last call

today marks the last of the days/nights on call here at Galmi.
it's 3pm on Sunday and so far i've admitted 12 i think. i've heard the ambulance twice. this is a funny thing - because Galmi does not have an ambulance. so that means some other facility (term used very loosely) is bringing someone to the Galmi Medical Center.

• today it was a load of 5 very sick anemic kids from MSF (Doctors without Borders) - all with malaria, all needing transfusions, and one having a seizure in the ER as i examined her.
• another was Salifou - a guy also from MSF who has some sort of badness in his abdomen - typhoid? we're not sure. may never be. fluids and antibiotics to broadly cover the possibilities.
• another was Rabi - a woman who i found in the ER on the floor - mostly unconscious - having some sort of seizure or posturing - and my differential diagnosis includes: cerebral malaria, meningitis or post-partum tetanus. she delivered a baby 7 days ago at home and has been ill for the last 2-3. baby is ok, but hungry, and now she doesn't have milk. and there's not exactly Enfamil on every shelf around here to substitute. so sad...
• another is Faurera - a little girl who had a fever, diarrhea and vomiting, and her family took her to the Shaman (traditional healer) who gave her some potion. now her abdomen is huge, and she is very ill. often these children die from necrosis of the intestine and liver failure. she may just have had malaria, but now, it is that and whatever the toxic effect is of the poison she received. this is SO SO common here - please pray for her and for the Shamans to be no more. they are killing their people. and unfortunately, when the damage has been done, they come to Galmi Hospital and end up dying, which makes the family think it was something the hospital did... this is the deception of the evil one here.

Now, i'm off to follow up on all the tests i ordered and the multiple blood transfusions and such.

i leave on October 30th for another very long day of travel. and i'll be at Galmi until the morning of Oct 30th, so after today - just 2 more days of work. so hard to believe.