Idiots Abroad: Stories that make it all worthwhile

Moussa (Left) and his brother

Moussa Mahamat and Ahmat Mahamat are brothers from the village of Abeché. One of the northern villages next to Sudan.

Moussa the younger of the two brothers was a bricklayer and was walking to work one morning when something stung him. He says he didn’t see what caused him the pain. A week later he was unable to walk. His brother described him as crawling around on the floor like a baby. 10 days after he was stung he went to the Adventist clinic in Abeché and an American Anesthetist who has been to Béré in the past referred him to our hospital.

So with all the money they had they began there 1,400 km journey to Béré.

When they arrived at our hospital on February 15^th the carnet said:

My first look.

13/2/13

10 days after right foot wound, progressed to dry gangrene. Loss of all function and sensation below right knee. Pain felt from knee to groin otherwise no complaints.

Dr. Rollin and Danae operated right away. They preformed a Above the knee amputation (AKA). They described his leg as wood. They didn’t think that he was going to survive to make it back home.

Starting on 2/19/13 it became my responsibility to change Moussa’s dressing everyday.

My daily task.

I gave him 250mg of ketamine before each dressing change. The first time I unwrapped his band and removed the gauze that was packed into his leg I thought this is never going to improve. There was dead tissue, pus and some sort of slime oozing out. I stood there for what seemed like forever trying to decide where to start. When the all-inspiring Olen gave me the gracious words of wisdom “Be aggressive”. Now that I can do. I got my forceps and scissors and went to town taking a little dead tissue off here and there. Flushing it with a bleach water solution and rubbing vigorously. I repacked it with a lot of bleach water compresses and a new band. Just in time for his ketamine to start wearing off. I was satisfied with the end result and but it was no where near where it needed to be.

So everyday I did the same thing and slowly the infection improved all the dead tissue was gone, It was beefy red and filling in. I don’t know if a open leg amputation can be pretty but from what it once was this amputation is hands down beautiful.

The finished product. Infection
free and ready to go home.

On March 7^th we took him back into the operating room and closed him up and placed a Penrose drain. And on March 28^th he was discharged. Happy and healthy.

Zenabou (Middle) with her parents.

Zenabou Issa a 20 year women from Achaua which is about 200km north east of Béré on the opposite side of the country came to us on February 27^th. Her and her parents had traveled all over the country seeking help.

Sometime in January Zenabou went to a local trained by the Red Cross who go through a 3 month training course about health and medications and then are certified by the Red Cross to prescribe and give medications. She was sick so the medical man gave her a IM injection of Benzathine Benzylpenicillin in both arms. The dosage is unclear to me and what she was sick with is also unknown.

The next day her left arm was swollen and within 6 days it started affecting her left eye. They traveled north to a health center in Mafili where they stayed for 40 days and the only treatment she got was antibiotics (Flagyl, ampicillin, Gentamycin). Next they traveled southwest to a district hospital in Bangor which is just north of Béré. In Bangor they spent 10 days there. The local doctor there told her that he could only amputate her arm at the elbow even though the infection went all the way up to her shoulder. Any higher then that and she would die. So they headed back home to Achaua. When they arrived back with no success a friend of her fathers told them about the Béré Adventist Hospital and how good it was. So they made their way.

When I walked out of the Bloc to search for Zenabou Issa I had no idea who I was looking for. I didn’t know what I was expecting but after 15 minutes of calling out her name and people pointing me in all sorts of directions I finally came upon a frail women curled up in a ball on the ground under a tree. I took one look at her arm and wanted to cry. Her hand and forearm were black and it reminded me of a mummy her upper arm had no skin at all. It was pure muscle that was exposed. And by now she was completely blind in her left eye.

The surgery was quick. I assisted Dr. Rollin in disarticulating her shoulder joint and shutting off any bleeding. She was given PCM, IBU, tetracycline, cimetinine, cipro and Amoxicillin. For pain and infection