26.11.11

Improving diagnostics


Diagnosis is difficult in primary care, relying much on a good history and examination, but oft-times treatment can be quite empirical to cover the risk of a worst case scenario, a common problem in the third world. This means many are treated inappropriately, risking side effects and the development of drug resistance. 
We have set aside some funds to try and improve matters.

Oscar leaves on the 12th Dec for two months study at Padhar Hospital in India, for training in laboratory work and microscopy.
The clinic has become increasingly cramped and without any space for lab work we have taken half of our porch to be used for this purpose. Oscar has designed and with some help built the lab himself.
We will have rain harvesting tanks outside to give a reliable water source, the borehole we have been using now broken. This is perhaps not a bad thing as we had identified E.Coli infection in the water last month and had ceased to use it, pondering on the construction of a sand bio-filter. 
We constructed the blocks with sand from the river and though basic it will amply serve the purpose.
The lab is secure with ironwork grills, windows and awaits decoration. We are hoping to attach solar power to the clinic (from the defunct borehole) that will power another fridge, microscopes, and bench top blood analysis equipment.
We are very grateful to Dr Choudrie at Padhar Hospital (MP) who has planned Oscar's consultant led training which is designed specifically for the environment in which we work, and pathology most commonly encountered, TB, Malaria, Gastrointestinal infection, both parasitical and bacterial. Besides Malaria microscopy we will be aiming for TB and HIV testing, Blood grouping and transfusion, blood count with white cell differentials, glucose, leprosy identification, stool and urine analysis.

3.11.11

news- gas gangrene


Oct 2011

Three months after starting treatment this young lad is almost healed.
Initially his leg was rapidly breaking down, swollen and with audible small
gas pockets when pressed following the administration of an
injection from a local 'chemist' using a dirty needle.
The necrotic dead tissues were replete with maggots, debrided and cleaned.
He was on three intravenous antibiotics for two weeks.
Eventually clean and rid of the dead tissue healing seemed to miraculously start
and nutritional support was crucial.
The process has been long and for some time the mother seemed to
emotionally disengage with the child so encouragement to breast feed was
ongoing even when the child was discharged.
The amount of lost tissue should have necessitated skin grafting, but
this is beyond anything available in the riverine areas

Frankly it has been amazing to all of us how this young boy has recovered so well,
and it is a joy to see the family encouraged by his recovery.
Gas gangrene has a high fatality and often the extent of the disease results in
amputation.
Though scarred, young Godswill is getting back on his feet and doing well.