November

Have been busy compiling statistics for the monthly report that we send to Kampala. After they have reviewed it there they send it on to the Paris office where all decisions about this project are ultimately made.  There are five MSF operational centers in Europe and all MSF projects throughout the world are run by one of these centers.  Currently only MSF Paris and Epicentre (MSF's epidemiology division) are operating projects in Uganda.

One of my jobs is running a weekly hour long educational program for everyone who works at the health center.  This week I asked our visiting epidemiologist/MD, who is a world expert on sickle cell disease, to give us a talk. He gave a good presentation and got everyone in the audience wondering about their genetic status.  Uganda and the west coast of Africa have the largest concentration of people with sickle cell disease and most of the kids that have it here die by age 2.

Some of my patients this week:

-3 kids with severe acute malnutrition (SAM)

-a snake bite—did ok without anti-venom which we have

-toddler with burns on his chest, back and thighs (we get a new one of these every week due to the cooking being done at ground level)

-severe malaria (many cases, and a 17 month old that died from it after poor treatment at a drug shop)

-pneumonia (many cases in kids under 5)

-stroke in an old man (anyone over 40 is old here!)

-8 year old with a huge lump on the side of her cheek.  She's supposed to get surgery in Kampala but the United Nations agency which will pay for it is out of money until January

-2 young boys with broken arms

-women with a miscarriage, malaria and severe anemia (I typed and crossed the blood with the midwife and transfused her)

-adults with asthma with acute attacks from being out of drugs

-9 year old girl with malaria that had had cuts made on her upper arms and forehead to “heal the fever”

-possible TB in HIV+ woman

-child with large abscess under her chin
-1 week old with a large breast abscess

Happy baby recovering from pneumonia

Child with asthma in our "playground"--the dirt

During rounds one of the caretakers of a 5 year old with malaria started crying.  We asked her what was wrong and discovered that at age 14 she had been left to care for 5 younger siblings while her mother went back to South Sudan.  

It's getting hotter here.  Spent Sunday afternoon playing trivial pursuit and watching a movie in the air conditioned pharmacy.  When it cooled off around 6 we had a badminton tournament.  I was paired with our French logistician and we won!