Kenya/Ethiopia November 2017

Tenwek Hospital Bomet Kenya

We had planned to be doing Mitral balloon procedures (for explanation see blog December 26 2015 fixing hearts in Africa) in Kenya this trip, but were told that some of the essential equipment had broken down. We were saddened to hear this knowing we had a number of patients waiting to have valves fixed. Once we arrived we began screening more patients to determine which ones would be good candidates for the Mitral balloon valvuloplasty on our next trip in April. We found a few kids with early signs of rheumatic heart disease who can be put on monthly penicillin to prevent further disease and were able to do followup examinations on some of our past patients. It was amazing how well they are doing, beyond our hopes and expectations.

Moses
in 2015 we arrived with our small team to screen and start treating patients with damaged heart valves from rheumatic heart disease. Of the approximately 100 patients, some were medically managed, some referred for more extensive surgery, some were put on the list for future mitral balloon procedures and 9 were scheduled for the procedure. Moses was our first patient. He's was 14 year old at the time with a badly damaged mitral valve making it difficult to even walk short distances. The procedure was so successful that he was even able to climb stairs the next day. 

Moses on his second check up since his Mirtal valve was fixed

From Bomet we traveled to Eldoret to meet with the cardiac team at Moi Teaching and Referral Hospital. They are in the process of preparing to do invasive procedures and would love to learn Mitral Balloon Valvuloplasty. We are excited to begin teaching the procedure and passing on what we have learned. There was also interest in our rheumatic heart disease screening program (see blog December 26 2015 screening) which we were happy to hear. The only way to make a significant difference in the number of young people dying of this horrible disease to to find them early and begin treatment to stop the progression of the disease.

Etienne Update

Many of you may remember Etienne. When we first met him, he was being held at the hospital because his family was not able to pay the bill. He is the little boy in Cameroon who suffered sever burns to his feet leading to the amputation of his right leg below the knee and the most of his left foot. The burns happened under "mysterious circumstances". Where most of us would have been angry and bitter, He is a happy, loving and outgoing child with an infectious smile. With some help, he was able to be discharged from the hospital and is practicing getting around with crutches. It is a real challenge on the bumpy  dirt paths. He is currently looking at the possibility of more surgery and a long process of rehabilitation. The goal would be for  for him to be able to get fitted for a prosthesis. Mbingo hospital, not too far from him, has an extensive physical therapy department where they also do prosthetics. 

Etienne

During the first week, I only knew 8 year old Etienne from a distance. He would greet me, “Hey Doc, Hey Doc” from the pediatric ward window next to his bed. He has a million dollar smile and a positive attitude that I later learned was in contrast to his circumstances (a lesson for all of us).

During the second week I walked over to his ward to see and get to know this kid with the infectious personality. It turns out that he was healing from burns that resulted in the loss of the right leg below the knee and most of his left foot. I later learned that this occurred under suspicious circumstances and likely an uncle had punished him by holding him in the fire (We have two other boys from the same village with burnt feet delivered as a punishment but fortunately they will respond to skin grafts and will not lose their limbs). The mission has a new child protection team that is getting involved.

Etienne's mother stays at the hospital caring for him and trying to reduce her overwhelming hospital bill for the multiple surgeries and lengthy rehab. She has paid off 80,000 CFA but 240,000 CFA ($400 US) remains that she cannot imagine covering. To make matters worse Etienne will need 6 months of rehab and a prosthetic right leg and prosthetic right foot. Fortunately, the sister mission hospital, Mbingo, a former Leprosy center, does this type of work but housing expenses, hospital expenses and prosthetics will be an additional $1200 US. These are remarkably low mission hospital prices that barely support the function of the hospital as they try to help as many sick people as possible.

Etienne is one of these special people we meet every trip who we believe, if given the chance, will have a special impact on the world around him. He is everyone's favorite patient and has a heart of forgiveness and joy despite his physical problems and the events that resulted in his injury. We have learned to be more forgiving and grateful because of Etienne's example.

“Etienne is one of these special people we meet every trip who we believe, if given the chance, will have a special impact on the world around him.”