Typhoid

Today was a very slow day! I went to the hospital in Kpando this morning. Celestine is always at the hospital before I get there; however, she usually does not make it to the PT gym until after I've been there for 20 minutes. She usually is around saying hi to people, I think. However, today she was really late. I sat around for over an hour waiting for her to come. She finally showed telling me she wasn't feeling well so she was waiting to see the doctor. I told her I understood and that I would wait for her.

Around 10:30 a patient showed up. Finally, I had something to do. The patient was an eleven month old baby. She had been diagnosed with a weak neck. In actuality, the child has cerebral palsy. I really needed Celestine around because the mother did not speak/understand English well enough for me to explain what was wrong with her child. I tried to assess the child as best I could without any toys. Obviously, from the diagnosis of weak neck, the child has poor head control. Also, the child exhibited abnormal tone and reflexes. The mother was very caring to the baby, but probably does too much for the child. I talked to the mother about trying to help the baby sit, but with not too much support, to have the child on her belly throughout the day when she is awake to force her to life her head and look around. Also, if the child does not like the position or wants to be on her back, it may force her to learn to roll over. The mother told me the child sits throughout the day. I asked the mother to show me how she helped the child to sit. She pointed to a cardboard box. I guess it would be the African version of a playpen or I think we call them play and packs because playpen is too offense in the US, right. Haha.

Again, I am not a pediatric therapist. In the US, therapists have the opportunity to specialize so I've never worked with babies before. I know what I'm suppose to do, it's just hard for me to get a child to do things. Adults are nice because they can usually follow commands. If an adult doesn't listen to your advice then I can always say that's not my problem.

I finally told the mother she would need to come back on Friday and bring toys with her so we could work with the baby more. Celestine still wasn't around after playing with the baby for 30 minutes, so I had no idea on how to file the paperwork. Finally, Celestine came an hour later. She told me she has typhoid. I have to say I was pretty shocked. Typhoid is really serious. I figured you were on your deathbed when you get it. I guess Celestine must have gone to the doctor early enough. I just hope she made sure to get the medicine today. I told her it was really important to start treating it today. Typhoid is transmitted through feces. People are not great about washing their hands here after using the bathroom. I very happy I got the typhoid vaccination before coming here since I've ate at a lot of restaurants while traveling. Even if the place looks clean, you really have no idea if the person practices hand hygiene.

I walked home to eat lunch and then walked back to the hospital to see the little boy with burns. However, the nurses would not let us work with him today since he was sleeping. He cries during the ROM so I couldn't really argue. Sleep is very important for recovery! Celestine said she ranged him the previous days when I was in Hohoe, so I didn't press the issue. I think I need to make sure the mother starts performing ROM on him too that way he gets it done even on days when we are not there. If we cannot get his leg straight, walking will be very difficult for him for the rest of his life.

I forgot to write about something Cinderella and I were discussing in Hohoe yesterday. We were helping a patient perform a squat exercise correctly to strengthen his legs. The patient was performing a deep squat. I told Cinderella that I usually have patients only squat to 90 degrees since its less pressure on the knee caps. Cinderella told me that she tries to make sure her patients can perform deep squats because how else do the go to the bathroom. I never thought of this. Obviously, in the US, unless someone is fond of camping, there is never really a need to squat to go to the bathroom. Here, most public toilets are only urinals, a drain in the floor. Women must squat a lot to go to the bathroom, and if someone only has an outhouse or has to go in the bush like myself last week, then you must squat. Life is so different here in so many very simple ways. I've definitely learned a lot that a book will never tell me on this trip!!

Love, Kari