Shanksteps #76

 There are constantly new ways of doing things when one lives in a rural situation without many supplies.  We order medications and only half of our order arrives.  So we do without medications a long time.  We are forced to make due with what’s available at the time.  There are other medications available through pharmacies in town but the cost is prohibitive to the local population.  Our prices are already to high compared to the health clinics in the area.  Our prices have remained the same formany years but we are still just existing financially.  Even with our “high” prices we can barely pay our workers each month.  The government dictates the salaries of workers and unfortunately as of yet we have not received any financial help from the government to help purchase medications∑  In addition, in rural areas we use what is available out of necessity.  Here are a few examples: This hernia is to difficult to close with only sutures.  “Well we have mesh!” “Mesh?”  “Yes we sterilized it yesterday.”  To my mindset this sounds very strange.  I have repaired all hernias here with only suture since coming to Cameroon.  Now I’m in a hospital in Chad, and they have mesh?  After asking further questions I discovered that the “mesh” was a cut up mosquito net.  I thought, what! a mosquito net?  I guess there have been studies done with using mosquito nets as mesh in impoverishedareas.  So I tried it.  It lay very nicely in the repair.  After the surgery the man was healing well and went home in a couple days.   Another was in prostatectomies.  We have many old guys whose prostates are so large that they cannot urinate well and get urine infections.  And as we do not have sufficient supplies of medications for this disease, in general we treat them for a few weeks and then operate on them.  Well after the prostate is removed they usually bleed a lot and need continuous bladder irrigation.  Some people can afford the regular saline flushs and others cannot.  We have heard in the past some surgeons have usedplane water irrigations.  So we have done this at times out of necessity.  And it appears to work well.  Also the family can add water and if the nurse is busy and doesn’t do it, then at least there is still irrigation running. Another is our treatment of meningitis.  IN the US this is generally treated for a few weeks with intravenous antibiotics.  Here the people cannot afford it.  It takes a great deal to even convince them of a few days.  As soon as the person is awake again they want to take them home.  We generally do 5 days IV and then 2 weeks of oral antibiotics. I think the most important part of our patients health is Gods healing them.  In spite of our inadequacies and in spite if our lack of appropriate medications, people get well at the hospital.  We try to encourage our patients that it’s God that heals them at to look to Him.  Thanks for your prayers and please continue to pray for all those we care for.  We are all His children whether we know it or not.