Liberia 2017

Kwendin #14 | March 1, 2017

Yesterday at supper I looked around at the sky and could hardly see a cloud. I made the comment to Bob that we were very unlikely to get rain.

Just after supper Bob was outside for a minute and said he could see a few flashes of lightning in the far distance.

Within half an hour the lightning was easily visible.

By 8:30 it was crashing all around us. A few dramatic forks of lightning hit within a kilometre or so. And the rain came, not for long but long enough to give us another 100 gallons in the tank. And what a difference in the air temperature. Before the storm it is so hot and sticky and muggy, and afterwards it is cool and comfortable, all night long.

Today we hit the ground running. I knew I only had the morning in the clinic and we had scheduled a fellow to have a lump taken off his scalp. Before we started on him, we looked at the infected knee (healing nicely) and the infected hernia (also healing nicely). But the scalp lump was much more difficult than I had imagined. It dissected out nicely but the scalp edges kept on bleeding despite my efforts to over sew the bleeders. It went on for over an hour and eventually we got good control.

I ended up only seeing patients who needed surgery or had had surgery, until it was time to go at 12. One in particular was a fellow who had inured his foot in a motorbike accident 2 weeks before. The whole top of his foot was dead and stinking. I trimmed off some of the dead tissue and we wrapped it up with a nice dressing and put him in the car to take with us to Tappita for further care.

Kate and I arrived at the hospital before 1 and all our patients were waiting for us. The three out patients--the fellow with the swollen jaw, the fellow with the abdominal lump, and the injured foot--waited quite a while during the time we admitted our hernia patients. We had booked 5 and asked a sixth one to come in case of a no show, and it turned out we had 5 people show up and admitted them all. Kate led them through the admission process while I worked on the out patients. And while I was waiting to get them registered, the surgeon came by so I had a chance to talk to him. He was completely happy to see them and told me to bring them to his office once they were registered.

He was interested in them all. The fellow with the abdominal pain is booked for an ultrasound later this month when the tech comes back from vacation. The fellow with the jaw mass will get an xray tomorrow morning and Dr Asaye will take it from there--he had some ideas of just what kind of bone tumour it probably was. And the fellow with the foot injury got admitted for lab, xray, debridement in the OR and iv antibiotics. Dr Asaye will manage him.

I went back to the ward and finished off the paperwork on our 5 admissions and we were ready to come home. Our driver Mohammed was waiting for us and off we went. Bob had spent the afternoon in Tappita wiht George, buying some building materials and some fresh bread. We drove home with a 10 foot pipe sticking out one window of the car, and a rolled up set of galvanized corrugated iron sheets sticking out another window. We really felt African. Should have had 5 more people and a goat inside the car, though.

We paused as we went by the clinic and saw Kristie waving to us. So we drove down to the clinic and it turned out there was a lady in labour and also a few more patients to see.

Kate and Kristie joinned the midwives and within half an hour Kate had delivered her first baby. It was a bit slow to cry so Kristie came to get me. But the midwife was doing well stimulating the baby already, so by the time I scrubbed it dry with a towel it cried nicely. it was the first baby Kate has ever delivered, and the first delivery Kristie has ever watched. Once everything was cleaned up a crowd of the village women came in and there was exuberant dancing and singing. Such a privilege to be part of the whole process. Both Kate and Kristie were just shining with excitement.

Meanwhile my fellow with the scalp lump had come back to see me. His dressing was soaked with blood. So I had another look. There was a little ooze of bleeding from one end of the incision. I put freezing in and put two more sutures in and the bleeding stopped nicely. Thank you, God.

And we walked home. Bob had some fresh bread and we opened some canned tuna, and Kou fried up some plantain and some onions and there are still lots of bananas to eat. A good supper.

Dr. John Potts