A Weekend in the Maasai Clinic: July 24-26th

In the last few days in Lengast we did a two day free childrens clinic … well, mostly children. A lot of moms and grandmas and random old men wanted to be seen as well and we just couldn’t turn them away! We were Dr. Harry, Dr. Lint/Lindsley, Dr. Michelle, Dr. Blad, Dr. Brian/Brianna. (Brad and Brian are a medical assistant and a doctor that we met up with from Salem at Mt. Meru). We had three separate exam rooms set up and from 1-10 patients. Very often moms would walk in with 4 or 5 kids with medical problems, as well as a complaint themselves. And often times the kids had very different diagnoses. The medical students saw patients ourselves, examined them, developed a treatment plan and called in Dr. Brian when we felt necessary. In all we saw 250 patients in 2 days (10 hours). We worked through interpreters … some of them were great, and some of them not-so-much.

We saw a lot of Pneumonia, Malaria, Intestional Worms, and Fungal Skin infections, but we also saw some really interesting patients that we had not yet seen in the states:

1) Molluscum Contagiosum: Dr. Harry saw this patient with assistance from Dr. Brian, and it really looks like small pox. Shout to to Med12 … you remember this one from BBOD? Only surviving pox virus!

2) On Saturday morning, all of Harry’s patients seemed to be geriatric. She saw a lot of “My joints hurt” and “I can’t see well” and “I’m tired all the time.” Sounds a lot like our grandparents back in the states!

3) Michelle saw a patient who complained of bilateral ear pain. So I looked in his left ear and saw his TM perforated (definitely not the first time today) and then I looked in his right ear and saw some black and red things, which I couldn’t really differentiate. It kind of looked like a bug to me, so I called in Dr. Brian. He then asks mom through an interpreter “did he stick anything in his ear?” to which the mom responded “oh yeah, he stuck a stick in his ear the other day.” Through several saline washes and forcep excision from the ear, Dr. Brian and I pulled out a 1cm x 0.5 cm stick and pebbles from this kids ear. And he didn’t even scream at all, just winced a little bit.

4) Dr. Lindslay saw a kid with malformed limbs who wanted an mzungu (white person) opinion. This six month old girl had limbs that were malformed, and she had blue sclera and dysmorphic facial features. Med12? Diagnose the patient …. Osteogenesis Imperfecta!

5) Lindsay drained her first abscess from the neck of a 12 year old. In Lindslay’s words … “it was magical!” It drained beautifully … blood and pus just oozed out. In Dr. Brad’s words … “it was awesome!”

6) Mzunguphobia was also a very common diagnosis. When the moms pulled out their little toddlers from beneath their kangas (moms often carry their kids on their backs beneath a kanga) the kids immediately started screaming at the sight of a white person. Some of these kids have never seen a white person, and the sight of us was just terrifying!

7) The mzungu touch was also a common request. There were lots of moms that brought in their perfectly healthy kids for a “white person touch.” One of Michelle’s patients was a 6 month old girl with thunder thighs … the only kid in this country that I have seen with thunder thighs! And mom’s concern was “is she developing properly?” Yes … she is the healthiest kid we have seen in Africa so far.

8) Many moms walked into the clinic and told us that “it hurts when the dust gets in the kids eyes.” Hmmm …. I think that I have the same problem! Yeah, it really hurts when dust gets in my eyes too!

We saw a lot of kids with “pneumonia” which we diagnosed simply clinically. A lot of these kids probably had a viral URI, but since it was a short-term clinic with no follow-up the best solution was to treat them. We gave a lot of amoxicillin, I mean a ton of amoxicillin to treat “pneumonia.” Most of their lungs sounded really crappy, but we weren’t exactly positive that it was “pneumonia” instead of a viral URI. I think that we just created amoxicillin resistance in Tanzania.

One of our nurses was named “Candida.” Med12 … I’m not kidding you … her name was Candida, and it was really hard to leave the “albicans” off of that.

Overall the clinic was a lot of fun, we helped lots of kids. We did end up seeing some pretty sick patients … TB, Congenital heart disease, and the like … and we helped a lot of patients that would otherwise have not received medical care.