This weeks patients

Yesterday morning Inesta arrived in labor. She knew she was carrying twins. On exam she was 5cm and we felt little toes and the body in the cervix, so we moved her to the operating room and two healthy boys were born by cesarean section, the first weighing 2.600 kilograms and 2.010. These are the youngest of 8 kids and her second set of twins. Here at CSSC, the family member (usually husband) washes all the laundry, including all the drapes and towels from the operating room and the bed sheets. The husband also goes to the land behind the hospital to bury the placenta.

This morning Nanci and her husband Wilder arrived from a town over an hour down river. Their other 5 kids were delivered at home, but after her water broke and the baby's arm prolapsed, and Wilder knew that without help, the baby wouldn't survive. She arrived and Carmen our midwife brought the doppler to check for heart tones. She wasn't able to find heart tones, but we were reassured when the baby gripped her hand and didn't want to let go. Finally heart tones were found, and shortly thereafter the little boy was born by emergency cesarean section, with a strong cry and moving both arms.

Over the last week, we have also had two precipitous natural deliveries, two snake bites, a patient with dengue hemorrhagic fever, premie with severe malnutrition and congenital abnormalities, a 6 year old with with whole body swelling and glomerulonefritis, a 75 year old man with severe anemia and dehydration, 2 women with kidney infections, kids with pneumonia, a man with pyomyositis his gluteus that drained a pop can full of pus when we opened it, a woman with a miscarriage, another who was struck by stingray barb, etc etc.

One 10 year old girl got bit by a moth called a chicharra machacuy. Although scientific sources (wiki) tell me that it's not poisonous, she arrived with frequent strong muscle spasms of her whole body, extreme generalized muscle weakness (she couldn't even stand by herself), and hyperreflexia that could not be otherwise explained. With IV fluid, one dose of diazepam, and time she recovered. 30 hours after the bite, her only residual symptom was paresthesia (numbness) in her leg that was bitten, but has complete recovery of strength and reflexes.

Brian has taken on a lot of the administrative work, and I have been coordinating volunteers and donations. After our trip back home we have a renewed energy to work and learn. Seeing family and friends was great, and although we stay very busy here, we frequently think about and pray for everyone back home. 

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