Medcin

We’ve talked about our extra-curricular activities a lot, complete with photos of our weekend adventures, trying to illustrate how much Rwanda has to offer. Though we have spent plenty of time touring around, we’ve both been spending most of our time in the orphanage or in the hospitals. Ashley has been struggling with the direct personal stories of youth poverty and shattered families, where I’ve been witnessing incredible surgeries with very little, and patients that may have reached recovery if resources were available; instead they are destined to die. The intensive care unit has patients that need aggressive physiotherapy and long term care, but the reality has them flailing in the hospital until they eventually acquire an infection that kills them. The first picture looks like a uterus lollipop, invariably full of tumor. She is a woman in her 50s that started having abnormal bleeding over a year ago, but follow-up and investigations were costly, so she is now at high risk of having metastasis. And there’s no way to investigate it. The second is a syringe full of pus, about 15mls. It was aspirated from the lateral ventricles inside the brain of a 5 month old. The ventricles should be full of clear, watery fluid. He was born with myelomenigocele, advanced on the spectrum of spina bifida. If his mother could have had access to simple folic acid, he may have been born with a normal spine. There is no prenatal ultrasound diagnoses. And there is no option for vancomycin, the only antibiotic that could save his life. He probably won’t live out the week. The third picture is of a keloid, like super scar tissue, on an ear of a teenaged girl. She would never have gotten this far without intervention if resources were available. And the final picture is of an enormous spleen. There is a Rwandan 100 Franc piece placed in the bottom corner to give you an idea of the size – the Franc is about the size of a loonie. And your spleen should not be any larger than about a quarter of what is displayed. The cause is ‘Tropical Hypersplenism’, which is apparently attributable to malaria. It’s the 3^rd splenectomy I’ve seen for the same reason, and there is no prophylaxis for the bacteria that your spleen is responsible for killing. As far as Rwanda has come, and let me assure you, it’s very far – it still has considerable room for growth. I look forward to returning in a few years to give me a better sense of its race towards development.

Ashley and I have been talking about her work a lot, and I bet she’ll post some more pictures about it. Maybe not as gross.