Monday, July 9, 2012

Rocks in the head, 6 July, 2012

Some people have “rocks in the head” but how about a real rock in the head.  A little boy was brought in yesterday that had put a rock in his ear and someone else had tried to get it out so it was wedged down as deep as it could get.  We gave him some Ketamine (something to make him sleep for awhile) and tried various things to try to get it out but were unsuccessful. We told them to bring him back tomorrow and we would try again. We gave Ketamine again today. Samedi tried for awhile. He had found another metal instrument, a probe that might help. Danae also tried. Olen was in N’Djamena.  By now we were sure that the ear had been severely damaged but we still need to get the rock out. I said that I would try one more time before we gave up. I cut in the canal, (probably a no no) and tried some more with a little thumb forceps. The rock moved a little! then I twisted it around a little and voila it finally came up and out.  We put it in a little bottle and gave it to the father who was very grateful.  We packed the ear with iodoform gauze and gave the boy antibiotic and hope he doesn’t get severe infection in his head.    

Today is also a “crappy” Friday. The main toilets or latrines for the hospital caved in about 4:00 a.m. today. It appeared that they had not been built very strong and now the walls caved in and the floor all broke apart and the roof fell to one side. It has been enough of a problem anyway to get people to use the latrines instead of just doing it in the hospital yard in the grass or somewhere besides in the latrines. There is still another set of latrines by the Tb ward that they can use. The employees have a different toilet to go to that has water. Most people here don’t have any concept of how to use a flush toilet.

We have also had problems with our electricity. The fuel line to one generator somehow got severed and drained the tank dry. I put the line back together and filled the tanks with fuel but then the battery to start the generator was dead after I had bled the lines etc. The other generator has a “reverse power” signal that shuts off the generator and so far we have not found what is causing it.  It is not consistent as it works ok at times.  (Sunday  Gary Roberts brought over a battery for the Cat generator and it starts and runs ok now)

We have a little girl that had a “limb fall on her head” and has been unconscious or partly conscious for the past two weeks. We “observed” her for several days then decided to drain the “hematoma” on the top of her head as it seemed that she had a depressed skull fracture also. With almost no anesthesia we shaved her head and opened the area involved. When we opened it there was some bloody fluid and brain material that came out. The stellate fracture was minimally depressed. We irrigated and put in a drain which has drained clear serosanguinous fluid since but minimally yesterday so removed the drain.  Prognosis is grim for her.  She has been able to swallow a little liquid. 

It is malaria season now with all the rain.  There are lots of sick kids especially and often they are brought in just before they die. Sometimes 3 or 4 may die in one night.  Hey this is a hospital where we are supposed to save people but...  

How do you treat diabetic ketoacidosis with no lab and minimal meds. Sometimes the insulin works and sometimes it seems it has been in the heat too long. We have no metformin and only glipizide to treat with. Fortunately there are not very many diabetics (probably most have died off).  We also have problems with hypertension but have only propranolol and nifedipine to try to control the blood pressure. It seems that the most common hypertension is preeclampsia or ecclampsia but there are some others.

It is raining a lot lately and is nice and cool, 70’s and 80’s. The roads are hardly passable much of the time. Olen and Danae finally have their car, a Toyota Forerunner diesel 4 wheel drive. It was being driven home and got stuck on the main road from Kelo to here and had to be dug out.  Perhaps it was off the side of the road somewhat but it is difficult to tell where to drive in the deep water and mud sometimes. 

Kristin, Olen’s sister, came and is to arrive here in Bere today on the little plane with Olen and Gary Roberts coming from N’Djamena where she arrived yesterday from the US. This is her first time to be in Africa

Now it is Sunday, 8 July. It rained more last evening but the clouds were dark and beautiful and made a very nice background for some pictures around Bere. It had sunlight in the foreground at least part of the time and had houses, cows, goats, guineas, etc in the foreground.  I got back to the house about the time it began to rain.  Today there are nice puffy clouds. We had our usual week end, c-section yesterday afternoon. It seems there are more on Saturday than other days. 

We will miss going to Oklahoma Adventist campmeeting this year as it begins next week end. It was always such a great place to meet old friends as well as great spiritual meetings. 

Love,  Rollin and Dolores
Emails: and 
Mail:  Hopital Adventiste de Bere, 52 Boite Postale, Kelo, Tchad, Afrique

No comments:

Post a Comment