Adokorach's Heart

ADOKORACH, a 22 year old mother of a 1 year old boy began noticing difficulty keeping up with the other young women her age 3 years ago. Her heart condition made the pregnancy and childbirth difficult and dangerous. Adokorach lives in northeastern Congo near a mission hospital where we've taught general cardiology including cardiac ultrasound.

Ultrasound images of her heart sent to us revealed that Adokorach had severe mitral stenosis (a narrowing of one of the heart valves from scarring after her episodes of acute rheumatic fever). The valve should open up as large as a soda bottle cap to let blood through, but hers only opened to the size of a drinking straw.

More troubling, she had developed blood clots in her heart behind the valve narrowing which put her at risk of having a stroke at this young age. With her in mind, we brought a new lab machine out to Congo which would enable them to put her on anticoagulation and closely monitor her levels of blood thinning. The medication has dissolved the blood clots that were in her heart. She is now on them continuously until we can get her to Kenya to fix her valve.

Adokorach having her blood checked.

Training staff to use the new INR machine to monitor anticoagulation in patients in Congo.

Childhood Cancer in sub-Sahara Africa

Olive is a 7-year old girl living in rural Cameroon. Her parents noticed she was developing swelling in her abdomen. Within 2 weeks she also developed a growing mass on the right side of her face.

She was brought to Banso Baptist Hospital, a facility where we have been training young doctors over the past 7 years.

A series of tests revealed that her abdominal and facial masses were caused by Burkett’s Lymphoma, which is the most common childhood cancer in Africa and 100% fatal if untreated. With a long and complicated course of chemotherapy we can save 70% of these kids.

This wonderful mission hospital supplies the chemotherapy and the hospital stay free.

Training Vera (nurse practictioner in charge of the Burketts ward) to measure fluid status in a child with Burketts

We have been working with others to develop a protocol to increase the percent of children that survive the physically stressful chemotherapy. We have been training local staff to use the ultrasound machine to determine fluid status at the onset and during chemotherapy to prevent kidney failure which is one of the causes of death during the treatment phase.

Sweet little Olive was one of the children who survived chemotherapy without any relapse of the tumor.

We have already seen a reduced mortality with the new ultrasound guided hydration during chemotherapy in these sick, fragile children.