Medical Clinic in Kangama

by Heather Quinn

After a good nights rest, we ate breakfast and packed up for our hour and a half drive to the Kagnama village. Before we started off, we said a prayer as a group. We planned to do a day long medical clinic there in the health center and continue to gather public health information. Today was a Muslim holiday so the children didn't have school and a lot of businesses were closed. About 60% of the SL population are Muslim and 40% are Christian. 

On our way to the village, Phebian received a call from the CHO in Koidu hospital that is caring for one of our patients who had a hernia repair a month ago. A month post op he developed abdominal distention and swelling. Today he developed fluid in the lungs and delirium. Phebian gave the phone to Kirk to give some orders for care. The MD was out of the hospital today and won't return until tomorrow. Kirk gave orders to give LASIK, stop IV fluid, and monitor output. He's being treated for worms and malaria as well. He spikes fevers every few hours. We promised to go visit him after the clinic today and keep him in prayer. It seemed like he's in acute liver and heart failure with previous worm and malaria infections. Unfortunately the X-ray machine was broken at the hospital so there was no way to verify the diagnosis. The sonogram was done yesterday and showed an enlarged liver and abdominal fluid. In the US this would have been more easily diagnosed and treated. 

We arrived at Kangama at 11am. We already had patients waiting for us. We set up a 'pharmacy' in which I was the pharmacist with Alfred. He was my assistant and interpreter. Kirk and Vickie started seeing patients. We had 85 registered by the time we got there. People walked as far 7-10 miles to seek medical care. The village midwife registered the patients. Pastor Joshua was with Vicki interpreting. Phebian was with Kirk assisting him. Olivia went out into the community to gather data on water sources, community programs, the role of the midwife and TBA's (traditional birth attendants), and other important information. 

We took a quick lunch break around two. Vicki and I switched positions. I saw patients with Pastor Joshua and she acted as the pharmacist with Alfred. The most common things we saw were malaria, intestinal worms, HTN, constipation, skin rashes, cysts/abscesses, lipomas and headaches from dehydration and dizziness probably from either anemia or HTN. It was an interesting day. There was one case I saw in which a 25 yo female had a c-section in 2006 with her first baby and since then had no period and no subsequent pregnancies. She did have pain over the incision site but no other GU symptoms. My suspicion was adhesions in the uterus preventing her from getting pregnant or getting her period. I explained this to her then prayed over her and gave her vitamins and Tylenol for pain. After discussing this case with Phebian, it turns out that in SL sometimes the provider will remove the uterus without telling the patient if a c-section goes wrong. I was shocked at this! How horrible!! Now I know the likely reason of her complaint. I wish we could confirm with a sonogram but we can't. My heart goes out to this young girl. These are the types of things that the people have to deal with. I couldn't help but think that the people look really worn out, that life is hard - I could see it in their faces. Whether they are dealing with emotional or physical or social hardships. Life looks hard. 

We all felt like today was a huge success and we had a lot of fun! Even though the reality of their life is hard, they are loving and welcoming people. It's so humbling and endearing to interact with them. They wanted us to stay longer in their village. We told them politely that we'd love to but we have several other villages to go to. Today we probably saw over a hundred patients. Kirk went to visit the really sick hospital patient who seemed to be doing okay. There wasn't much charted in his chart as far as his treatment and the CHO didn't seem to know much. He was in training and doing the night shift. Pastor Joshua prayed over the patient. Phebian was really advocating for this man's care. She truly cares for her people in need. Tomorrow we plan to go see him again on our way to the Tafaye village. We will do community education there. A good change of pace from the hectic medical clinic day today. After we returned to Uncle Bens, we had a good evening debriefing and just hanging out. 

We love it here. God is with us. Keep us in prayer.