First Day at Nixon Hospital Part 2

Ah! I should always remember that nothing is as planned in Sierra Leone!

For one thing, initially they had said we were going to surgery, but of course, they ran out of suture and there was no more petrol for autoclaving the equipment.  So it was a day of rounding the inpatient patients and clinic.  

Immediately, it was clear that the problems were different from the U.S.  The first lady came in with continued discharge.  We felt her abdomen, and there was a huge mass in her lower abdomen as well as smaller masses elsewhere.  She had actually presented 4 months ago with a mass in her cervix with discharge and told to go to Freetown where there are pathologists to analyze her tissue, but she never went.  So today all we could do was send her to Kenema - a larger city 30 min by car - to do an ultrasound.  When the doctor told her everything, she was sitting there with tears streaming down her eyes.  

Meanwhile, we also had a kid present with possibly scabies all over her body, a nurse with tinea corporis on her inner thigh, and another child with possible pneumonia.  There were also the typical diabetes and chronic hypertension patients.

There was also another man who came in for TB follow-up who still tested positive for TB after 1 months of treatment.  I was kicking myself for not having my TB mask today, but the doctor didn't seem to be too concerned.  Hm...

There was bound to be someone with parasites, and sure enough, there was a man who's stool had S. Mansoni ova in it. It was the first time I've actually seen the egg under the microscope.  It's so gross...and now it makes me afraid to take baths.  

The first thing I saw when I entered the lab was a young man cranking something, which to my amazement, turned out to be a centrifuge.  I had never seen a hand-cranked one before!  I was also amazed to see them do the Wiedel (sp?) test for typhoid fever on a broken piece of tile.

The inpatient wards were pretty standard, nothing too shocking.  But maybe that's just because I only understood half of what they were saying.  I will definitely need an interpreter.  

I also discussed business this morning.  I arranged to have dinner every day for Le 20,000, or $5.  I think it may be considered a lot, but I don't really know.  Ah well, I'll be tired and not want to make food for myself.  I also don't really have a way to make food myself since I don't have a stove.  Although there's the option of borrowing someone's stove and buying some charcoal.  I may try that on the weekends...we'll see how adventurous I become.  

Ah!!! Scary noises = scary bugs...time to sleep!