Today marks the first day of clinic at Mama Pilista! We started our morning by remembering our purpose for being here. Years ago, Doctor Bonyo Bonyo had the dream to become a physician and eventually return to his community to provide medical care. Our goal is to continue this mission with him by offering comprehensive, quality, culturally-sensitive care. We are also here to strengthen our own history and physical examination skills. During this journey, we will be chronicling our experiences at the clinic.
Together we saw many interesting cases as student doctors and physicians. A woman came in with a large infection of her finger that had been going on for 2 months. The infection appeared to have spread beyond the skin and there was fear of osteomyelitis; however, we were limited as to what imaging studies we could perform and thus decided to treat with antibiotics and hope for resolution at follow-up. We also saw several cases of malaria within the same family–each member presenting very similarly with cyclic fevers and chills. Another interesting case was a woman who was in acute distress, bent at her waist, and clutching her right chest. She had recently had numerous studies done at a local hospital with differentials including pleural effusion, TB, or something more severe like focal cancerous nodules. As a comprehensive clinic that is sustainable and run by the community, the clinic is able to collaborate with other hospitals. For this patient, we will get her studies back from the local hospital first before determining her definitive diagnosis. We also saw a young girl with HIV+ status with a fever of over 104 degrees. At the time she was not taking her ARV medication and appeared extremely depressed. With the risks of developing opportunistic infections and potential death, she was informed about the importance of adhering to her medication management. Bonyo agreed to be her mentor and we ensured that she would follow up at the clinic. The clinic has a fantastic tracking system for HIV and is able to partner with members of the community to keep CD4 count high and viral load down.
The word “harambee” means “all pull together” and we believe that this community does just that. It is evident that when one member of the village is sick, the rest of the village unites and raises them back up. Even after our first day, we believe that this clinic is a unifying force and essential component to the community. We look forward to treating more and learning more over our next few weeks.