Shanksteps West Africa 2026 #02
We arrived in the afternoon yesterday. We unpacked and then prayer walked around the hospital. We prayed that God use us to reach people here that don’t yet know Him who are ready to hear. Also that Gods angels guard around us and the hospital and protect us from the enemy (satan) and that Gods will be done in us, through us, and in this hospital. In the evening, the lady who is cooking us food, dropped it by. We had rice with one sauce that was peanut based with vegetables and another peanut based with maringa leaves (tastes a bit like spinach but much smaller leaves from a tree). As we were ready to go to bed a stiff wind started blowing and we heard thunder and saw lightning. And it cooled off to about 70. Having slept very little on the airplanes, we fell fast asleep till morning. That is after killing about 15 mosquitos in our room with an electric fly swatter. Invaluable here. We had forgotten to bring one, but there was a working one in the guest house we are staying in. Yay! We kept the door shut to our room and got no more bites overnight. We definitely are taking our malaria prophylaxis.
In the morning we headed to the hospital in time for 8am worship with the staff and were introduced. Next the surgeon (the only doctor here today) took us on his rounds and showed us around the hospital. There were a variety of patients, and Ill guess about 17 patients. They were here for malaria, body aches, open fractures that were in traction or in various stages of granulation, those who had had skin grafts, and those fractures who had been fixed with a SIGN intramedulary nail. (A great system of giving fixation that doesn’t require a C_arm for placement.
After that it was a clinic day. So as we started there were somewhere about 40 patients waiting when be began about 10am. Audrey and I decided to see patients in one room while the surgeon saw patients in his office. We took the new ones and him the follow ups for previous hospitalizations, and some new. We saw patients till about 6;30 PM before finishing. The nurse translator would bring the patient in and take their vitals and then ask what their symptoms were and why they had come to see us. Many with body aches and headache, and many with articular pain. We would speculate about a diagnosis then see if there was a test here that was remotely useful for that disease. If there was a test, then we would order it and they would go off to get those labs or x-rays. Late in the day when we finished all the new patients, we started re-seeing all those we had ordered labs and x-rays on to see their results and decide on a treatment. Some we had to admit to the hospital most were treated as outpatients.
One we admitted was a 12 year old with right lower quadrant (RLQ) pain. She had been treated at a clinic a week ago and her pain persisted and so she came here. She had no documents as to what happened there nor what she was treated with. I was concerned about appendicitis or typhoid. So after she did tests I saw her back for an ultrasound. I attached my butterfly ultrasound to my phone and looked around her RLQ. Im not great about finding an appendix on ultrasound, so I didn’t see one. But there was some haziness where I wouldn’t expect it so figured it could be. But she also already had survived a week without apparently bursting. So I decided to treat with antibiotics. That would cover typhoid and appendicitis. It’s sometimes hard to know when to operate here unless there is peritonitis. No CT scans or the variety of labs we use in the US. Later on I went to see her as we left- and she feels much better. So I’m praying that trend continues.
Another we admitted was a man with a history of a gastric ulcer treated in the capital a number of months past. He even had an upper endoscopy report with him that said he had an ulcer at that time. He continues to be anemic (low blood count) and keeps getting transfused. He felt weak so came here to see what we could offer him. His hemoglobin was 3 (normal >13). So we ordered 2 transfusions of blood and will see how he does tomorrow after the second one.
Another memorable one was a 13 year old by with body aches and weakness. The translating nurse thought we should check him for sickle cell disease. His symptoms didn’t match that real well- but Ive learned over time that when I think of something or in a case like this when someone else thinks of something- I order it. It is often Gods Holy Spirit prompting (the still small voice) to do what is needed. And yes he did have sickle cell disease. His hemoglobin was 6, but we looked it up and they typically shouldn’t be transfused till 5 so we gave him some iron with folate tablets
Other patients tested positive for malaria, rheumatic fever, suspected typhoid (not typhoid test here), broken ankle the woman walked in on that said it hurt (yep!!) Medial and lateral malleolar fractures.
We are very tired and headed to bed early. May God strengthen and guide you at each step, during this life journey He wants to have with you….!!!! _______________________________________________