a baby, cancer, and two bleeders

CAUTION: a nasty photo ahead.

“a baby, tumors, a bleeder, two burn victims, malnourished, plus about 20 or 30 other people.” If I ever got on facebook, that would be my status. Not nice, I know.

I probably shouldn’t tell medical stories, but being such a newbie to the world of medicine, I have a hard time not sharing.

First, two weeks ago. I stepped out my door to Jessy (our coworker) yelling for Michael. Michael was of course away. So Jessy said basically, “here comes a BAD cut”. I looked into the distance to see the person covered in red coming towards us.

I told Jessy, “looks bigger than I can handle so please go arrange a motorbike to evacuate him.”

Then I promptly ran around the kitchen,

threw open the medicine tote,

didn’t find anything I needed,

laid out my medical books,

and then ran outside again.

The man got to the house, and it was bad, a nasty machete cut on the outside of where his thumb connects to his hand. I got a chair for him, and made him sit outside with his arm up, and started to open his wrapping. Blood spurted out like a hose (seemed arterial to me). So I yelled to Mirna (my house help) to get a rag. She brought my pretty dishtowel from New Zealand, but whatever, I just took it and pressed hard against his arm.

I continued to press hard and made Mirna hold up the chapter on bad cuts. It said not to tourniquet, but to apply direct pressure for 20 minutes. I did. My friend stopped by, so I asked her to take his blood pressure (I’d been teaching her to do it), she was quite rattled, but was able to eventually figure it out. His blood pressure was still strong.

My hands were shaking, my legs were shaking. I looked at Jessy and asked if he could take over. His big eyes told me all I needed to know. He left not long after. When he came back he said that he’d gone and laid down so he wouldn’t faint. Elly took a turn so I arranged food and some sugar water for the man and his wife and kids. Then I took a turn again. Then our neighbor, the motorbike driver, took a turn. Finally we figured they were ready to ride out. I gave them ten dollars to help with their boarding costs (medical care is free since they have the equivalent of Medicaid). One of our teenage neighbors rode behind the guy to help support him just in case he fainted.

His arm was stitched up, and he came back up. Last week he resumed work. Not long after he popped the stitches. So he tourniqueted his arm to stop the bleeding. By the time Michael saw him his fingers were all black and puffy, and he was fainting from lack of blood. Michael strongly encouraged him to go out again, arranging the motorbike and all again. Since then he’s been bounced around to different hospitals. Now he’s in the nearest, biggest city awaiting surgery. Jerry and Armin (our coworkers) are there helping him through the medical process (since he doesn’t speak much of the national language). They are also helping a little girl from another village who has tumors all over her body.

Second, not long after I had two different boys come with nasty oil burns. Both went over their wrists, I cautioned them to keep them clean and keep on moving the arm so they don’t lose their range of movement. Fortunately/unfortunately I am all out burn cream, and gauze for debridement, and I don’t have sharp scissors. But, the one had already done a great job of taking care of it.

Third, a week and a half ago a large group of people came up, leading a very sick young woman. I measured her arms, took her temperature, everything. But couldn’t find a reason for her sickness, except that her arms were very VERY small (16cm if I remember right). She was obviously malnutritioned and anemic. I found out that she has four children, and a one year old that is still nursing. I told her she had to eat, and drink. They were here for a long while so that she could gather enough strength to walk home. In the meantime I made her a thin rice porridge with an egg, sweet milk, and asked some people to climb up and get her a young coconut. With the coconut I made a pudding thing. All of which she ate very, very little. I went back to my books. In my books it said that people who are malnutritioned often don’t have fevers, so treat anything that seems likely. If there’s an upset stomach treat typhoid, a cough treat pneumonia, etc. So I told them to buy typhoid medicine. It was frustrating to only have a little bit of knowledge, and not to be able to really help. It was also frustrating to see her not eating, not drinking, not making herself well. She’s still not better yet.

Then, a week ago, there was the baby. But I’ll tell you about that in another post. Ooh exciting right?

Two days ago, when Michael was gone again, we had millions of millions people come by. Well maybe it was just like 20. But it never stopped, all day long. Even while I was trying to finish up school with G. I’d give them the basics, take their blood pressure, tell them to drink more water, maybe get some antacids…and then run back in to work with G. There was one boy who had a high fever because of dysentery, he was shaking and his eyes looked strange by the time I saw him. I gave him some fever meds, and showed his mom how to do cool compresses to bring his fever down. FINALLY his fever broke, but they ended up spending hours on our front porch.

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