Drawing

An example of how differently my children draw:

Primum Non Nocere

Sorry for the hiatus - it's been quite busy!

A little blurry, sorry

We had a most peculiar case 2 weeks ago.  A patient hospitalized for an entirely unrelated surgical issue developed meningitis.  It was concerning but she got better.

Then a young mother in the hospital developed meningitis.  She had just had a C-section.

Then another. And quickly, another.

My colleagues involved in the cases noted that each had had spinal anesthesia, from separate, single-use vials, but all from the same manufacturer.  We switched manufacturers and there have been no further cases.  Interestingly, cultures from each patient and from the anesthetic used are all negative.  It's possible it is a 'chemical' meningitis - irritation rather than infection.  Testing is ongoing.

It highlights some of the unreliability of medications and their purity in developing nations.

Autumn

Well.  Rainy season has ended - it's hotter again, but the hope of cooler weather is one the horizon.

Financial counseling

One of things that takes some getting used to, here, is that finances are probably the major consideration in medical care.  We are understaffed, order fewer tests, and make do with less information in order to keep the cost down.  While we have a 'poor fund' at the hospital, the reality is that paying the bill (several days might run $26 US, a week with lots of tests might run $100 US) is a major hardship for many people even though our bills are between 1/2 to 1/10  that of other private local hospitals.

Once the poor fund has determined what you should be able to pay (and they are generous) it's then up to you to find the funds.  That generally means selling something or borrowing from everybody you know.  Now imagine you get sick again: you've already borrowed from everyone you know and that extra 90 cents a week you're able to scrounge after food is busy paying off everyone you borrowed from.  Can you allow yourself to be readmitted?  No.

So it's not infrequent that people go home then, by choice, with very dangerous conditions.  We do our best give them the optimal treatment in the circumstances.  It can be very hard for families to makes those decisions for loved ones: the decision between your uncle's life and everyone else's food is not an easy one.

snapshots

"Look, I'm a carpenter!" 

"I told you it was loose!"

"Oh no, it's degenerated to banana-fights..."