Who did I find on the children’s ward?

I thought a lot of people may be interested to hear the types of illnesses that some of our patients are hospitalised for.  So here’s a snapshot of some of the children on our children’s ward one day this past week.  All names have been changed to preserve anonymity.  Warning: there is some medical talk in this blog, so don’t read on if you’re squeamish or prudish!
Ward round on the children’s ward –
Dr Augustin one of our local doctors in the white coat,
Emilie a short-term French nurse
and Moussa one of our local nurses

Child 1
Mariam, aged 3, had been admitted two days previously for malaria.  It’s not really peak season for malaria at the moment (it’s not rained since October and so there’s very little standing water around, which mosquitoes need to breed in).  However it’s still possible to get malaria.  Unfortunately Mariam’s malaria had not been properly treated in the recent past.  Often, before ‘resorting’ to coming to the hospital, people try and treat illnesses either at a local health centre, or by traditional medicine, or they buy products from street medicine sellers.  All of these methods are much cheaper than coming to the hospital but they’re not always successful.  After admission to us, Mariam received injections to treat her malaria.  She was much improved and was being discharged on oral medicines to complete her treatment.

Child 2
Hassan, aged 7, had been admitted a few days earlier with trauma to his abdomen after falling from a camel.  He is from a nomad family and they all own camels to transport their belongings and families.  After undergoing an x-ray and an ultrasound, it was proven that he’d not done any major damage internally which was good news.  He had blood in his urine though, which showed that he had done a bit of damage inside.  So he had been catheterised and monitored to make sure that he wasn’t losing lots of blood.  A few days previous to this ward round I’d seen Hassan very sleepy on the bed and not alert at all.  But this ward round he was sat up, smiling and alert which was good to see.  His urine was flowing clear and so his catheter was removed.  His father was told that as soon as he passed urine normally, he could go home.  Smiles all round 🙂

Child 3
Ali, aged 9, had been admitted a few days earlier with an abscess on his outer left thigh.  It is unclear how he got the abscess.  Maybe he’d been given an injection in another health facility and it wasn’t done in a clean way?  Maybe he’d cut himself somehow and the wound just didn’t heal properly or quickly?  We end up working with a lot of unknowns!  Ali was two days post-op, having been to the operating theatre to have the abscess opened, drained, cleaned out and dressed.  He was now on painkillers and antibiotics.  The dressing was due to be changed on this ward round and so he was given a small dose of sedative to help with the pain of that, as the wound he’s left with is pretty deep.

Child 4
Abakar, aged 5, was hospitalised for osteomyelitis (bone infection) in a bone on the side of his left foot near his big toe.  I asked how he could’ve ended up with osteomyelitis, as this is a deep-seated infection that takes a while to develop.  The doctor said he’d probably injured his foot maybe playing football or kicking a stone.  The wound may’ve appeared to heal over but actually inside the ‘healed’ wound, it wasn’t clean and infection kicked in.  Abakar had also already been to theatre and had the wound and the infected bit of bone cleaned out.  He was on antibiotics and painkillers.  He had his dressing changed after having been given a bit of sedative too.  He needed ongoing dressing changes but he was discharged, to come in as an out-patient to the dressing clinic to have these done.  This is fine but ideally he should’ve stayed on the ward a while longer to ensure adequate pain relief and antibiotic dosing, but his family didn’t have any more money to pay for his inpatient care.  So the doctor had no choice but to discharge him.  Despite not being ideal, as long as he comes to dressing clinic, he should be ok and heal up well.

Child 5
Saleh, aged 10, had been admitted the previous night after having been bitten by a snake.  This is a pretty unusual occurrence here in N’Djamena, there a fewer snakes than you may imagine.  He’d been given ‘anti-snake bite’ treatment and painkillers and was being discharged as he was doing well.

This is just a snapshot of some of the patients we’ve had as in-patients at Guinebor Hospital in the last week.  Watch out for another blog in the future where I’ll describe some other cases we’ve seen here.