Sickness in rural West Africa

Some of our patients are so sick and in such pain. There is a twelve year-old boy, Ernest, who never complains, but is dying from an extensive sinus neoplasm. His biopsy was taken three weeks ago, but no report yet. We try to relieve his pain with oral morphine three times a day. If his biopsy reveals a lymphoma, he may be helped with radiation and chemotherapy, but he has lost so much weight.

Because her corneas became dry from her burned eyelids retracting, skin grafts were place in the eyelids of the burned epileptic mother of four who fell into a fire during a seizure. Her surgery could not be performed in the main theatre because the central air conditioning system is not working. Since her deteriorating vision would not allow a wait of two weeks for the air conditioning to be fixed, the surgery was done under local anesthesia which added to her pain. The eyelids, now with the full thickness skin grafts, are covering her corneas and hopefully this will save her vision.

The above situations demonstrate the difficult conditions in which sickness is treated in the developing world. The shortage of pathologists to help diagnose and the lack of basic maintenance to facilitate a do-able working environment are just two examples.

The boy in orange was playing under a car when it drove away and he had his scalp taken off. The smiling boy had 95% of his left ear avulsed in a road traffic accident. The ear was sutured back and is doing well.