Chinsapo Clinic

Wednesday we went to Chinsapo Village for a clinic. Last year, we held the clinic under the trees. This year, Mirjam Molenaar and her ministry has managed to build a school block, surrounded by a wall, and has a borehole and a separate toilet facility (squatty potties, but important that the children are not relieving themselves in the bush). She even managed to get the bridge repaired! So we held the clinic in one of the school buildings. Charles Msukwa, Clifford Kuyokwa, Alice Li, Jonathan (nurse from ABC), Annullita, and myself were the 'team'. Charles had a couple of volunteers from IBF (local church) and of course, Grace, who works with the Chinsapo ministry. I am not sure how many people we saw. Jonathan started by taking blood pressures and temps, but ended up seeing some of the straightforward patients. It was, as usual, a zoo. I completely understand that I really don't make a difference for people with chronic problems. Oh, we can give them a month's worth of blood pressure meds or diabetic medications, we can give some pain medications for their chronic pain, we can even give cough meds for the unrelenting coughs during this wintry dry season with dust and smoke everywhere. My goal is two-fold: first to show the love of Jesus to the least of these by going into these villages, and second is to find and treat the acute illness / injury. I also try some basic education about wound care (washing with soap and water), chronic pain (most are due to years of overuse of their bodies), and the fact that we don't 'cure' certain diseases and they need to continue with medication (high blood pressure, diabetes). I am not sure how well that works. I always see a lot of people with eye irritations (not infections) from the dust and smoke. If anyone has contact with an ophthalmologist willing to give me samples of allergy eye meds, I would be very grateful. Here they use a steroid eye medication, which is frowned upon in the US.  Several of the patients were 'reactive' (meaning HIV positive) with complications of their disease / medications. One had Kaposi's sarcoma of her leg and wanted me to 'cure it'.  There were some wounds in children that were infected. Lots of fungal infections (skin and hair). A few cases of scabies. One very malnourished, ill child (but Mom stated that child was non-reactive) - Grace enrolled her in the feeding / nutrition program. Lots of runny noses and coughs among the little ones. Seizure patients out of their meds. Diabetics out of their meds. Blood pressure patients out of their meds (I see a pattern here).  We were going to stop at 1, but so many patients were there we extended to 2, and then to 3 but then we had to leave. It is always hard when people still have not been seen. We need a better plan = like cutting off new patients at a specific time, but we are still trying to 'hone' our clinic management skills and it is always hard to tell people with sick children 'no'. I have posted some photos - beware that some are graphic. Also, if you are following this blog and not friended me on Facebook, please do so, there is additional information and photos there. Also, if any doctors are following this, look at the 'rash' patient's photo and see what you think! Enjoy the photos!

Grace addressing one of the groups of patients who have come. The new school block is in the background.

The 'triage' desk where patients get a number - first come, first served. Not sure how many we saw because the families of 3-4-5 all got one number. I do know that I saw a '157' near the end of the day.

This poor man had been blind since childhood, then about 10 years ago what sounds like cerebral malaria - since then he can barely walk, no longer communicates, talks to himself, doesn't sleep at night. His father is his caretaker. All I could offer him was thorazine at night time so perhaps his sleep cycle will improve (for his Dad's sake).

Jonathan and an IBF volunteer taking BPs and temps.

Awesome pharmacy staff!

This lady was covered in this rash for years and years. Seen at KCH and told 'no cure'. I don't know if it is psoriasis? Very unsightly and she kept herself covered. Any ideas out there?

Malnourished child who was taken to hospital about a week ago and given injection. Now with early abscess at injection site. This is very common here - US nurses tell me it is because they give huge amounts of meds in a single shot. This abscess was not opened at the clinic (no fluctuance combined with no real area to hold child / do procedure) but I gave her oral antibiotics, vitamins, probiotics and Grace got her signed up for additional nutritional support.

This wound was several days old. Antibiotics and wound care instructions. 

This poor child had her heel caught in bike spokes 4 days before the clinic. She is two. There was still dirt and grass in the wound. Alice took her to the well and washed the wound, bandaged it (gave Mom extra materials), used antibiotic ointment and oral antibiotics and wound care instructions. Her achilles tendon is intact, but if the infection spreads, it could destroy that tendon.

Packing up - left over patients just hanging out, watching us.

Clifford and I discussing issues with this patient, who had seizures and was out of his medications. See how short our table is? I spent almost all day bent over like this, writing in their books. Hmm, I had chronic back pain by the end of the day! You can see Jonathan and the pharmacy in the background. This is early in the clinic, by noon, every area with a mat was covered with women / children / men sitting and waiting. I would have to step over people waiting to get to the patient I was seeing if I needed to listen to their posterior lungs, feel their back, look at their legs. It gets crazy!