Hard to say goodbye

          I can't believe how time at Karanda has flown by!  As I'm getting ready to leave and visit Victoria Falls & South Africa soon, I'm realizing once again that goodbyes are hard.  Here are a few reasons why it's hard to say goodbye:

Thanksgiving in Zimbabwe with a wonderful group!
(both the Stephens families, Kidwells and Christiansens)

She's the sweetest.

Anna rocks!

Kiersten carrying plates of sadsa (the staple food in Zimbabwe) from our weekly single ladies lunch

Mrs. Nyamande and her granddaughter, Vinbinashe

Mrs. Chirendo is a true inspiration!

Miss Emma is a great scrub tech!

I will miss all the nurses, nursing students & staff and am honored to call them friends

'Tis the Season...for Snakes!

          I admitted 2 patients with snake bites yesterday, both from puff adders.  Puff Adders can cause some serious, painful damage!  Fortunately, my understanding is that puff adder bites are not deadly, unlike black momba envenomed bites.  One of the patients even brought in the decapitated culprit (pic below).  I also saw a snake right by our house last night, but didn't get close enough to figure out what type. :)  I have my snake scoping walk perfected; it’s a slow, high stepping walk while sweeping the light back & forth, and so far it seems to be working.  No bites yet.

Left hand bite

Ouch.

Puff Adder minus head

Puff Adder

         Happy Thanksgiving dear friends!  I am grateful for you--for your friendship, support and encouragement!  Thank you for journeying with me on this challenging adventure, you all are so loved. :)

World RTA Day & Antiretrovirals

         Today is World Day of Remembrance for Road Traffic Accident (RTA) victims.  We see many RTA victims weekly, usually at night.  Sometimes they are vehicle vs vehicle, tractor vs vehicle and sometimes vehicle vs road.  We worry about head trauma, blunt internal organ trauma, vertebral fractures and spinal cord injury that are often evaluated by CT scan and x-ray in the US.  Here we have no cervical spine collars, no CT capabilities and x-rays are not available on the evenings or weekends, so ruling out brain injuries or fractures can be difficult.  

CN is 12 year old girl who was heading home at night from a school excursion with her teachers and classmates when their tractor overturned on the edge of a steep shoulder.  While her classmates sustained minor injuries, CN had a severe concussion and lung contusion (bruise) and required oxygen for several days.  In honor of RTA victims here are a few pictures below.

CN early in her hospitalization

CN in her pretty dress ready to go home with her aunt

BN, 13 years old and currently in the hospital

                     I have shared about the widespread and devastating effects of HIV/AIDS and wanted to share a bit about antiretroviral medication.  Antiretroviral therapy (ART) makes an enormous impact on the lives of our HIV patients and can keep them healthy for years.  And here patients can get them at no cost.  To initiate ART patients must meet certain clinical standards or blood count standards and have at least 3 counseling sessions to discuss the risks, benefits and necessity of medication compliance.  The medications are usually helpful, but can have deadly side effects.  I have seen several cases of medication induced hepatitis and Stevens-Johnson syndrome (SJS), a potentially deadly reaction involving the skin and mucous membranes.  The skin often blisters as do the lips and mouth and even the GI tract and lungs can be involved.  There is often at least one SJS patient in the wards per week and unfortunately one patient died last month.  Pictures are truly worth a thousand words for this incredibly painful condition.

SJS survivor

SJS survivor

Waiting for rain

          It’s getting hot again.  The last few weeks of October brought temperatures hovering around 100F and as my body was finally adjusting to the heat we had a wonderful reprieve!  I can’t remember being so appreciative of clouds, rain and goosebumps as I was last week.  This week the oven temps are rising and building up to the start of rainy season and cooler weather--I hope.  Today the sun beat down over a cloudless sky and the trees were still without a breeze.  In my mind the day was broken down this way: hot, hotter and back to just hot instead of morning, afternoon and evening.  Very thankful for fans and electricity. :)

This week in pictures:

Our friendly, noisy neighborhood herons

Different view of the world--Gallows traction for femur fracture

Flamboyants!

          For those who read the last post, there is an unfortunate update about TN.  Her little body was too weak to keep fighting and she passed away this morning.  Please pray for TN’s family as she is the 3rd of 3 children to die and her parents are HIV positive and devastated.

“Our desire is not that others might be relieved while you are hard pressed, but that there might be equality.  At the present time your plenty will supply what they need, so that in turn their plenty will supply what you need.  Then there will be equality, as it is written: ‘He who gathered much did not have too much, and he who gathered little did not have too little.’”

2  Corinthians 8:13-15

On the wards

         I have been rounding in male ward and peds lately and want to share some of the constant companions that I have been seeing over the last few weeks.  This is TN and her mother.  TN is the third born in her family, but the only surviving sibling as her brother and sister both died at age 3 months from “cough.”  She is 1 year old and weighs just over 8 lbs (3.8kg).

TN and her mother

        TN suffers from marasmus, a form of protein-energy malnutrition mainly due to lack of calories, in comparison to kwashiorkor which is primarily a protein deficiency resulting in a swollen appearance.  Often, features of both forms of malnutrition are present and aren’t easily separated.  And these conditions are usually associated with infections, especially diarrhea.  TN had chronic diarrhea for months before coming to Karanda, but after being with us for over 2 weeks is starting to gain weight and become more interactive.  She is beautiful and I love seeing her personality come to life.  

So sweet.

You looking at me?

 I smile every day in male ward and let me show you some of the reasons why!

OT with a big smile and external fixator

Who could resist smiling back?

The awesome male ward nursing staff