Lumps, Bumps and a legitimate Lord

I have been remiss in writing! I must say that inspiration had flagged a bit and couldn't think of putting into words some of the stuff that I've seen, but you're just gonna have to put up with my fumbling through this one.

Ten years ago there was a bloody civil war that swept through Sierra Leone where rebel soldiers literally cut a swath through the countryside, chopping hands, arms or limbs off to induce terror or for the sheer heck of it, murdering, raping, you name it. The diamond fields were used to fund most of the munitions (watch Blood Diamond for a point of reference). The history is seared into the memories of the people here, where those who could escaped into Freetown that was largely spared from active turmoil. Millions of people poured into a city with the infrastructure designed for a couple hundred thousand. (Thus the mess outside.)

So picture the problem outside our door. Or, rather off our dock :-) Still no infrastructure, i.e., some rather dilapidated, overrun hospitals that won't touch you if you don't have money and can't pay up front, but your arm has just been shattered because it was fired upon on close range. Or you have any of the many diseases that plague any other place in the world with nowhere to take the problem to. Then this enormous white ship sails up one day, and announcements go out over the radio that this miracle ship can fix your legs, or your baby's cleft palate, or your facial deformity.

The thing that is just so deceptive about the evil one... grrr. I could just spit. If you have a physical deformity, here it is a sign that you are cursed and are evil. Therefore, babies with cleft lips are thrown out to die or cleft palates, if you have a goiter (lack of iodine in your diet so your thyroid, a gland on the front of your neck, gets enlarged to the size of a mango). Many, many a patient comes to the ship - mothers who have been thrown out of their families and divorced because they had a baby with a cleft lip/palate. The mom wouldn't abandon the "demon child" and been pitched out.

 People with lipomas are marked as cursed as well. If you have this odd growth on the side of your face or arm are ostrasized universally, thrown out of their families, if you own a shop to make a living, people will not buy from you for fear of being cursed as well. You can imagine how belief like this take root in a society where there is no medical resource and no idea how these odd lumps and bumps spread or occur, so it's just very sad and all these beliefs are perpetrated. The most wretched I still believe is the myth that sex with a virgin will cure your AIDS/HIV, so rape of babies in South Africa is a big problem. Grrrrr. But that's South Africa and I'd better not ever write about it - I'd never shut up. But I digress...

   So I had the honor of taking care of three such special patients this week that come to mind. One is a lovely lady, she speaks only Temne so there was a major communication barrier. I have a working defensible understanding of Krio and can sometimes make myself to be understood, but Temne sounds like Klingon to me and no such luck there. (Although we do come in peace :-)  heehee....
But I digress..

   This lady has a goiter, lump the size of a large mango on the front of her neck. We had to check preoperatively to see if she was pregnant (standard procedure for women between certain ages) but she told us flat out - no contact with a man since her husband left her because of this deforming lump on her throat. A few hours later she's back on the ward, flat neck, small dressing on her throat. Awesome! and thanks to Dr. Blair's fabulous hemi-thyroidectomy technique, she'll probably go home and be able to be with her children again. We hear this happens a lot - so they go back and can reintegrate into society, and have a story to tell.

Another gentleman about 40 years of age was sitting on his bed doing bead work, using his toes to secure one end of the thread and threading it in complicated little patterns with shiny beads, and I wondered what was up with his arm because it was curled right under him, deformed as if he was born with it or had had polio - so I just asked. He raised his shirt sleeve and proceeded to pull his bone around from where it should have been in a stationary position. When I asked what happened, I was told flat out the rebels shot it at close range, shattering the bone and since there was nowhere to go with the problem it just healed in place. He was lucky to survive really, and you can imagine the suffering the poor man went through in the healing process. Now, this was ten years ago - you can imagine how long you suffer with these injuries.

Another kid we took care of this week had an eye in not so good a shape. You could see it was shut and a bit shrivelled, and he is blind through it, but causing him intense pain. He is 21 and I read on his H&P exactly what happened. When the rebels came through his village, he was running through the forest to escape and a stick pierced him in the eye. He's been in pain every day since. Until yesterday, when Lord Ian McColl (yes, he's an English lord, how cool is that?) fixed it for him. The eye had to go of course, but he replaced it with this thingie (ok, can you tell I don't do eyes) that looks like a plastic eye sheath, which Lord Ian said will hold the shape of the eye socket in place, and then when he returns from England in a few month's time he can replace it with a glass eye. Cool, huh? So this poor kid who'se been in pain since he was 10 years old gets to go home today.

Now isn't that just lovely?