On Wednesday, we joined forces with a team from Washington State that included two nurses; a group from California that included a doctor, pre-med student, EMT and nurse; along with our nurses from ABC, Carson and Becky; and the high school student, Kristen, who has been shadowing Carson and been such a help on village clinics. We also took 4 translators - Oscar, Charles, Esnart and Sandram. We all piled onto the bus and the Epperson truck and away we went for the 2 plus hour drive. Sam Kawale (Gusu is his ancestral village and his 'ministry') came with us and gave everyone an idea of what they are trying to accomplish in this village - health care, food security, spiritual growth, education and micro finance.
We arrived to find a line of patients waiting. Everyone pitched in and we ended up seeing over 300 folks (I didn't keep count, Becky did this!) We saw the usual problems - many of which are worsened by their lack of routine care, general hygiene, and understanding of basic health care. What we take for granted - washing wounds with soap and water, keeping them covered, taking Tylenol or Motrin for pain / fever, protecting yourself and your family from breathing in dust, smoke and other pollutants, washing your hands after the toilet and before eating, kitchen 'hygiene' for lack of a better word, clean, safe water.... these things are either not known or not available. As Joseph says, there is no CVS around the corner! The dust and smoke (from fields being cleared, trash burning and cooking fires) are non-stop. It gets in their lungs and causes chronic coughing, it burns the eyes, the sparks from the fires can burn the corneas, kids (and adults) with seizures can fall in the fires... the list goes on and on. It can be overwhelming. The government appears to be short of medications, so many people we see know they have a medical problem but were getting their medications from the government facilities - now there is no medication and they have no money - or transport- to go to a pharmacy. There are no medicaid, medicare, indigent care, food stamps or other welfare programs here. The medical system is socialized as best as I can tell, with the poorest people getting free or low cost care at government facilities. Unfortunately, if the government is out of something, that means the patient is out of luck! Transportation alone can be a huge challenge - most people walk everywhere. Lucky ones have bikes. There are a few motor bikes. The village folks don't have cars and the minibuses only come along the main roads. It can be very sad and very frustrating. I always hope that we make a difference in some lives when we are there. On the bright side, we saw Taona, the girl we found in this village 6 weeks ago with an open fracture. She is back home, walking on an almost healed leg with good range of motion in the knee and adequate strength in the leg. We also saw Jonas, the little boy with the seizures who had fallen in the fire a couple of times and had infected burns. He was almost totally healed from his burns. I gave the dad a crash course in scar management (thanks to Sue Cantrell for teaching me that!), and we refilled his seizure medications. He had only had one seizure since we started him on dilantin. We were excited to see these two kids doing so well! For the medical folks out there - we saw a child with a diagnosis of sickle cell disease (he will probably not do well in the village), who also had some type of heart problem (the government hospital noted in his health passport that they thought it was VSD, I am not sure). He had significant clubbing. I saw a child that I am pretty sure has Down's syndrome - but no mention was made in her health passport and the Mom did not know she had any health problems. She was there for ear infections. Another older guy who smoked (pretty unusual actually - they grow their own, but most sell it as a cash crop, they don't smoke it) - he was short of breathe and had clubbing. A child with a hand and foot rash - looked like terrible eczema, but her nail beds had changed so she might have had a psoriasis problem, too. Lots of minor wounds on legs, one gentleman who had pulled a thorn out of his thumb 2 weeks ago, now he had massive swelling of the hand - however, since it was not red or hot and only minimally tender, we thought we should not open it up there, but send him to the hospital. Another man showed up with the worst foot wound / infection I have seen here. He said it was 5 years old and denied any trauma as the starting point. However, it looked like ~1/3 of the sole of his foot had been exploded - whew and it stank (like pseudomonas!) It was nasty, nasty! I think he may have the infection in the bones as well. We washed and bandaged, but told him he needed to go to the government hospital. The last gruesome case was a lady with a lesion on her heel. It had started 3 years ago with a small area that bled, then it began to grow and turn black. It had not grown lately and was minimally sore to her; to touch it was rubbery and not particularly tender. Dr. Mike and I consulted - we think it was probably malignant melanoma, although the history doesn't fit exactly. Using an interpreter you never know, though.... we referred her to the government hospital. If is it melanoma, she does not have a very good prognosis at all. After we finished the clinic, while on the way home - bouncing in the bus, exhausted, dusty, mentally fatigued, we got a call from Fredna Brown. They invited us to dinner - what a wonderful thing! We got cleaned up and went to their house for goat stew, rice, cornbread and chocolate pie. It was heavenly! And we always enjoy our visits with the Browns - they have a great sense of humor and tons of funny stories.
Thanksgiving / praise - travel safety; friends such as Gaylord and Fredna Brown to fellowship with here in Malawi; supporters in the US who give so generously of their money, their medical supplies / clothing and their prayers!!; Taona and Jonas and their recovery; the safe arrival back home of Sue and Katie.
Prayer: our continued road safety and ability to find fuel; that somehow we touch lives in a meaningful way, even when we are fatigued and discouraged; that our families back home will stay safe in our absence; that we can be a mirror to reflect Jesus at all times.
Photos:
The bus and the truck.
Taona and her family in front of their home
Distributing clothing brought by the Washington State Team
Dr. Mike and Oscar
Joseph seeing patients
Hand lesion with nail involvement
Clubbing in older man
Two photos of Jonas's healing burns
Me holding child with possible Down's syndrome
Family portrait
Foot lesion - malignant melanoma?
Hand that had thorn removed, hand still swollen
Foot wound
Entire set up at the front of the church
Dr. Mike and Oscar
The pharmacy set up
Me,laughing at something Joseph said...
Shop on the way 'Slow but Sure', on the dust road to Gusu.
A little guy watching us roll by
The bus - Sandram and Carson with a member of the Washington State Team
Same Kawale as he talks about Gusu.
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