So, I’m in Togo. In case you hadn’t heard. I’m on loan for a
couple of months from Loma de Luz to Hopital Baptiste Biblique/Karolyn Kempton
Memorial Hospital in Tsiko, Togo. The
hospital here in Togo is short handed and in need of family doctors while Loma
de Luz was experiencing the wonderful challenge of trying to find space to fit
all the doctors into clinic rooms who were there working.
It is impossible to come to another hospital and not be
comparing and contrasting constantly, at least in the first few days. The
climate and setting reminds me of both Honduras and Zambia, with many of the
same tropical insects, critters, and flowers.
One thing I was sad about in leaving Honduras to come here was that I would
be missing mango season- one of the most wonderful times of the year in my
opinion! What greeted me on my drive to
and through the hospital compound was piles of mangos and mango trees heavy
laden with fruit. Grace. This is my
first time returning to the continent of Africa since 2009 and I had forgotten
how colorful the clothing and how elegant the womens’ dresses are. My favorite
image here is seeing the front of a lady with two tiny feet sticking out, one
on either side of her waist, coming from the baby (or sometimes toddler)
strapped to her back.
HBB/KKMH was founded in 1985 and it is reportedly a 50 bed
hospital, with a busy maternity service and outpatient department in addition
to the inpatient wards. The clinic is largely run by Togolese Physician’s
Assistants with the American doctors coming to help after finishing hospital
duties. Overnight call and emergency
cases are also first seen by Togolese PAs who call the doctor if they need
help, or simply report the overnight cases to the team in the morning on
rounds. On my first day I only rounded on maternity, but even there saw 1) a
lady with flash pulmonary edema starting 3 days after delivery, 2) a newborn
with sepsis, 3) a 20 week pregnant women with right lower quadrant guarding
that we suspect is from an abscess, 4) two sets of twins delivered by C-section
the day before, 5) a 25 week premature infant who is feeding and growing and
now 1 month old, 6) preemie twins born at 30 weeks gestation who are now 6
weeks old, 7) an HIV exposed infant presenting for follow-up to the well child
clinic. Maternity had 2 women in labor and the ER was
humming with a 5 year old with leukemia who came in with neutropenic fever, a 6
hour old baby born with spina bifida at an outside clinic rushed to the hospital
when he was having trouble breathing, a 4 month old coming in for feeding
evaluation with a cleft lip/palate, a cataract, an undescended testicle, and no
weight gain essentially since birth (name that congenital syndrome, anyone?? I’m about to consult Google for some
insight). That was a ton of medical
lingo but you get the idea. This is a busy hospital with lots of pathology,
illness, and also death. There is a lot I need to look up, learn, and research
and I’m hoping there is time to do so.
Today I learned a new option for induction of labor- walking up the
nearby mountain to try to bring on contractions! I’ve seen patients from all
over Togo, as well as from Ghana and the Ivory Coast.
Internet access here is available, for which I am very grateful,
but slower than in Honduras. I’m still available by iMessage (which I can check
about once a day) and e-mail, but Skyping and FaceTime will have to wait until
I’m back in Honduras in August. I’m
staying in the very lovely guesthouse where they have amazing cooks/kitchen
staff who prepare meals every day and do laundry and cleaning. I’m feeling quite spoiled. The surrounding area is beautiful with some
rolling hills that I’m itching to explore and I hear there’s even a waterfall
nearby. I’m sure there are hard times
ahead and a steep learning curve but it is good to be here. If any of you speak French and want to do
some tutoring via e-mail I am an eager pupil. I haven't been out of the hospital during daylight hours long enough yet to get any good pictures and the internet gremlins seem to conspire against me in posting things; I will do my best to get some pictures up soon.
From Africa with love. -Mackenzie
