Easter Holiday

      The ambulance rolled in bringing two patients from Kelo Hospital about 25 miles from here. One was a strangulated hernia and the other was a ruptured ectopic pregnancy. I’m not sure why no doctor would see them there or why they got charged for the transfer that was supposed to be free. Someone probably pocketed some money which is common here in Chad. The strangulated hernia was in time so did not have to remove any bowel that was stuck in the hernia. The ruptured ectopic pregnancy would have died had it been much longer. Her abdomen was full of blood and was hypotensive yet was sent with the diagnosis of possible threatened abortion and nothing was being done for her. She survived the trip and the surgery here and is doing well now 2 days later. 

     Later in the day a man was brought in with a huge bite almost down to the bone out of his thigh by a hippo where he had been fishing in the river. We, Danae and I, spent quite a bit of time cleaning it and trying to put it back together and draining it. They say there are more people killed in Africa from hippos then from lions or elephants. A big danger yet is from infection as the hippo mouth probably not very clean and the river water not very clean either. It was the first hippo bite that either of us had seen. 

      And did I say that the first case on Easter was a huge liver abscess that we drained about a liter of purulence from. 

     The baby elephant that has been here a little over a week is not doing very well. He has diarrhea again and is not eating very well and had a seizure Monday. Probably his electrolytes are not good. We have the “elephant lady” from Malawi here now. Packages are arriving with different things for the elephant. He needed enzymes for digestion and stiff nipples and bottles for him to eat from. They are here now. They say there was only about 30% chance of surviving his loss of family, trip to here, and not feeding well and his diarrhea but it was certainly worth a try. Some elephant specialists from Kenya say that for baby elephants under a year old even in the best of circumstances have only about a 50% survival rate. Of course we all hope for better.
      Last week we did a skin graft on a shoulder of an Arabic lady. We had amputated actually disarticulated it at the shoulder because the entire arm was necrotic and infected also quite a bit of the shoulder skin was bad also. We debrided it and tried to pull some muscle over the area when we amputated then let it wait to granulate in for about 10 days. We took split thickness skin from her thigh and placed it over the shoulder area and so far it looks good. She lost her arm because of a benzacaine penicillin injection in the arm that was apparently dirty needle. Still not sure what the injection was for. She has lost also the vision in her eye of the same side, don’t see how they are related. When she first came in I thought she was going to die but now with the infection gone she looks and acts so much better. The family has been very nice and attentive.

Our emails are drbland@sbcglobal.net and dfbland01@gmail.com
Rollin and Dolores