A Twenty Five Day Struggle To Save An African Infant's Life

A nine month old girl was transferred to our hospital in respiratory distress after being fed hot porridge by her mother. Was the respiratory distress due to a burn of her larynx or did the porridge enter her lungs? Examination of the larynx revealed a swollen, reddened larynx obstructing her breathing and an endotracheal tube was passed relieving her airway obstruction. In order to prevent the child from removing her life supporting endotracheal tube, she was sedated; a feeding tube was also passed. She developed pneumonia, malaria, diarrhea, abdominal distention and her endotracheal breathing tube came out on the eighth day. At that time, the swelling of her larynx had subsided and she was able to breath. Finally on the twenty-fifth day, after her mother had been educated on feeding, she was well enough to be sent home.

 Examining the infant girl prior to discharge.

 Burned, swollen larynx with endotracheal tube passed through her vocal cords.

                                                             
  Ready to go home.

Medical Cases from Africa

A four year old presented who aspirated a tamarind seed two weeks before. Every time we tried to remove the large, swollen seed through the vocal cords it would fall off the forceps. Breaking the hard seed into smaller pieces to allow passage was also unsuccessful. Even by paralyzing the patient we could not extract the seed. Keeping the patient sufficiently oxygenated was a problem. An incision was made in his trachea and the seed was removed directly from the wider trachea. The child was discharged healthy in four days.

A 60 year old man presented septic, with a deep neck abscess. He had had a tooth removed six years ago. His x-ray showed a dense object in his peritonsillar region and examination of the oral cavity showed a partially visible object. His neck was drained of 150 milliliters of exudate and removal of the object revealed it to be a round piece of wood with a ceramic base. It looked like a prosthetic crown or the broken end of an oral clamp. The patient denies having had a prosthetic crown put in after his tooth removal; however, it will be shown to the maxillary surgeon for further clarification.

                                          Tamarind Seed

The Advantages of Practicing Otolaryngology in Ghana by an American Otolaryngologist

Practicing otolaryngology for twelve years, the majority of the time as the only otolaryngologist without other specialists in an area of over two million people, has required studying, reading, consulting physicians, accessing Hinari and Youtube. Caring for many sick patients has been the best teacher of all. Helping to restore the health of others resulted in increased confidence and the personal satisfaction of contributing to society.

Living, working and sometimes disagreeing with the Dagomba of northern Ghana resulted in appreciating another culture, religion and race. It taught me the common human feelings shared by all men. The Dagombas welcome strangers believing we are enriched by each another. One of their proverbs states that a stranger can do no wrong. They forgive my many mistakes and truly appreciate the little help I have given.