Edited by Rita Agarwal MD
The Children’s Hospital
Denver, CO
This is another in an ongoing series of letters from Mark Newton, a pediatric anesthesiologist and missionary doctor in Kenya. Mark did his anesthesia residency at the University of Texas, Houston and his Pediatric Anesthesia Fellowship Training at the Children’s Hospital, Denver. He has been in Africa for 4 years and has 4 children. The newest is Elena Grace whom he and his wife recently adopted while in Africa. For more information on the Kijabe Medical Mission Hospital go to http://www.webwink.com/nateandkim/KIJABE.HTM
Interesting Anesthesia Week in Kijabe! (Or Lessons I never learned in Medical School, Residency or anywhere else for that matter.)
Greetings to each of you from Kijabe, Kenya. A few weeks ago, my week was unusual, even for Kenya, and I wanted to give you another view of life for the doctors working in another part of the world.
We had a pediatric neurosurgeon visiting from Uganda. He is the former residency director at University of Kentucky and visits us every 6 weeks. We had started the first of 6 frontal encephaloceles repairs (very rare in the west) on Monday and even though the case was interesting, I was on the phone most of the morning arranging for the posse of men to track down the rabid dog which had bitten many dogs over the previous two days. My week as an infectious disease fellow had just started!
Fortunately, our own dog is a good fighter and fought him off during a time when our children were around the rabid dog. After completion of the first encephalocele, I went home for lunch and found....... the head of the rabid dog in the back of my truck. I had to send the head to the National Veterinary Lab for a confirmation. Two weeks later, however the chaplain’s dog came down with rabies so we had the definite diagnosis. The National Vet Lab did not have a light bulb for their scope so they were never able to tell us anything. Lesson number one in infectious disease week: Don’t rely on "sophisticated" equipment for diagnosis.
On Wednesday, I was delivering corn and beans to an area where all of the cattle have died because of the drought. The Masaii men brought a 7-year-old boy to me and informed me that he was very sick with a high fever and a rash. As he was climbing into my vehicle, I said he looks like he has measles and left him with instructions and medications to treat his pneumonia. Thursday, we had visitors from that village who said that now ten people had the same disease and they were very worried. I organized for six nurses and myself to go the next day to the village. We immunized 240 children for measles. This was lesson number two and a vivid reminder of the lack of basic medical care only 45 minutes drive from Kijabe. We treated several others who developed pneumonia post measles.
I now felt very much the ID guy and was going to write the CDC for a special diploma. The next morning I received a phone call from the ward, which informed me that we may have a patient or two with an arbovirus, like lasse fever (or one of the viral Hemorrhagic fevers from "Viral Hunters"). I was chosen to take the virus to the CDC-like lab in Nairobi to be analyzed by the CDC East African experts. It was very interesting and educational but not something I was taught in my residency program. Lesson number three: someone’s got to carry the virus! The weekend brought me back to the beginning of the week with the first encephalocele who developed post operative seizures either from cerebral malaria or encephalitis. We happened to find some vancomycin in a box and the child survived but after two intensive days. Lesson number four: be grateful for what you have. I write these letters to remind each of us that many times we can be stretched further than we imagined possible outside our comfort zone of anesthesia. I trust each of you will have a great day and please remember the less fortunate peoples of rural Africa.
Extra: We had another child with a puff adder snake bite who arrived 50 hours after the bite. The starving children are chasing rabbits and rodents into holes and then blindly sticking their hands in to get the animals, thus the bites from snakes. We got some anti-snake venom and in our fake ICU, he recovered and will not get an amputation.
God Bless each of you,
Mark Newton for the entire family including our new member Elena
Grace, now 3.7 kg and 7 weeks old
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