Learning to work with limited resources

Learning to work with limited resources.

The patients come to the hospital so sick. Besides the medical problem at hand, they usually have malaria and malnutrition and in this condition their diseases overwhelm them. Even after entering the hospital, the laboratory and radiology capabilities are limited.
For example, a twenty-seven year old female student presented to a local clinic and then a hospital where she was treated for malaria, which is the knee jerk therapy as everyone has malaria. However, she had more than malaria. When her symptoms progressed, she presented to Tamale Teaching Hospital where I missed the diagnosis for a week because of an incomplete history and physical examination, the difficulty with language and communication, and the lack of laboratory and radiology capability. Since Tamale Teaching Hospital does not have a CAT scan she has to go by ambulance four hundred miles to rule out a brain abscess. She had a middle ear infection which spread into the neck and medially along her temporal bone and possible into her brain.
Poverty is a huge problem. A twenty year old young man, an orphan with no family, has a parotid tumor. He refused the advice of the village elders to go to the traditional healer and came to our hospital instead. His ten dollars is short of the forty dollars necessary for the biopsy and there is no government program to help financially. I will pay with donated money for the biopsy. Another example of poverty is a seventy-five year old woman who has thyroid cancer and hyperthyroidism and was placed on anti-thyroid medication to reduce her rapid heart rate prior to a thyroidectomy. Although she started on the medication she did not continue because she does not have money for more.
The new hospital construction is underway and the ground floor has now been completed. Dedicated doctors and technicians are here and working hard.