Amazing, surprising, dismaying, all at once

I asked the students what they found amazing, surprising, dismaying,  etc.  I will intersperse some comments.  

From Laura Melcher:

Hi Ken!

Thanks for the email! I hope all is well with you as you prepare to join us at Ilula.

To cut to the chase--yes, I am having a great time! Here are short answers to your very good questions:

Amazing: the resiliency of these children (and adults, for that matter). With my interest in Ob/Gyn, I've spent a lot of time on labor and delivery, seeing firsthand the challenges infants face as soon as they enter the world--minimal resuscitation available, lack of basic antibiotics, and most saddening, the low availability of enough good food. And yet  most kids grow up ok!

Surprising/Dismaying: the lack of physical exam and history-taking that the medical and clinical officers perform. I would have supposed that given the lack of resources for laboratory and imaging diagnostics, there would be more emphasis on easy, cheap physical exam. But typically the patients in the clinic and hospital have minimal if any vital signs recorded, much less cardiac and abdominal exams. (In my studies with online USAID modules - I have achieved Novice status, I see many things we might be able to improve on. I am not sure where the energy will come from with over-burdened staff, already doing yeoman's work.  Here in the US we do many things just for the sake of documentation.)

Haven't given out any plumpy nut yet, but I think it's because we haven't made it obvious enough to the medical staff that we have it. Certainly several children I've seen could use it! Delivered 6 babies, though 2 did not make it.... ...Interesting and sad stuff. Assisted on 2 C-sections, hopefully more to come! Performed about 4 OB ultrasounds with Dr. Tessmer-Tuck, which is amazing learning! Discussions are underway for Dr. Saga to get more US training soon.

Looking forward to seeing you soon!  (And likewise, I can hardly wait!)

Laura

 And from Will Amundson:

Hey Ken-

It's going great so far!

I can't believe the variety of illness we see on the wards. Crazy things I've only read about, like cerebral malaria and cryptococcal meningitis (both patients that would have been intubated and in an ICU in the US), to healthy, happy women just waiting to give birth. Clinic has also been fascinating, with parasitic infections galore.  (Uh, wear your shoes!  And take notes.  At rounds next year, I want you to say, "Well, when I was in Africa....)

I've been discouraged by the speed that rounds must usually progress in, due to the staff being stretched thin, and the very limited physical diagnosis employed by the staff. It has been a great learning experience for us to be here, and I think the staff like to hear our opinions as well.  (As you all can guess, I am very sensitive to the "stretched thin" part.  It is an unfortunate fact of life at Ilula.  Not enough time for all the work.  The staff is extremely generous in having us there!)

See you soon!

Will

Here is a photo looking out from the guest houses.  Probably hasn't changed much since 2011: