Monday, October 4, 2010

Bamako, Mali 10/04/2010

Our last Monday. Busy day.



Throughout Bamako are open troughs through which the water flows. There is much trash and debris in them, and it is a public health issue. Where does one start to provide infrastructure for a city? My guess is that a water treatment plant with underground drain pipes and sewers would help with many problems here. Clean, potable, running water - what a luxury!



Sweet, smiling, confident and trusting mom with crying baby. Little girl was to have her hand fixed, and she was so cute. Many of the hand problems that we repair change a hand from non-functional to useful. Not all end up looking like a normal hand, but the thumb function in opposition to the fingers, and the grasping function of the fingers might be provided. Suddenly they have the potential to function with two hands, which may mean they can work, provide basic functions at home for themselves, and embrace their world.



Steve with beautiful mom and baby.



Her tiny hand being grafted with her own skin. The fourth and fifth digits were fused to her palm from birth and would not open. She will hopefully be able to grasp now with all fingers.



This one year old boy was fast asleep with his mother. I scooped him up and got him to sleep without him ever waking. Not a peep! Made my job easy.



This little baby had amniotic bands, which constrict a limb from birth and prevent normal growth. Only a few months old, hopefully she can catch up on some of her growth and lose the swelling in the left foot. She was crying and fussing, so our coordinator Manon wrapped her up on her back like the locals do and the baby quieted right down. Nice and close!





This was the first time we unwrapped this most difficult release and graft of the popliteal space. The knee was almost fully flexed and the child had to be carried everywhere, not even able to sit. Now at least he can sit and hopefully with time get his leg to open out. Mostly clean, it was redressed and we will check it again before we go. Pam, our hand and splint specialist will be here one more week and can check on this patient as he needs it.



Looking closely at this child as he had his dressing changed, I noticed the buttonholes were tied with string. Can you imagine being too poor to afford buttons? We had one earlier during the first week with string on the belt loops of his pants; he had no belt.



The guerney we were using fell apart, so we have had to start using a litter (stretcher). The patients get transferred from the recovery bed to the stretcher, and then are carried out.



This young man was the first on the stretcher. He had come back for a dressing change with anesthesia, as pulling the gauze off can be very painful. We all told him after he was done what beautiful eyelashes he had. He wanted to see his photo, stared long and hard at himself, and then smiled. Nice end to the day.

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