Medically, more interesting cases:
85yo male seen in outpatient clinic with very large goiter causing venous compression, presenting with nocturnal dyspnea, nocturnal cough, and intermittent LE edema. Also with epigastric pain on exam. Apparently the goiter is so deep that it is inoperable. All labs and an echo were normal. Hopefully some omeprazole and lasix will help.
Elderly woman admitted with several month history of dysphagia and epigastric pain, found to have white count of 38, hemoglobin of 5, and creatinine of 5. Took about a week to get a chest x-ray because she was persistently hypoxic (people can’t get x-rays on supplemental oxygen), but after treatment for presumed pneumonia we got this CXR showing a mediastinal mass vs huge aortic aneurysm probably compressing the esophagus (and trachea). She was discharged today, poor prognosis.
Hospital entrance
Laundry drying outside of the hospital
Map at the entrance of the hospital
Outside the hospital
Slide drying rack (i.e. window in the office of the acting program director)
How expired people are transported to the morgue
Inside one of the national health books. #11: Please, commit yourselves to the fight against the spread of HIV in our country. Cameroon is dying slowly from AIDS.
Of course...
The most common Cameroonian food: fufu and ndjamajama
Dr. Jam (one of the senior residents) and me
Dr. Jam's wife and three of his four kids - the family lives next door to where we are staying. The littlest boy took off his pants the second he walked outside.
-Karen
Tough cases with few resources -- I'm sure it is beyond frustrating to be unable to provide the help that would be available in the First World. But one does what one can, and you do more than most people, chapeau (hat off) to you. Is it really the case that Cameroon is dying slowing of AIDS? Is it worse there than elsewhere on the continent? Maybe much of sub-Saharan Africa is suffering the same fate. Perhaps you are already back on the road at this writing. Safe travels, much love, see you in a few days in NYC, G-d willing, of course.
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