Children

(Surgical pictures at the end of the post, scroll slowly if you don't want to see them.) 

It's a recurring theme in Tchad that nobody seeks medical attention until they're about to die, or whatever ails them becomes unbearable. And since they are extremely resilient, sometimes that means years.

Today we had 3 surgeries, the first of which was a 4 year old with an exposed femur fracture for 1 year. The exposed bone was dead, of course, but surprisingly, he had no infection.

So Dr. Scott cut off the dead bone and put the 2 ends together, put them on an external fixator and closed. The hope is that the bone will actually grow enough to compensate for the loss and he will have legs of equal length. In any case, he will definitely get to walk. Again, something that isn't possible with an exposed femur fracture...

Then another little kid, from yet another motorcycle accident. That one was 10 days ago, but the arm had gotten stuck on something and almost completely ripped from the torso. Almost, but not completely. Except the nerves, ligaments and blood supply was part of what got ripped... and the result is a child attached to a completely dead, cold, putrefying arm. I'll let you imagine the smell. So it was an amputation, leaving the wound open because of the infection.

The third was a woman with a large, hard mass on her thigh. It looked like a giant mole. It was deep into her sub-cutaneous fat, but had not reached her muscles. Besides a little bleeding, it was removed without complications. Of course, we have no way of knowing if it spread somewhere else, and that thing was massive. 7cm by 5cm at least.

Anyway, I had been craving surgeries, and it felt great to scrub in again, but that little kid who lost his arm made me really sad.

Things that happen in Tchad that you have to get used to but probably never will...