We need an orthopedic surgeon...

   

 This little boy is about 18 months old and just came to see us yesterday. He has severe club feet. I told the mom she needs to buy him some 'hard' shoes and he needs to start wearing them on the wrong feet a couple of hours a day. She is supposed to return also with a phone number where we could possibly get a hold of her if we do find out an orthopedic surgeon is coming. He is trying to walk and the way his feet are now he stands on the outside part of the side of his foot and not on the sole of his foot at all. But I'm hoping if she will do what we ask her we can maybe help his feet to straighten a little because they weren't stiff in that position that was just how they bent without support.
     It has truly been a week of unusual maladies. Monday morning started with a 3 year old with cholera in my room and then an 11 year old who was mostly unresponsive and was having some seizures in Githane's room. So we didn't see any other patients for quite some time. The three year old was so out of it when I started her IV she didn't even flinch. Actually she was unconscious for a little while. She was VERY dehydrated and was having vomiting and diarrhea of course. We don't know for sure what the 11 year old has. The nearest we can guess is meningitis. She had a history of a bad headache a day or so before but when she came in she couldn't even talk. Her pupils were unresponsive to light and she didn't blink either. The problem is, there isn't an MRI scanner in Port-au-Prince that we know of, only a CT scanner and we do not think whatever she has would be revealed on a CT scan and we aren't convinced she would even get scanned. Her prognosis did not look good at all but she is still holding on and is definitely coming around. We are giving her IV antibiotics every twelve hours. She can possibly see some light but can't see much else but she can talk now and answer questions appropriately. So... We really have no idea how this one will turn out. We have tried to warn the family though that if she lives she may never return to how she was before this sickness.
 

Little cholera girl got IV fluids for several hours then was conscious enough she could start drinking too. She was able to go back home that afternoon. One interesting point about her- her mom said all the rest of her family wanted her to take the little girl to the witch doctor. They didn't want her  to bring the child to the 'hospital'. Actually her husband was so upset with her that he wouldn't even come with her. She was a very grateful mom, hopefully the rest of the family is too.
  Of course before we were finished with even those two patients a lady came who was in labor. It was her seventh child so didn't take long and wasn't a difficult delivery. That baby was an angry little thing though... And she had a big mouth and a fat face. It is so much less stressful though when the baby opens it's mouth and howls!

     Tuesday started about 6:00 with a lady in labor. First time mom, ready to deliver in the near future but not immediately. So Keith and I came back to the house for breakfast then went back and started the day in earnest. We thought there would be a baby born early but this lady refused to push so... The baby's heart rate was good so we just waited a while. Gave her some oxytocin too. Still she wouldn't push. To make a long story short, she had the baby about 11:00 and the baby was dead. The cord was around the baby's neck and I guess it had just been too long. It's very frustrating when I think of what would have happened in the U.S.  This lady's baby would have been monitored continuously and when the heart rate started to decrease or if anything funky was happening the lady would have just had a c-section. No questions asked. Here she is stuck with what we can do or else she has a three hour ride to a hospital. Discouraging, never the less.
    Also, the lady from last week who had a baby that died then came back in herself several days later ... We sent her down to Port, and the next day she died. I think she was septic. Depressing...
   Then on Tuesday right before we left for lunch a six year old boy came in with a prolapsed rectum. Todd helped me with that one. It took three or four of us to hold him down then some skillful maneuvering by Todd but we did get his problem solved, for the present. They stayed at the clinic until I returned from lunch and as everything was still in its normal position we sent them home. At 2:30 he was back with the same problem. This time it didn't take quite so long to return it to its normal anatomy but then we made him stay on his stomach for at least 30 minutes and gave him some Benadryl so he would relax. He fell asleep so we sent him home again. This time with more Benadryl for when this wore off and his mom carried him with one hand clenching his butt cheeks together. It looked rather humorous but it must have worked because he hasn't been back.
    We also had another little girl in with cholera yesterday but this one didn't need IVF's just oral rehydration and monitoring. This little girls' mom told Mirlene though that this child is always sick. She said if she can find anyone who will take her she will give her child away because she thinks the devil is tormenting her or something like that...
    By the way, I do enjoy comments on my blog. Makes it much more encouraging knowing someone is reading it...
   One more funny incident that happened to April and I last Saturday. We went to the market in Foret- des-Pins as we do almost every Saturday. It just happened that this time we didn't get home before the rain came. First thing, when we went to market we didn't see any moot drivers that we knew so just took a ride from the first person who offered. This guy didn't seem to be real experienced with driving but did okay. Probably part of his problem was that he just wanted to talk with us and seemed to really 'like' white girls. When we got to market he wanted to know if he could just wait for us so he could take us back too. We told him he really shouldn't because we didn't know how long we would be there... And we were thankful he took our word for it. So on the way home we were riding with one of the church brethren. We told him how the guy that morning really enjoyed taking us and he said that guy was "naughty" :) about half way home it started to rain... For real! I was glad I wasn't the one driving because the rain was coming down so hard and fast that it was hard to see. It didn't let up either. On the last hill coming into Orianie the water was several inches deep all the way across the road, not so easy to dodge potholes when they are not visible. Anyway, we were all laughing pretty hard by now. Going through the town people were huddled under their tarps or little pieces of plastic. We laughed and waved and kept on going. My phone has a very bad attitude when it gets wet so I was trying to clutch my bag closed under my arm for all I was worth. The hill just before our house is not a good hill to drive moto on when it is muddy. It turns into a mudslide. Sorel just put on the gas and away we went though