Saturday, July 21, 2007

Burns

By Britt:

I haven't posted for a while, so I thought it was high-time to update you on some of the medical goings-on of La Digue. I've been really busy the past month or so, averaging 6 or 7 patients a day. The wound-trend seems to be burns - a vast majority of which are coming from Barbancourt, which is the village over from ours. Burns take longer to heal and are much more painful. I know from an unfortunate encounter I had with a motorcycle muffler last summer; so burns are not my favorite, but I also like the challenge and consistency it takes to get them to heal.

This little boy's name is Jouli; he is five-ish. It happened last Saturday (7/14) when Jouli tried to help himself to a hot pot of coffee. Apparently he had already been given a cup and was trying to get himself more. (ummm ... I'm glad we don't give our 5-yr-olds coffee; they're hyped up enough as is! I asked if that was the norm and I was told that yes, many Haitians give their young children coffee.) He dropped the pot, spilling it over the left side of his ribs and butt.


Jouli and his family live in Petitbwa (the mountain village we hike up to occasionally - at the top of the mountain behind our house). They had tried a couple of home-remedies (a homemade paste thing on this particular one) but came down to try to find him help after those didn't do anything. The above picture is on Thursday before I cleaned/dressed it.


This is Jouli's burn today, after just three days of dressings. It is healing very well and he has a relative that he is staying with in Barbancourt until it's finished healing.

This burn is on the upper thigh of a twelve year old girl from our village. She says it happened on Wednesday when she spilled bleach on herself. I tried to ask if it was a different kind of bleach than what they use to wash clothes, but she didn't really know. I don't think I've ever had a chemical burn before. Oowie!


This next girl is 5 and from Barbancourt. Franchesca was burned about a month ago when a hot plate of food fell on her. Her mom had been putting some sort of ointment on her hand; it was already partially healed when she first came this Wednesday (see hand pictures below, pigment is already returning in some places.) They said the ointment that they were using was no longer doing anything so that's why they came here.


There is one portion of her hand and the burn on her chest that are pretty severe - I think they would be classified as full-thickness burns by the newer medical standards. She also has a couple small burns on the side of her face. The interesting/bad part about Franchesca is that she is a total fighter. Oy! Li gen lespri anpil!! (Wow, she has a lot of spirit!) She kicks and screams and I'm pretty sure was trying to bite me the other day. It takes two or three grown men to help me with her dressings. Someone has to hold her legs, someone has to hold her arms and usually I am able to hold her chin up and clean and dress the burns (all the while she screams things like "I don't like you!" "You let go of me NOW!" "I'm gonna die" and "I'm telling my dad.") Granted, these burns are definitely causing her a lot of pain - but she is making it a lot harder on herself by fighting with us so much. I don't try to reason with five year olds though. We just get the job done and try to bribe with suckers (so far to no avail with miss Franchesca, but all of the other burn patients' dressings are completed sans tears thanks to the sugar on a stick trick)
Her left hand is burned completely: in-between all fingers, the palm.

This morning, Franchesca was being really horrible to the cousin that came with her and I kind of leveled with her in a not-so-nice tone & told her how it is - that she needed to stop saying those mean things to someone who was trying to help her get help. Afterward, I felt bad for loosing it at her and was just trying to explain that we didn't like having to restrain her or make it hurt but that we had to in order for her to get better. Franchesca cut me off mid-sentence, looked (more like glared) me straight in the eyes and said "m pa bien ave ou!!" which basically means "I'm not good with you" or "I don't like you." I laughed and said "na we demen cheri" = "see you tomorrow, darling" (Didn't I say that I don't reason with 5 year olds?)
This little boy is named Mondi - he is such a sweetheart. Mondi being a doll makes up for Franchesca's lack of nice-qualities. ;) He is so cute, I'll set out a sucker for him to have after I change his bandage and I can hear him reassuring himself "If I don't cry, I get a sucker." Cute, cute kid and another happy thing about him is that he is an only child. (Woah, wait - that came out wrong. I'm not downing big families .... just hear me out) The reason that I like this is that when I asked his mom (who clearly just adores him) if she had other children, she said no that she could only handle one right now and that was all she was having. I wanted to like pick her up and swing her around for "getting it" but I didn't want to embarrass her. :) I did congratulate her on being responsible and recognizing that having more children than you can handle is a disservice to your kids and yourself and is a huge issue in this country.
Mondi after his dressing change this morning, with his new pair of shoes we found in a box of donations. Thanks to whoever donated these to Lifeline!

This is majorly weird .... but I saw/treated something just like it a month ago on a different person. This is on the leg of a 14 year old boy from Barbancourt. He fell off of a tap-tap about a week ago and scraped his leg. But by the time he came to me, an abscess had formed and all the skin below the abrasion was infected. This is the abscess I drained with Carsen on Wednesday. There was already a hole, about the size of a qtip that pus and blood was leaking out of. So we numbed it, made the hole a tiny bit bigger with a scalpel so that the packing would fit, squeezed all of the pus out, and packed it. But now the skin totally stretched out and he has this huge hole in his leg.

So what am I doing with this? Well, look at the picture below. This is a similar situation. The wound to the left is a burn from a motorcycle. A week after the burn happened, the hole to the right started to form. I tried packing it for a few days but it really seemed to be making it worse rather than better so I switched to triple antibiotic ointment and it eventually healed. I think I will do the same thing for the above boy ... unless someone has a better idea - let me know.

I've only had one or two new patients for stitches. And no amputations; you'd definitely hear about that. :)
I leave in five weeks ... it looks like I will finish out my time here as busy as ever. It's really kind of weird that I'm leaving "for real" ...... I think it's easier for me since in my head I always knew that I would be moving/leaving to go back for school, but I just don't really believe it yet.
Well I think that's it for me. I need to go finish my final project for my World Religions course ... once I better organize the facts that I learned from my interview with the witch doctor, I will post something that might help better educate or maybe further confuse you about Haitian Voodou.
~Britt