I was working on Sunday 8.00 am – 800pm. As per usual the things we see in ER are extreme. A gentleman who was short of breathe for a week – his xray showed his right lung filled with fluid. We drained 900mls of fluid ( he felt much better) and sent him for TB testing – the most common cause.
Another lady had a lump in her vagina ( a simple prolapse I suspected). Hmmm not in PNG. On examining her she likely had cancer of the cervix, a prolapse and was pregnant. I admitted a couple of babies with dehydration and another lady who had been beaten up by her angry husband. this time he didnt chop her but beat her with a stick – she had two black eyes and a fracture in both hands. He had also hit her abdomen and she was 28 weeks pregnant – but was reassured by an ultrasound scan.
Clinics through the week are so interesting but also very challenging. I find it hard to speak through an interpreter – so much easier when they speak English – as some do. I often see obvious cancers – if they have a breast lump with no lymph nodes and normal chest xray the surgeons will remove the lump. On tuesday I saw a lovely lady with a hard lump but she also had lymph nodes. I must admit I sent her to the surgeons anyhow but they may not operate. I saw another man who came in complaining of an enlarged liver. He was requesting an ultrasound scan – but I didnt need a scan to see that his liver was very large and hard. On scan he had a probable hepatoma ( cancer of the liver). There was not much normal liver left. I had to give him the diagnosis. So hard. That same day there was another man who had most probably leukemia – again we have very little to offer him.
On the wards there is a lovely old lady with a fractured hip – in Kudjip Hospital there is no orthopedic surgeon and no hardware to fix it. (I am sure the surgeon would try and fix it for her if he had the metal hip which he doesnt). She is on traction for 12 weeks and then hopefully will form enough callus around the fracture to be able to walk. If she went to the capital for an operation it would cost almost $1000 CAD which is way beyond her.
Another lady has meningitis and has lost her vision. The family waited 2 months to bring her in so she is really quite sick. However I am hopeful that she may recover. In the bed next to her is another lovely lady who has had right side abdominal pain that looks like a liver mass on ultrasound scan. We will treat her with medicine to treat parasites just in case it is not cancer …but we are worried.
I could go on and on about the patients. They are all so lovely and in a way accept death and illness. People present very late and the illnesses we see make me think of what it was like 100 years ago. It is such a privilege to work amongst these people but also such a challenge with such limited resources. I have such admiration for the missionary doctors. They are so good at what they do, have to deal with such tough decisions every day , work very hard and yet are so gracious to help volunteers like myself.
As we have very limited access to shops ( we are not allowed to leave the compound without a chaperone) I have been baking lots ( whilst watching the great British Bakeoff on the computer) I will certainly be making focaccia bread at home as we have really enjoyed it. Banana bread is also an old favourite. I also tried my hands at Bagels ….they were edible but the dough was too sticky..
We also discovered how to roast peanuts. Ric got one of the security guards to get him some pineapple and peanuts from the local market. (Due to so many people being chopped I am glad not to venture out too often) There are also some people on the compound growing peanuts. They grow underground – take about 4 months to develop.
We bought some in bunches. The first time we left the bundle for a couple of weeks as we didnt know what to do with them. Turns out this was the right thing to do. Then we roasted them. The second time we shelled and roasted some when we first bought them. They were still wet so took forever to roast. The last time we dried the peanut bundles for a couple of weeks and then roasted them. So much fun and really fresh.
Ric is really enjoying his time here. He has figured out a few of the issues. One group of houses with tin roofs had problems. Every time something was switched on they felt an electric shock. (some used gloves to switch things on. After exploring the issue Ric discovered there was no neutral wire and was able to instruct the locals to fix the issue.
Cant believe we are over half way through our time here.