Added to site: Wednesday, 22 July 2009
Back on the road to revisit Sheltering Wings Orphanage at Yako, Margaret (Tauranga) has plans and a vision for increasing the play/learning resources for the young children, and benefiting the older children also, with an outdoor safe play area with easily made components, under the shade of large trees that are already on site, in a suitable area. I deliver some much needed children’s medicines to the small first aid post staffed by 2 Burkina short course trained nurses. While these two have been working in the orphanage, Ruth has noticed a reduced need for child hospitalizations in nearby Sentra Medical.
By public transport, Margaret (Tauranga) and I are soon in Ouagadougou and the next morning heading east to start the plan for Bernadette, to clearly document her heart condition so we can take steps to improvement. Two days it takes us to travel the 500 kms that starts as a bitumen main road with army escorts on the bus to deter bandits, to the final 55 kms of dirt track where there is an irregular once a week bus service, which has no timetable, as no one can predict when the bus will breakdown !!
Fortunately we met up with someone who knows the Mahadaga hospital manager Mambagari and is able to contact him in Diapaga the provincial main town and ask him to wait for us and take us the final 2 hours to Mahadaga.
As we drive into the small town of Mahadaga in the dark of early evening, we meet Bernadette who jumps for joy and her face bursts into a huge smile of hope when she sees me ,she feels she is nearer getting fixed, from the constant feeling of a heart pounding her, from the inside of her chest.
On the way to Mahadaga, we already had met in Fada the man from Niger, who Gavin, Tessa and I had identified some weeks ago as having osteomyelitis of his lower leg
He was in hospital for dressings, the needed surgery was outside the experience of the hospital, and they had done nothing other than feed him, (supplied by the SIM missionaries in Fada), for the past 10 days. The local association of Niger people was having difficulty knowing what to do from here.
He was actually smiling and walking quite reasonably despite the piece of infected bone sticking out of his shin (under a bandage of course). Clearly he needed definitive surgery to remove the infected dead piece of bone, this could be done by Dr Elliott in Djibo, but he needed at least 1 friend or family member to support him for his time in hospital or he needed to return to Niger, and to maybe visit the SIM hospital, not far from his home, in Niger, to get the surgery done there. This man is alone in Burkina and unwilling to return to his family in Niger.
The morning after we saw him, Rob from SIM, Fada, took him and us to Kentchari, half way to Mahadaga, where we dropped him at the bush taxi stop at Niger border with enough money (from Rob)to get to his home and the SIM hospital in Niger.
While in Mahadaga for a day , I talked again to Bernadette’s mother and asked her to start getting Bernadette a birth certificate, as I figured she would need a passport to leave the country if she was to get her heart valve repaired.
The next morning at 5:30 am Mambogiri took us, Bernadette, Margaret and me to Diapaga to get the bus to Kentchari, Fada and Ouaga. Unfortunately Margaret tripped while finding a ‘bathroom’ at the bus stop and wrenched her sore foot, but with help getting on and off the bus, soon we were in Ouaga and straight to the Dr’s surgery for a cardiac echocardiogram , and a Chest X-rayfor Bernadette. Part way through the examination , a man in the waiting room started having chest pain , a heart attack, and the doctor needed to take him to hospital ASAP.
The next day, the echocardiogram was completed showing faulty Mitral and Aortic valves, needing replacement, a heart that was not yet damaged by the valve problems and so Dr Evariste (Cardiologist) put Bernadette to the top of the list (of 14 people) for operation in Spain as he considered her an ideal candidate because of her age.
The Spanish charity does two cardiac operations a month for him for free, because of Burkina’s poverty and no cardiac surgeons. The patients need to fund the transport.
More blood tests for Bernadette and the next morning she was on the bus going home and phone calls were made for someone to meet her at the bus stop 55 km from her home. She urgently needs a passport, a letter of permission to operate from her parents, and to be at the airport in Ouaga in early September. The cost is 1.5 million CFA (about NZ$6000) from this end, the Spanish charity expects her family to pay 100,000 CFA, towards her transport to Spain, and the Spanish charity pays the operating, hospital and rehabilitation costs with Catholic sisters in Spain looking after her rehabilitation for 6 weeks.
Once Bernadette was on the bus, it was time to organize limping Margaret home to New Zealand. All day at the Air France office saw her revalidate her ticket at 5 pm, purchase a ticket for me to assist her through to Paris and 7 pm that night we were checking in.
There were moments of doubt however, when I was asked to step aside by security at the door to the plane, and taken back to behind the check in desk, so they could search my hold luggage with me, but everything was fine and 30 minutes later I was on the plane.
Once in Paris, I helped Margaret the next day, onto the plane to New Zealand, and I was able to ensure that she would be given wheelchair privileges in Dubai and Auckland. That left me with 4 days in Europe due to a booking mistake at Ouaga, unless I paid Euro 1900 to upgrade my seat to return to Burkina ( it had become European holiday time of course)! !
A quick trip to YWAM in Stuttgart, Germany to meet Alex, with a train trip to Zurich, unfortunately the people I was hoping to connect with in Zurich both appeared to have gone on holiday so night time train back to Paris, sleep at the airport, to fly back to Ouagadougou on the Friday 10th on wait list due to holiday travel overbooking. The ticket was made possible in the departure lounge, and so I reached the Saturday morning 5 hour bus to Djibo.
Monday 13 July ; No operating today as one assistant on day break for working Sunday, one on annual month holiday and one had been struck by motorbike and now had a broken arm and damaged lateral R.knee collateral lig.
In the outpatient clinic that afternoon we saw a breast cancer, a young man with an enormous spleen and ascites, skin lumps and bumps, a 12 yr old boy with a large fungating umbilical hernia that was leaking faeces through a fistula, granuloma type lesions on the foot, a malignant melanoma of the foot., eye problems, abdominal problems, hernias, men with prostate problems with catheters in place,
The next morning the operating list demonstrates the same variety with dilatation of urethral strictures, dilatation of an anal anastomosis in a baby repaired for anal atresia, excision of pre-auricular granuloma on the face, examination under anaesthetic of 3 year old child who had her hand crushed by a millet pounder the previous day with some surgical repair, bilateral hydrocoele excision and repair of a vesico-vaginal fistula in a 25 year old woman whose only baby died as a result of poor or no obstetric care.
Morning of July 15th the surgical list included hydrocoele excision , hernia repairs and another vesico-vaginal fistula repair in a woman with a very severe defect due to poor obstetric care, which looks to be part of a possible 4 stage operational plan that may well extend over more than one year.
In the Outpatient clinic that afternoon, more hernias, hydrocoeles, prostate problems, vesico-vaginal fistulas, antenatal checks in women likely to deliver at the hospital because of previous problematic child births including post partum haemorrhages, and childbirths requiring symphisiotomy. Abdominal tumour, probably ovarian, fungating cancer of the lip, eye problems, skin problems , a mass on someone’s bottom and a 4 year old with urinary retention probably due to a bladder stone.
It's as well I don't mind sleeping in airports!