Monday, June 4, 2012

4 June I love green

Here in Chad it is getting green since the rains have begun.  A lot of crops have been planted and some are beginning to grow.  One can see young rice, millet, beans, watermelon and other things as one walks around some of the “fields” that have been worked up mostly with a plow pulled by a team of oxen. Occasionally one can find a tractor but they don’t seem to know how to drive it with a plow or disc very well. A month ago everything was brown now is is green. Some of the trees and bushes have put out new leaves also. We perhaps got two inches rain today.    
Oh yes I love green backs, especially Ben Franklin just like anyone else. 
I like lots of color such as in some of the flowers that are beginning to bloom and the birds that have come in since the rains have begun and there is more for them to eat.  Some of the sunbirds and warblers  are very pretty and have such sweet songs.  Although the colors on the rollers esp the Lilac-breasted roller and the Abysinnian roller are very beautiful.  God is the best artist there is with all the color that he arranges including the sunsets and the beautiful clouds.
I like the color pink especially on eyelids instead of very pale from severe anemia such as Hemoglobin of 2 or 3.  Chronic anemia is very common. Much is caused by chronic malaria and various parasites as well as some from chronic malnutrition.  
We had another day last week with two appendeceal abcesses. The leg amputations are all doing well with sutures out and using their crutches to “walk” around. The boy with no skin on much of his lower leg and had a contracture of knee so he could not walk now has had a split thickness skin graft that has mostly taken and we straightened out his leg during the anesthesia. He now is walking although that leg is very weak yet. They boy with a crushed hand that had the thumb and index finger missing and much skin missing now has had a skin graft but we haven’t unwrapped it yet to see how it is doing.  We got a lady in two days ago that had a C section somewhere else several days ago and they didn’t close it properly. She came here with severe severe infection and the wound is open. I debrided some necrotic tissue and now one can see the uterus that fortunately is keeping high and helping to hold the intestines inside.  It probably will have to heal in by secondary intent. We saw another lady today with vesico-vaginal fistula but we can not help her because it is caused by a large cancer in the apex of the vagina.  She had had a previous hysterectomy somewhere else about 2 yrs ago. We had a lady recently that could hardly swallow liquids and not solids. We opened her abdomen and stomach and put in a G tube so she could be fed.  We don’t have CT, upper GI, or gastroscope but ran rubber dilator up her esophagus from the stomach and it hit an obstruction in the upper chest and some blood came down so we think she has cancer in her upper esophagus.  Maybe the G tube will help her for awhile.  We saw a man  a few days ago with a large non tender mass in his mid abdomen. We aspirated some clear yellow fluid from it. It is not connected to bladder. We had a catheter in the bladder. Don’t know what it is yet and he has not come back in for surgery yet. 
Olen, Danae, and I have been looking at various plans for possible new buildings in the near future for Bere Hopital.  How many ways can you make a new OR and maternity with the limitation that it has to be in a building not more than 21 feet wide but can be whatever length in multiples of 3 feet.  We are hoping this will be built before a year from now. The colors are optional as long as it is earth brown which is the best because it won’t show the harmattan dust so bad that comes in dry season esp Jan. We hope to have a Nursing school started within a year. The lady to direct it is here now to begin putting together plans and curriculum for it and fit it into whatever regulations there might be. Her husband hopes to get a radio station started.  
Zane seems to be doing better now hopefully. He finished the course of ceftriaxone. He is afebrile today and hopefully will stay that way. He is standing alone and tries a take a step so it won’t be long that he will be walking I am sure.    
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