May 11th – 14th Soon enough it was time to get Gavin back for his plane trip to the UK and to carry on to Djibo to work beside Dr Ken Elliot. However on our way to Ouaga we stopped for the night in Fada to break the long hot dusty journey and as we walked into the SIM guesthouse compound there was a man sleeping under a tree in the driveway. Later that afternoon, upon enquiry, we found out he was not the gardener, I had supposed, but a waif who had drifted in a week or two before begging for money for food and cigarettes. He had a crude material cover around his lower right leg, and was fairly uncommunicative. After some time with the house helper for Mark and Karina, we found out he was from Niger and some 6 months previously had fallen at his village and injured his Right leg. When we uncovered his leg ,part of the distal third of his Tibia bone was poking through the skin with the attendant infection, and it appeared he was able to walk with difficulty and the assistance of a strong supporting pole.
Tessa and Gavin swung into action with dressing of the surrounding infection and starting him on pain relief and antibiotics for the next two weeks as well as Antidepressants for his clear clinical depression. Yes he needs further treatment, this requires his agreement, and whether this is operative bony fixation and antibiotics or amputation and prostheses, will be discussed with him and possible doctor involved as he hopefully rises out of his depression with medicines, and food and Ongoing care. There are three people with complex disease in Mahadaga who clearly need investigations and treatments that are not available in Mahadaga but which are important for the continuation of their life although it will cost a little more of course.
Bernadette is a 17 year old woman with a 6 year history of an increasing pounding in her chest with a limit to how much walking she can do (2 km) before she becomes breathless and develops chest pain. On examination she has a palpable thrill in her chest and a loud murmur coming from her heart. She needs an ECG, Chest X-ray and Echo cardiogram to clearly define her cardiac problem and then the work will start to find a way of getting this repaired if it is a repairable defect. Otherwise she will die young with a heart that feels like it is beating itself to death !!
Boundi is a 14 year old girl who was deemed smart enough by her family for her to be sent to Ouagadougou at the age of 11 to gain a better education than is possible in Mahadaga. She was in Ouaga for 2 years staying with her brother there and going to school. However at the age of 13 yrs her brother sent her home to the village as she had become both deaf and mute and had great difficulty walking and her brother did not know what to do and she could no longer continue her education. She has been back in her village for a year now and her walking has improved but her deafness and muteness remain. On examination her walking, was almost normal but she is profoundly deaf and mute. Otherwise she appears bright and alert. She needs assessment by a paediatrician, and maybe a child psychiatrist in Ouagadougou to try and unravel the cause of this severe problem and then to maybe look at treatment options !!
Toumbonl is a 30 year old woman with 8 children who came to see us in clinic with a 3 year history of epigastric pain, dizziness and headache. We took her blood pressure at the time, 135/80 and felt her pulse. On examination she was short of breath at rest with a resting tachypnoea of 26/minute. For her epigastric pain and possible symptoms of hypovolaemia we gave her water drinking advice and famotidine. For her regular pulse with irregular volume we gave her aspirin and now we need to get her an ECG to rule out atrial fibrillation and start her on appropriate treatment. Mahadaga does not have an ECG machine so to Diapaga, Fada or Ouagadougou she must go as this is a symptomatic heart defect that may well shorten her life as a mother of 8. April 30th – May 10th Mahadaga Clinic work with medical manager Mambogiri (Nurse) as local language translator. Apparently about 7 % HIV positive on voluntary testing last year, malnutrition, endemic malaria/tuberculosis/typhoid disease as well as scorpions/snakes/centipedes.!!
8 am to 1 pm with no breaks, Gavin and I see malaria, typhoid disease, malnutrition, HIV related problems, probable Tuberculosis, intestinal worms, Giardiasis, Sickle Cell Disease, Beta thallassemia,
anaemia, hypertension, osteoarthritis, schizophrenia, depression, Post Traumatic Stress Disorder, Rheumatic Heart disease, Asthma, Heart Failure, cataracts, Iron deficiency, ear infections, fungal and bacterial skin infections, to name but a few.
In the afternoons we visit hospital patients that we are called to see ; a 30 yr woman with jaundice and a Ross River fever like syndrome of painful joints in the hands and feet, a 35 year old woman who has been living on the edge of the hospital grounds for 7 years with a tumour of her spine and paraplegic. An operation on her spine in Benin 5 years ago hasn’t changed anything and on examination she has a septic arthritis of her knee,( infection of her knee joint), a 5 month old baby with fever…
We carry out small operations, excision of lipoma, draining a hydrocoele (fluid collection around a testicle), suture up trauma lacerations, reduce incarcerated inguinal hernia in 4 year old boy,
assess another 5 yr old boy with grapefruit swelling around testicles since 1 yr of age for hernia repair in Diapaga, 55 km bumpy road ride Away.
One night we are asked to see another volunteer, helping the nearby handicapped rehabilitation centre who has received a scorpion sting. In Mahadaga, we can buy millet and sauce (very unappetizing) and on occasions mangoes and onions. Fortunately we had bought pasta, rice, couscous and tomato concentrate in Ouagadougou and milk powder for Melioni, so our diet is sufficient.
Out on the main dirt road of Mahadaga it is incredibly busy. There seem to be numerous free roaming goats pigs, sheep, donkeys and dogs, along with bicycles and motorbikes, donkey drawn carts and truck and trailer units from the nearby cotton factory, occasionally using the track as well as plenty of pedestrians. It is the official siesta time between 12 midday and 3pm because of the heat, so things tend to be much quieter on the street and in the clinic. Over the course of 8 clinic days we see almost 400 people and Gavin carries out some teaching regarding abdominal pain that is well received by the 15 nurses who attended the talk and practical examination of the abdomen to rightly ascertain the diagnosis. Mahadaga is a dispensary under Government definitions and only after it has one doctor for a 12 month period can it hope to attain Centre Medical (hospital) status and can then advertise and attract doctors for more short term servicing.
There are between 130-150 baby births here each month, no operating theatre and because of no doctor they are not allowed to carry out life-saving blood transfusions. Next day 29th bus to Kantchari and ½ size bus to Diapaga, with tired but grateful eyes to see the SIM (Mission) 4WD driven by Dale Johnson there soon after our arrival in torrential rain, to take us on the last part of journey to Mahadaga. Leaving Christchurch on evening of 23rd made it a 6 day direct journey and we are quite remote, pot holed sand/mud road, to a place where there may be 1 public bus a week… maybe April 28th On Tuesday we take the bus to Fada, 4 hours and stay the night at SIM guesthouse , meet Karina, participating in a youth ministry 17-24 yr olds.
April 26th,27th
Sunday recover from flight and Monday given back passport at airport with visa on arrival for 1 month given. April 25th Next plane to Ouagadougou arrive 7 pm on 25th. Meet Gavin Bond,
final year med student from Nottingham UK, at airport and sleep night at SIM hostel (opposite Ouaga International School). April 24 Depart Wellington to Auckland meet Tony Denny and
Margaret Reid with further supplies to take, then Emirates to Sydney, Dubai, Abidjan. No long delays, no overnight stops just direct to
Burkina Faso Unfortunately baby stroller taken consigned at Auckland ever arrives at Abidjan ..we are sure Emirates will find it???!!!
March 24 – April 24
Time spent in New Zealand with Melioni recuperating from her successful cleft palate surgery which was carried out in Auckland She now has the opportunity to thrive and lead a healthy happy and useful life Also opportunity to catch up with supporters and family, recharge batteries, sort out and relocate some of my remaining New Zealand assets and resort and repack ready for shipment a large amount of donated medical supplies. This stay also provided the opportunity to discuss revamping the website and this work is well under way. In between all of this is planning for a second three month commitment to go to Burkina Faso (north of Ghana in sub Saharan west Africa) to work with Dr Ken Elliott at Djibo 200 kilometres north of the capital Ouagadougou and also to visit Mahadaga to the west of the capital by the Benin border