainly didn’t want to step on the little fella, especially as he’s been quite good at eating all of the spiders in my room.  I even was witness to a kill.  Actually gave out a little cheer after he got that scary black spider.  In fact this gheko has been in my room since I arrived.  I’ve decided that he’s actually the one who lives here and I’m the intruder.  Luckily we’ve even developed a bit of a friendship.  Sometimes we play the staring game.  Me from my bed (while I’m writing this) and him from the wall.  Or we play chase…with me always the one chasing him.  We even play hide and seek, sort of like this morning in the bathroom.  Despite the fact he always seems to be the winner, it never takes away from the “fun”.  I guess we’ve struck an unsaid agreement of sorts.  That is, as long as I don’t tell the staff that they need to get rid of this tiny squatter in my room, he’ll continue to eat the spiders that usually crawl on my walls (which absolutely creeps me out more).  We’ve learned to coexist despite our very different backgrounds and actually have become quite good roommates.   I’m going to miss the little guy when I leave and (believe it or not) hope to see him again when I return.

Herd of elephants walking by dining room

Herd of elephants walking by dining room

Anyways, on to more serious things, like the mass of patients that were waiting for us at the clinic.  But today was different.  We had a plan!  Vanessa with the help of a clinician triaged the patients, most seeing more than one physician.  We also ranked the severity of the conditions and had one of their clinicians examine the “easy” ones and our doctors would focus on the complex cases.  A much better system!

Dr. Michael and John having a light moment

Dr. Michael and John having a light moment

We shortened our lectures and began treating patients by about 10:30.  By lunchtime we had seen many patients presenting with a myriad of issues.  Dr. Paul had one patient with vitiligo and another with  neurofibromatoses, a rare genetic condition where the patients grow multiple skin lesions on their face and body and develop other more serious associated complications.

Dr. Sidiqa spent the morning at the hospital ensuring the screening was going as planned on the second group of cataract patients and also did post-op on the patients who had the surgery yesterday.  Overall she was happy with the results.  Three of the patients were asked to stay one more night in the hospital for observation.  Dr. Sidiqa will head back tomorrow morning to check on the post-ops from today’s surgery before heading back to the clinic to see more patients. 

By the time she reached the clinic today she had 34 patients waiting for her.  So her afternoon was full!

After lunch the crowd seemed to intensify again. There were still patients in line to be registered but the staff was holding off until we were able to work through the current registrants.

One of the patients was part of our complex case care program, whereby the most complicated cases get reviewed on a bi-weekly basis by our doctors in Canada.  This poor woman has severe blistering erosions and ulcers of the mouth.  We’ve been following her for a year and her condition has perplexed Medcan’s global network of specialists.  When we saw her today the condition had improved but apparently it seems to follow a pattern of improvement and worsening.  We took our own biopsy which we’re hoping will reveal the answer or provide more clues.  The procedure was excruciating to watch.  A touching moment was when Vanessa asked the woman if she wanted to squeeze her hand.  The woman hesitated for a moment and then took her hand, not letting go until long after the procedure. 

Another case involved a woman who had 5 children, all separate pregnancies.  The first died after 4 days.  One can’t walk and is blind.  Two can’t walk or talk.   And one is severely delayed and is the one that brings her here today.  She has come with symptoms of puffiness which we did some lab work on and were awaiting the results.  The family situation was, as difficult as this is to fathom, devastatingly, the father of the children actually wanted to kill them as they were too much of a burden.  At that point the mother took the children away and is caring for them on her own.  A strong and feisty woman as you can imagine.  When she said goodbye to us she thanked us again and again and I just looked at her in amazement.  I thought to myself this is one of the most selfless, courageous people I’ve ever met.  I can’t imagine what her typical day is like caring for 4 children in such need, on her own, in this challenging environment.  And yet she does.  Because that’s what keeps humanity going, we care for those who can’t care for themselves.  But I simply can’t imagine how she endures day after day.  It is yet another experience here that will stay with me forever. 

Tomorrow is outreach.  Dr. Sidiqa will be splitting her time between the hospital monitoring the cataract patients as well as the Lewa clinic and then the outreach.  Busy busy!!

The rest of the docs will see a few patients for follow-up and then make their way to the outreach.

But until then, a good night sleep as it will be a full day again tomorrow!

Thanks for reading,