The patients just keep rolling in.....

So officially here in Malawi it is "winter" which usually means the end of malaria season. But for some reason we are still seeing alot of malaria patients coming in very sick and being admitted for IV Quinine. Some of them have already been on anti - malarials and just don't get better. Others get really sick right from the beginning.

At the start of today we had 0 patients in our inpatient unit as we had discharged them all over the weekend. By the time I knocked off at 6:30 pm we had 9 more patients.

While a nurse and I were trying to start an IV in a 1 year old who had really bad pnuemonia we got called down the hall by another child's parent because the kid was seizing. Thankfully our covering doctor was still there. We gave rectal Valium which seemed to stop the seizure but then the only way to arouse him was by a sternal rub and even then all he did was move his arm. It is hard to say whether the seizure was caused by the high fever or by cerebral malaria since his malaria count came back at 4+ which is the highest it can go. We will pray that he has a full recovery but only time will tell.

Unfortunatley we were not able to get the IV in the other child with pnuemonia so we ended up giving his meds IM and keeping him on nebs and O2 overnight. If he still needs a line in the morning we will have one of the clinical officers put in an internal jugular.

Two of our patients that we admitted have cancer which is a bad thing to have here in Malawi. There is no oncologist here in Lilongwe and the best we can offer someone with cancer is to either go 4 hours away to Blantyre or to fly out to South Africa. Neither one is very feasible when you are in alot of pain with limited financial resources. One of the guys we have been treating since January just with morphine for the pain. Every month or so he comes in for and increase in the dose. We have nothing else that we can offer to treat him so it is very sad. The other guy came into with probable prostate CA. His bladder was so distended that when I cathed him I got out almost 2 liters of urine. I don't know how he was even walking around like that. Once he is stabilized we will refer him out for treatment.

The rest of the patients were malaria patients. Usually treatment is straight forward. IV Quninine x 3 doses 12 hours apart and then discharge home as long as they have no fever.

I thought maybe you would like a glimpse of what it is sometimes like at our ABC clinic. And those were just the ones that got admitted. We saw many more as outpatients in the clinic who were treated and sent home. Days like today are very busy but are also the most rewarding.....

Becky