The Difference Between Manhattan and Northern Ghana

Buying donated clothes at the market.

Contrast in shopping between Northern Ghana and Manhattan.

Photo of tetanus child.

This five year old presented with tetanus, spasms of his jaw and neck from toxin produced by the bacteria clostridia tetanus. With excellent care, tetanus has a ten percent mortality rate, but due to the lack of resources has a sixty percent mortality rate here. This child was vaccinated, but breaks in the cold chain may have rendered the vaccine impotent. Tetanus spores commonly enter the body from a deep contaminated wound. This child has an ear infection in which he may have introduced the tetanus bacteria by rubbing with his dirty soil contaminated fingers.

Rope injury to neck of six year-old boy.

This boy was a passenger riding on a motorcycle when a rope across the road caught him in the neck. It caused a partial laceration of his trachea. This super guy allowed me to pass an endoscope without anesthesia through his nose down to examine his injured voice box. With conservative management he did well. Upon discharge, his mother thanked us for saving her son’s life. Better pay one cannot receive.

Follow up on the thirteen month old child who swallowed the clothesline clip necessitating a tracheostomy.Now fine.

Road Traffic Accidents and Ingested Foreign Bodies in Children in Africa

This past week, a modified Benz bus slid on its side injuring five women who were on that side of the bus. Four of the women had their right arms amputated, two also had their ear totally avulsed, and one partially avulsed her eyelid. One was a fifteen year- old girl. Luckily no one was killed. Road traffic accidents in the developing world will soon kill more than malaria, which kills two a minute.

Clothesline clip at 12 0'clock, bottle cap removed at 1 o'clock and other items removed from children.

Children put coins and other objects in their mouth. One thirteen month-old child aspirated a steel clip which was from a clothesline fastener. The plastic ends of the clothesline fastener had broken off, freeing up the metal clip. The two sharp ends of the clip were pointed upward and as it was removed, the sharp ends caught behind the larynx. The child needed a tracheostomy to prevent upper airway obstruction and was transferred to Kofo Anokye Teaching Hospital, Kumasi, where they were able to remove it several days later. This is the third child I have seen who swallowed a clothesline metal clip. I asked the manager of the local Melcom Department store to order clothesline clips which are steel and would not break. He readily agreed. Another practice here is opening soda bottles using one's teeth on the cap. A fourteen year-old boy swallowed the soda bottle cap and it was removed with difficulty.

Woman with loss of right arm and repaired eyelid