Tuesday, September 4, 2012

Week #2 Nyankunde

We hope that you are enjoying our photos and stories from Nyankunde!

It has been a very profitable time here, a time of learning a new medical system, all set within a very personable culture and language.  We are living in a village where there are no local stores-rather a local market, dirt roads, plenty of houses, and a hospital.  We are surrounded by green hills as far as the eye can see.  Every ridge is farmed.  Nyankunde is a little hamlet of a town amongst the palm trees, a place that has historically been a place of healing.  It feels like a privilege to be here.  Voila notre maison (here is our house).

The yard says "Bon Samaritain"

How can one describe the immersion that takes place?  Suddenly I am conducting rounds in French (or doing my best to), looking at my own ultrasound, examining a child's urine under the microscope, trying to determine the many causes of jaundice in this place, and how to best use rare resources.  There are many children with malnutrition here, and several without parents.  I diagnosed and am treating my first case of pellagra (vitamin B3 deficiency), countless cases of malaria, and even saw a girl with (what I believe to be) a rare autoimmune disease.  So much of diagnosis depends on the physical exam and clinical evolution, not lab tests.  It is a paradigm shift and something to get used to.  Yesterday I was at a child's bedside when the child stopped breathing, and I had to decide on an appropriate intervention.  In the US, I would not think twice about resuscitation, but I had to really think about what supportive interventions were possible.  The medical challenges are many, but it really is rewarding to see children improve. 

Omviti learning the hoyer lift

Other things...Warren is tinkering as usual.  We have almost installed a solar hot water heater on the house.  Our house will run completely on solar, with the exception of a propane stove!  We have been taking showers literally under the stars the last few days.  I told Warren tonight that we should install an outdoor enclosed bathtub for bathing!

We have been running together in the evenings...up and down the airstrip.  It feels good to run again...but will be better when we can take our bikes out as well.

Setting up a new OR building and ICU is a BIG job!  We are really hoping to get things organized and clean, ready to use the facility in January.  I have reviewed my surgical instruments and concluded that there is a retractor for every purpose.  

Brand names are important.  Case in point: "John Dear"

Nyankunde Hospital is behind us hidden in the trees
 The big excitement tomorrow will be the planting of our garden...stay tuned.  Love that "John Dear" wheelbarrow!

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