Sites of the day:
*epilepsy (partial complex sz) in a 10yo. Reported symptoms: tired --> lies down for 30-60minutes --> wakes and is confused and speaks jibberish.
*febrile sz (5yo & baby)
*Polio (17yo boy): Pt reported that he'd had this for 2yrs. Unusual to get polio at age 15. We tried to get more information about where he lived to see if there was any correlation with a recent outbreak or anything, but we were not very successful. He was very reluctant to tell us what area he was from. MD treated with PO (oral) Naproxen for pain & topical anti-inflammatory for right knee. We can only treat his symptoms. The damage from the Polio has already been done. (Right-sided weakness and muscular atrophy. His right knee had very significant patellar swelling. It was very pronounced and nobby-looking. I guess a good way to describe it might be like a baseball sitting on top of a twig, or something. Very distinctive Polio walk/limp. Basically, his right leg is totally deformed and weak, so it kind of drags along while he supports himself with the Left leg and a walking stick.) I reall wish I would have taken a picture of some of these things, but here's a pic from the web of the effects of Polio. I couldn't find the pic I wanted, but this is a good diagram of the muscles effected by Polio:
*vaginal yeast infections (many causes for this kind of stuff, but one way is from sitting in bad water, such as a lake, puddles, etc, to bathe, wash clothes or dishes, etc). We saw this kind of thing a lot in Dominican Republic.
*more tinea capitis. By the way, this (ringworm) is a fungal infection. Round patches with defined and slightly raised edges:
Ringworm (tinea capitis)
versus
Folliculitis. Patchy and more irregularly shaped.
Once these pustules start to dry up/scab over, it is a little more difficult (for a newbie) to distinguish from Ringworm.
*Shingles in a 25yo woman (down her Left leg). Likely HIV+ because she's so young. Also, commonly Shingles is seen on the back around the rib cage, but it can occur along any nerve pathway...and if you know your nerve pathways (which I don't) you can easily identify it was Shingles because it follows that path exactly. The husband a dark patchy rash accross his face (nose, forhead, and cheeks. Likely HIV dermatitis).
*umbilical hernia
Today was my last day at the med clinic. We returned back to Mfangano on the 430pm boat, which naturally, left around 530pm. I've been "mzungu'd" to the max over this side, but maybe the cherry on top of all the "mzungu-ing" was from the boat conductor. Someone else on the boat has something like "Now, where is this mzungu going?" And the conductor defensively responded: "This is our mzungu! Go find your own mzungu." So now I proudly hold the title of Mfangano's Mzungu. :)
IT TAKES A VILLAGE:
As we were walking up to the shamba, there was a big gathering of people by the airstrip. Some sort of meeting apparently. We later learned that a relative of Stanley's was among them. Well, by that I mean he was the main event. As it turned out, the gathering was an intervention. The guy's mother told on him to the community youth group because while he should be in university now, he prefers playing pool all day and has no motivation to work or go to school. So, his fate was to undergo interrogation and caning by the youthgroup, who then proceeded to develop a plan of action for him. His sentence: he has been assigned a teacher by the youthgroup and is to be woken at 6am each morning for studying. Needless to say, he's not at all happy about this and ignores all of our probing question regarding "Tell us what happened Thursday evening? Where were you?"
These types of interventions are the typical mode of getting someone back on the right track. Not too long ago, ome parents were accused/known to be neglecting their children (leaving them in the house, not being good parents). The village found out, brought both the mother and father to one of these sessions, and they were both caned and severely scolded for their parenting (or lack thereof).
Also, if a man is found to be beating his wife, he's caned as well.
Therefore, it takes a village. I wish we had this kind of community support in the U.S. I think we'd have a lot fewer problems if we had more people being accountable for each other.
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