Friday, 30 November 2012

Blast from the past- Mamadou, Hodgkin's Lymphoma

From time to time I have seen Mamadou's brothers here at the hospital because they have been sick. One by one they have come in with malaria. I kept telling the older brother that Mamadou needed to come in so we could see him. He said he would bring him.

A few weeks he was here, but with severe malaria himself. This picture was taken a few days after treatment. Notice the SMILE! He never smiled with me during his treatments for chemo, but I guess I don't blame him. It was so good to see him doing well after treatment. I think he was even happy to be here knowing he was going to get candy without all the shots and medicine! :) 

So thankful for successful treatment of his cancer!


Fatoumata, Lupus (presumed)

Fatoumata came to us with eye swelling which had caused near blindness as well as overall joint swelling and the inability to walk. We believe it to be an autoimmune rheumatological illness, quite possibly lupus. She has been treated with corticosteroids as well as several eye medications.



Within a few days she was able to sit up by herself. After a bit more she began walking again. Her vision has also improved (20/100 with her right eye). She went home this week and is now coming back weekly for check-ups and more medication. Here is a picture of her with her parents before leaving on Monday.


They wanted a picture of Fatoumata and me today when they came back for the follow-up. So here we are.

Wednesday, 28 November 2012

Tetanus

From time to time we have cases of tetanus that come in. This is not seen in America because people have more access to vaccines. Vaccines are a good thing and prevent illnesses. I know they have gone out of favor with a lot of people but when you see the actual illnesses they prevent it makes it so clear why they are necessary. But that's all I'll say on that. :)

This boy came in rigid and unresponsive.

After treatment he was walking around and doing well. He has his arms up showing that he can extend and bend his arms which he couldn't do before.

This baby is still being treated here and is making slow improvements. One little vaccine for the mom during pregnancy would prevent this.

Wednesday, 21 November 2012

Moussa


Moussa passed away this morning. As I look at this picture it is hard for me to believe that the child I carried to the morgue this morning is the same child. Oh how he had wasted away to nothing. 

When I came in this morning he was already in agonal breathing so I knew it wouldn't be long. I sat with him for a long time. Though he was unconscious, when I said his name and told him I was there, he grunted. I really believe he knew I was there. I laid down on the floor beside him (as for the last few days the ground was his place of choice to lay) and gently rubbed his head. The poor thing had suffered so much and the end was in sight. As I mentioned before he had asked me to go to church. I wasn't able to fulfill that wish to my regret but as I was thinking of that this morning I started to sing some of the few songs I know in Bambara. His grandmother joined in and we serenaded him for the last 10 minutes of his life. The last song we sang right before he passed says,
 An taato file san fe,                                   We are going to heaven
 An ka so nyuman de be yen.                        Our beautiful home is there
 Matigi tarra an nye fe                                  God has gone before us. 
       An bee be taa sigi a fe.                               We all will go sit next to Him.

How fitting to sing this as he left this world and I believe he was welcomed into heaven by a great chorus. It is humbling to sit with someone, especially a child, as they leave this world. It was not a moment I will soon forget. As awful as it was, it was a privilege to get to be with him and his grandmother at such an intimate time.

I love Malian culture but one thing that I cannot understand is how they deal with grief. I am not saying it is wrong, it is just completely different than how my culture would handle it. I was the only one crying when he died. Our nurses looked at me like I was crazy. I cried as we wrapped his body and carried him to the morgue. Though he was only skin and bones the load was unbearably heavy. I hate carrying dead children. 

As I walked away, still trying to compose myself, a patient met me at my door. How I longed to go in the office and cry a bit on my own, but someone was there. And with that, the day went on. The fact that Moussa had just died was a mute point. Malians have an incredible capacity to deal with grief. God's will, they say, and continue to move forward. It may as well be the will of God but it stinks and hurts nonetheless. It is on these days that I feel like a fish out of water here, unable to comprehend and follow suit in their behavior. I want to scream, "A child just died! Don't you understand? We cannot move on right now. We need to sit and mourn. A child, a young, precious child died. I cannot act like nothing happened." But alas, this is not my home or my culture, so I try to respect their desires as much as possible.

I am thankful for having known Moussa and seen his sweet smile that lit up the room. Though at times he was a very trying patient for me, he was always sweet and undeniably cute. 

To all who knew him, I think he will be forever remembered with his big smile sporting his pinstriped suit (see here).

Sunday, 18 November 2012

Djeneba, burn patient

Djeneba left our hospital a few weeks ago and went back to Doctors Without Borders which is in town. This is the day before she left as she was riding around on the little car eating rice and sauce. She really started to like me before she left (probably due to the fact I gave her candy each and everyday). I wasn't prepared that she was leaving so it was a bit traumatic for me when they came and took her. I was hoping she would be around longer since she was such a sweet little girl. If in the future she needs more skin grafts we will see her again, otherwise her treatment will be taken care of in town.


Friday, 16 November 2012

Yanoussa/Moussa, Wilm's tumor

Dear Moussa has been with us two weeks now. It is sad because I took these pictures the day he got here. I thought he looked terrible then. Now, two weeks later, I think he looks pretty good.

He barely eats. He now just stays in his room, moving from the bed to the floor to the chair. He doesn't have enough energy to smile. He is literally skin and bones. Even the fat pads of his heels are hanging skin. 

Yesterday he told me to come and sit by him and he laid his head down on my shoulder. He mumbled words which I couldn't understand. I asked his grandmother. She said he wanted some da, a juice that is common here. Then he mumbles something else. She told me he wanted to go to church. She told him it was Thursday and not Sunday. Then he closed his eyes and rested, his energy spent. 

These are the times that cancer really glares its ugly head. What a terrible way to die, wasting away day by day while the cancer grows and takes away the strength of the body.