Tuesday March 8

Tuesday March 8

Yuk messaged us while we were waiting for our ride to the hospital that the man with the enterocutaneous fistula was a go, but the woman with the 3 enterocutaneous fistulae( we have given her the nickname of "Trifecta") was refusing to have surgery till she saw her family. On the good side, however, 3 children who had swallowed caustic chemicals and had esophageal strictures were given the go-ahead for today. So Santiago and Jenn started on the man, and Yuk and Konneh started on the kids, as we had been allowed to have 2 rooms. Soon after that Yuk and went down to start clinic...oh, before we started Dr. McDonald came up to the OR to ask us to come down to evaluate a man with a bad leg who was outside the ED. In fact he was sitting in the bed of a police pickup truck,mandate had what has to be oneof the grossest things I have ever seen. He has filariasis (elephantiasis) with secondary ulceration and infection. And it really was enough to make one gag! I told her that I couldnt think of any surgical procedure that would be likely to improve things.

In clinic we saw a number of interesting cases including a recurrent large goiter which Santiago and I decided would be more of a surgical challenge than we wanted to accept on this visit; a man with advanced anal cancer; a possible Kaposi's sarcoma of the leg; and the usual variety of hernias.

Konneh has malaria, and son he will be taking tomorrow's holiday (Decoration Day) off to rest. Most people living in malaria-endemic areas develop malaria occasionally during their adult life, but it is generally mild and short lived.

After clinic we chatted with Señora for a while about patient financial issues, and then went back to make afternoon rounds. Everyone is looking good, and we took a number of photos.

After going back to the Guest House we went out to Sajj again for dinner, mostly because they have a big screen TV so that Santiago could watch Arsenal playing Barcelona. The place was packed with similar fans, and a good time was had by all, especially since Barcelona won !