Janie Hemphill’s Blog

Final post from Nalerigu

There were over 60 babies on the pediatric ward Thursday night.  The floor was covered with mothers and babies trying to get some sleep when I came through at 10:30.  Instead of having a bed number, the charts said ”floor” at the top and the nurse called out the name of the one I needed to see as we waded through the bodies, trying not to trip or wake them up.  I braced myself for the sight of the ward the next morning as I walked through the door.  It didn’t look as scary as I expected it to, but then the nurse let me know that 15 babies were waiting with their mothers outside until I finished seeing IV beds.

There have been a few memorable cases throughout the week.  Last Friday I was given a patient’s card in clinic that said, “bitten by mad dog 1 week ago”.  That was the first time I ordered a rabies vaccination series.  His dog had started biting other dogs and then bit him before he was able to kill it.  I saw a case of tetanus for the first time as well.  The man had lockjaw and very tense arms.  He was sent to the isolation room within the isolation ward because part of the management of tetanus is to limit the amount of stimulation from light and noise.

Carpet vipers were fiesty the other night.  I had to get 4 viles of ASV to the wards in just one evening.  I was handed a chart that I expected to be a routine case, but when I got to the bed it was a 7 year-old boy and he had blood all over his face and ankles.  I hadn’t seen a snakebite victim who was actively bleeding, which is the outcome we treat to prevent.  Unfortunately, the boy’s tribal markings were placed the day before he was bit and the anticoagulant venom was causing them to bleed.

One new admission on my last call was a very weak 14-month old boy whose belly was distended.  I got Dr. Faile and he pointed out that the outline of loops of bowel could be seen on the tight abdominal skin.  We took him to the operating room late that night and found that the bowel was inflated like a balloon and there was an intussusception in the ileum.  It reduced well and I left feeling great that I had the opportunity to see an intussusception case from the time it presented through the operation.  I was not expecting to get a knock on the door at 2am to come see the child.  I guess he was just too weak before the surgery and didn’t survive through the morning.

Saturday I went to the market to find fabric for Joyce to make me a dress.  That night, she and Yisah invited Julie and I to dinner in their home.  Yisah handed us the 2-foot tall broom you have to bend over to use, and the dust pan, and told me, “Janie, you are going to work in a traditional African home today.”  So Julie and I swept the courtyard where the cooking would be done.  She had a few ingredients brought from the market to make banku.  I stirred the fermented corn which would become large balls of a playdough-like substance that we would pour a spicy stew over.  In Africa, eating is done with the right hand.  So we passed around the bowl of water to wash our right hands before eating the banku.  It’s not something I would want to eat again, but Julie and I kept putting another bite to our mouths because we were so appreciative of them inviting us over and taking the time to teach us a few things about their cooking.

This will be my last post before leaving Nalerigu.  I’ll spend one night in Tamale before leaving early the next morning to fly to Accra.  The next couple days will be a frenzy of picture-taking and getting all the information I need to stay in touch with people here.  You’ll hear from me in Accra, and I’ll add pictures to all of these posts when I get home.