It was Sunday, market day in Koza. I awake with diarrhea at 4AM. I cant sleep after this. Have diarrhea a few more times by 7:30 when I head in to the hospital for morning worship and signout.
Sunday means that hundreds of people are in the market and extra people are in the hospital too. Dr. Roger and I saw about 24 outpatients. One had a huge abdominal tumor that was a little mobile, and we will attempt surgery, another had a muscular tumor in her upper tricep that appeared separate from the important vessels on ultrasound, a 5 month old child with Pertusses (whooping cough, that normally children, even here, are vaccinated against), a child with Beri Beri and malnutrition, and another malnourished, dehydrated and with malaria, and the rest were pneumonia, malaria, typhoid and dysentery. Also saw one of the workers boys who had a huge leg abscess. It had begun with ankle swelling, then the leg swelled and they drained out pus at the ankle and mid calf. I looked at the leg and after giving the kid Ketamine to help him sleep, I felt his joint. At the opening I can feel the ankle joint exposed. I filleted open the leg from about mid calf down, exposing the musculature below. Drained a lot of pus, and packed it. Saw a few patients in clinic again. Then by 4PM made it home for lunch. G