Sunny Days and Black Clouds

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This afternoon we had a long break so Pam took us out to lunch at a place called the Tea Pot. It is an outdoor cafe that is in the middle of a garden center so it is surrounded by lovely flowers. The weather has been beautiful, high 70s and sunny every day, so an outdoor lunch was really nice! On the topic of weather, it has warmed up enough at night now that we no longer have to sleep in long sleeve shirts and socks. Also, when you look at the weather forecast the chance of precipitation is 0% every day. I'm pretty sure that at home it always says at least 10%. Try not to be too jealous 😊

When we got back to clinic we walked into a 7 year old on a stretcher who had been transferred from another hospital after spending a month there. The medical officer was not there yet (in fact she didn't show up until 4 pm) Katie was brave and volunteered to tackle the admission. You know what it is like to get a transfer from Moses Taylor that has been there for 2 weeks and you have no idea what they have been doing...that was this admission. He was very ill, but was very interesting from an infectious disease standpoint. He has HIV, possible TB, and was transferred due to convulsions. He is severely malnourished and I am not sure if he will make it through the weekend. It is a very sad case because his mother died from HIV and his grandmother is all that he has.

In the meantime I had 2 admissions of my own. The first baby I saw was 5 months and the weight of a 2 month old. Mom claimed she was feeding the baby 33 oz a day of formula but it seems pretty unlikely. The baby has pretty classic marasmus (malnutrition) To make things more interesting, she also has choanal atresia (unformed nasal passages) and ambiguous genitalia and I couldn't read what the specialists had said about these findings. The other admission was a kid with bloody vomit and diarrhea who has been admitted and worked up twice in the past and found to be normal. Wish Dr. Tron and Dr. Peters were here to help us out!

For any of our infectious disease friends who may be reading this we are having a bit of an argument with the medical officers here about TB diagnosis and would love your input. They say that older kids who are able to give a good sputum sample do not need to get a mantoux test because it will be positive in everyone anyway. We think that you can have sputum negative but mantoux positive TB and that it should be done on anyone you suspect to have TB and the books we have here seem to support us. Any thoughts?

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Photos

The little girl I thought might have CF
They are Baster. (the word comes from where it sounds like it does) They are a mix of African and German.

The 8B team
Dr. Mphosa, Lorraine, Me, Sarah, Sinya with Jessica and Annita in front

The 8A team
Rustem, Elia, Katie, Betty, Sebastian

Comments

[Richard Gair]

What are you doing in there?
I hope this picture was taken outside the mens room when no else was watching...they might think we Americans are lurkers? LOL Continue the wonderful work you are doing. How long will you be there?

[Aunt patty]

Amazing Trip
Hi Lauren and Katie. The both of you are truly amazing. This trip you guys are on and the work you are doing there looks awesome. Been following your blog and find it truly interesting. Have a great time and be careful. Luv ya

[lmorea]

Yes we were outside the bathroom :)
We will be here through the end of august