BURKINA FASO UPDATE: June 15- June 3 0

Now back in Djibo after ensuring Margaret’s well being.

I was straight back into assisting and learning from Dr Ken Elliott’s wealth of surgical experience. Hysterectomy, and open prostatectomy and repair of trauma to the chest of a young boy were the operations for the morning list before we started an afternoon outpatient Surgical review,

However after only a couple of patients the wind started outside and soon there was a gale force wind and dust storm which made the middle of the day seem like night time . I was unable to see without a torch and of course there was a power cut at the same time. Sand and dust got everywhere. The dark of the storm turned into blood red sky as the dust cloud thinned and soon enough it was pelting down with rain, much needed but travelling horizontally. This all took about half an hour, and the many people outside the hospital, patients and supporting relatives just huddled down into their cloaks and turbans and waited the dust storm out.

Low back pedunculated mass in a 10 day old baby, cavernous haemangioma next to his eye in 3 month old boy, children with osteomyelitis, man with a pedunculated soft tumour of his palate, 35 year old woman with uterine prolapse, elderly gentlemen with indwelling catheters because of prostatism and urinary retention, a young woman with a vesico-vaginal fistula, an abdominal mass in a 56 year old man with bilateral hydronephrosis and of course a string of inguinal hernias.These were all seen at the clinic that day

The next morning the operating list included the removal of a large salivary adenoma from the angle of the jaw, removing a sequestrum of dead bone from a long term osteomyelitis of the Tibia, repair of an inguinal hernia and more !!

So it goes on from the bilateral plastering of infants with Talipes Equinus to the open prostatectomies on men in a hospital which has no available blood for transfusion.

We operate many times for removal of bladder stones in patients as young as 2 years and as old as 70 years. Another common result of not drinking enough water in this dry and dusty climatic area. Repair of fistulas between the bladder and vagina of women secondary to poor childbirth supervision and assistance is a very common operation. Sadly also to think that for every woman with a vesico vaginal fistula then the baby was probably born dead because of the forces used to push the baby out through a pelvis that was not able to accommodate the baby and no access to Caesarian Section.

Excision of facial neurofibroma’s and mastectomy for enormous fungating fibro-adenoma are some more examples of the enormous variety Dr Ken experiences as the doctor prepared to operate in this part of the Sahel.

Meanwhile outside the Operating Theatre and clinic room the desert starts to green up as the summer rainy season has started with 3 rains in about 10 days and the trees are getting their new leaves and flowers and the grass begins to grow out of the red sand. At last some food is appearing for the goats and camels and donkeys and sheep and horses that are forever on the lookout for the smallest morsels.

Last weekend it was time to go to Ouagadougou to recapture Margaret’s passport from the airport Custom’s office, and get some more money and to send the webpage update to Roger in NZ. After the morning surgery, there is an afternoon bus to Ouahigouya and on to Ouagadougou.

However it wasn’t long before the bus ran off the road on a straight stretch and through some trees before coming to stop in a patch of mud. It had been raining quite hard that morning. What a shake-up that was, watching the bus from inside, career through the green environment, hoping that there wasn’t an abrupt meeting with one of the giant Baobab trees that dot the landscape.

Fortunately it was a gentle meeting with the undergrowth with only minor scratches and bruises sustained. Once stopped, there was a panicked, rapid run to the rear exit by all of the other occupants as though the bus was going to explode at the front; which fortunately, it didn’t. The next hour was spent watching the bus reversing into other trees while trying to get back on the road, while oil leaked from broken pipes underneath the bus. There was considerable damage to the front of the bus but once back on the road, ( three trucks had stopped to help if needed ) it was deemed driveable and off we went.

HOWEVER, within half an hour the bus was stopped again, this time by a torrent of water from the morning’s rainfall, streaming across a concrete culvert. For three hours we waited for the level of the water to abate a little and the current to diminish, and eventually the bus ventured across, before any of the other stopped 4WD traffic did, with good success and a bus full of applause !!

On the bus went, however it was showing signs of illness from the two incidents that afternoon until over the next couple of hours it stopped several times and the bus crew would get out and try and rectify the problem whatever it was. 20km from Ouahigouya however the bus appeared to stop for good, this was about 8 pm, having left at 1;30 pm for what would normally be a 2 hour trip !!At this stage one of the bus crew was inside the bus whacking the gear lever with a large wrench trying to disengage the gears even as the engine was stopped !!!!

Eventually the bus was restarted and for the next 20 km, the bus travelled only in first gear to Ouahigouya, However once there, the next bus to Ouagadougou had already departed a long time before so the only option was to find a room in a nearby cheap hotel and catch the first morning bus to Ouaga to carry out the tasks required.

Of course the trip back to Djibo on Monday afternoon, again by bus was an easy run in comparison and then straight back to work!!

Next week I plan to return to Mahadaga in eastern Burkina Faso to find Bernadette with the severely compromised heart and take her to Ouagadougou for investigations to see if the problem can be fixed by surgery.