Well, as I am sitting here dealing with a frustration-reformatting yet another computer, I might as well write about some of the triumphs we’ve had. This past Friday I was doing outpatient consultations and the nurse rushed in and said that we had an emergency. She ushered in a mother, carrying her 3 year old son, who was comatose. Meningitis? I wondered. Cerebral malaria? Oh, yeah-let me ask the history first. “What happened?” I asked the mother. “He drank ‘Thioda’,”she said. Thioda is the insecticide that local people use here, in the family of organophosphates. It seems to be the method of choice that people use for suicide. Also, this was our second child who had come in with accidental ingestion. The first child was a terrible case; his mother was not at home, because she had gone to give birth. She went on to rupture her uterus and need a hysterectomy. In her absence, the older child found a soft drink bottle which was unfortunately the receptacle for the insecticide. He drank it and later died.This child showed the classic signs of organophospate poisoning-pinpoint pupils, increased lung secretions, drooling, unconsciousness. We quickly took the child to the pediatrics ward, started an IV, washed out his stomach, gave charcoal to absorb the poison,and gave atropine, atropine and more atropine-the preferred antidote. With help from a visiting medical student, the other doctors, and the fast acting nurses, the child survived. This was our first case of Thioda poisoning to survive-hopefully not the last.
The other triumph occurred the same day. We had been following an HIV positive woman with swollen, painful legs. On closer inspection, she had some dark spots in her mouth and on her legs, leading us to make the diagnosis of Kaposi’s Sarcoma. Previously, we had sent such patients to Kigali-a difficult and daunting prospect for the patients. A few months ago we had a tip from a South African colleague working in eastern Rwanda that it was possible to get chemotherapy drugs from the central government pharmacy supply. So we had on hand the necessary medicines. I emailed our clinical HIV supervisor in Gisenyi and he gave me the protocol. So, on Friday, we gave this patient chemotherapy, without complications. We pray that it will work well-she still has seven more treatments to go.We are thankful for the small victories, and the opportunities we have to make a difference here.
But thanks be to God! He gives us the victory through our Lord Jesus Christ. –