Sunday, December 2, 2007

Days 12-15: Working, Walking, and Wildlife

Working

While here at the Baptist Medical Centre, both Amara and I have had the chance to get our hands wet and perform more procedures than we would have at our level of training in the U.S. We have plenty opportunity for doing ultrasounds, excising small masses, suturing lacerations, and helping with skin grafts.

Here is Amara with a man receiving a split thickness skin graft. In this procedure, a piece of skin is harvested from a part of the body such as the thigh, but only a thin part of it, which is done using a tool that looks and works sort of like a large potato peeler (that's how William, husband of another med student here described it). Then, that piece of skin is run through a mesher, which cuts it fancily into a mesh (imagine criss-cut fries at Carl's Jr). This makes a skin graft which can be stretched into a larger size than what was taken from the thigh to cover a bigger area (in the case below, an area on the top of this man's foot and front part of his lower leg which had to be debrided/cleaned off since he had a non-healing ulcer there that spread and caused a lot of the skin around his foot to necrose/die):

To learn how to perform a skin graft yourself, click here (courtesy of William Haun).

One night, a man was brought in who had just been in a motorcycle accident. He had multiple cuts on his forehead, some gashes on his foot, but the biggest/deepest cut was actually running across his lower eyelid, right below his eye! Essentially, his lower eyelid had been split open fairly deeply. He was very lucky not to have damaged his eye, but the suturing was very tricky since this was a delicate area, the tissue was soft (and kept moving around), and also because the patient kept shifting and blinking.


I've had a large number of insect bites on both of my legs while being here. At first, we thought they were mosquito bites, which would be bad considering the prevalence of malaria here. But after looking at the pattern and reading a little in an African dermatology atlas and a tropical infectious diseases textbook, we have concluded that they are more likely to be bedbug bites. The pattern is more clustered, kind of like flea bites, and they tend to happen at night. The bed bugs (Cimex lectularius) come out of old mattresses when it is dark at night and munch on human blood. At latest count, I had 35 bites on my left leg and 46 on my right. I have since started to wear long pants and socks to bed, after which I have not noticd any more bites of this type. Reaffirms the old adage, to "not let the bed bugs bite."


Amara and I walk to work every day and pass a nutrition resource center. On the ground in front one day we saw this:

Nothing's more nutritious than a bowl of blankets and baby!

Walking

Yesterday, we went for a nice little exploratory walk in the grasslands behind the hospital grounds. We were accompanied by several Ghanaian children (who seem to cling to foreigners whenever they see them) and Dr. Hewitt's amazing dog Sandy, which just joined us incidentally when we walked past it on our way out. This dog actually used to belong to someone else who used to work at the hospital, but then that person left, and the dog was given to someone else to take care of. That family moved far away (like many miles). One day, the dog was missing. About 3-4 weeks later, the dog was found back on the hospital property. In any case, it was a very cool dog. The dog would stop every once in a while and seem to mark where we were. When we would get to forks in the road, he would stop and wait for us to make sure we went the same direction. Anyway, we hiked in the grasslands for about two hours, which included passing by the creek here:


There are two Japanese medical students visiting the hospital this week. We played cards with them last night. First, we taught them how to play Hearts, and then they taught us how to play Sichinarabe (a very famous Japanese card game):


Wildlife

We visited the Catholic church of a boy named Prosper here (his father is a nurse at the hospital and he comes around to our house fairly often). The service had some traditional aspects of Catholic masses, but it also had some pretty lively singing/dancing. Here is Amara worshiping "wildly":


This little piggy didn't go to market but instead was just sniffing around on the ground on our walk back from church (featured because some of our audience happen to like pigs):


Today, Dr. Hewitt drove a group of us to a scenic area about 40 minutes away called the Escarpment. Here is a view of the picturesque bluffs from afar (the rocks on the top of the edges on the right are where we were climbing/standing atop, shown later):


Me, Amara, Dr. Kirby, Shinthke, Dr. Hewitt, Dr. Burgoyne, and Twyla Burgoyne on the bridge near the river:


The next two pictures were taken at the home of John and Deniesce, who have worked to help reforest the area. Amara with a horse.. she loves horses..


Me with a babboon.. I love babboons.. just kidding..


We hiked through tall (itchy) grasses to get to the nice view..


Here we are standing on top of the rocks that I mentioned earlier:


Sitting pose:


Posing between rocks:


Hanging from a tree:


Amara took this pretty picture of the setting African sun to signal the end of our fun day trip:

3 comments:

William said...

Potato Peeler!
http://www.haunsinafrica.com/slideshows/skingraft/

Anonymous said...

Great pictures ! Bummer about the bed bugs, though ! Hope you have that figured out now.

Keep up the wonderful work. Keep enjoying the experience.

Love,

Dad

Heidi said...

WE LOVE YOU! Chanda and I have been praying for you both every night! I am so excited for you and can't wait to see you again soon!
Heidi