After yesterday’s frivolity, back to ward work today – the babies generally doing well in maternity including a couple born at 28 weeks gestation each weighing about 1 kg both progressing well.
Children’s ward not too full which is encouraging but found a new admission – a girl of 12 who back in February had developed some pain and swelling above her right knee. This progressed and later some pus was discharged. She received “treatment” in the village which included cutting the skin around her right knee. She was at some stage taken to another hospital but it doesn’t seem much was done.
The following month she had a pathological fracture through the infected lower right femur. No effective treatment was received. This may be partly due to poverty and the family being unable to afford either the cost of treatment or transport to a hospital.
She presents with a small sinus discharging on her right thigh, which is markedly swollen and angulated. The result of her untreated fracture healing incorrectly aligned is that she has shortening of the right leg [a 6.5cm difference].
She is not in a lot of pain as the fracture has healed and is stable but she has marked deformity and would limp if she tried to walk. She is now on intravenous antibiotics and will need these for some time to try and clear the infection which is deep seated.
All this would have been avoided if she had been treated correctly in the first instance and it’s really sad to see such cases. Once again there is a challenge of health education…
On a happier note, the photo of the two boys shows them enjoying lunch – a mixture of pototoes, avocado and beans! They both have fractured femurs from falls and are being treated with skin traction using stones in an old paint tin as the weight and other paint tins utilised to tip up the foot of the bed.===========
Hanna has unfortunately picked up some sort of cold and, very unusually for her, has spent the day in bed… hopefully she’ll feel better tomorrow.
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