Africa Vision 34

Africa Vision 34

N’Djamena, January 9, 2008

Back to Bebedja

In a wink of an eye we were in Mondou. Racing across the smooth road from Ndjamena I managed to sleep nearly all the way. Lady fortune decide to intervene and we spent 3 hours in a garage for Toyota old timers well at least we have a new cooling fan in the motor of the car now and I managed to plunge through Robert Fisk’s ‘The great war for civilization.’ If not to read it can double as a pillow. I went for a bike road across the neighborhood and now know how it must feel to win a stage in the `tour de France. From all nook and corners people popped up to watch the nasara (white man) rides a bike. There are plenty of nasar in Mondou but I guess most of them use a 4 x 4 or a donkey.

The first patient I saw this morning after the morning rounds was a 3-year old boy. As the nurse had taken a finger prick to establish the blood group and I put the stethoscope to the chest to listen to the heart there were no beats. No breathing movements, nor response of the pupils. The child had died. In the hospital we are very restricted in reanimation. Partly because of lack of materials or capacity to treat for example with a ventilator. Partly because patients are presented in such a late stage that the outcome would not be good. In this case the mother waited for a month to come to the hospital while the child had fevers and had not eaten for over a week. It is not always easy but it is as it is.

The burn patient I talked about earlier in the blog has slumbered into a deep coma. After 5 weeks of treatment the pain and the infections have become to much to bear and the family wants to take her home so she can die in peace in her own environment. The two nomadic kids with bullets left the hospital after several days doing well. Right now we are entering the period of meningitis and the first choice medicine ceftriaxone is out of stock. So far there are three cases in two weeks. One child brought in today may be having meningitis as well.

The hospital has received two state of the art echo-graphy machines. One will be placed at the delivery ward so pregnant ladies and those who have gone through a miscarriage do not have to be hauled all through the building. The old one has gone to the out patient department. So a quick echography can be done (that is off course only true if the solar panels are lit). I sped my morning going through all the goodies these new machines can deliver.

Our surgeon is still missing in action and the state doctor pops up or not depending on his blood sugar and/or his mood. Apparently there are some American social scientists working on HIV in Bebedja. I hope to meet them later today or tomorrow. The work art John’s Hopkins a nice public health school. As my fellow doctor Gusto has been all call all the last month he was quite happy to see me. Finally a day not on call. I guess most doctors working in Africa know that feeling. The work just never stops and if you want you can go on and on. We even managed to discuss a bit about telemedicine. There is a prospect of having Internet at the hospital so images and case history can be shared with experts worldwide. We also went into a potential area of our mutual interest: leishmaniasis. I think I might have found leishmaniasis skin test good to do some diagnosis here. And then we talked about potentially the biggest menace in the area HIV. We are thinking about a workshop for the nurses on the social aspects of the disease. The mixture of bars, money, poverty, lack of education, youth, curious believes is a good feeding ground for a HIV outbreak.

Peace,

Ashis