Updates

Luna came into the clinic yesterday for a weight check. She was up to 2.7kg!

We have visited her twice in her village, Wikedupa, which is just a few kilometers outside of Asmara. She seems to be well-cared for and loved. Last time we went I brought my stethoscope, otoscope and pen-light. Her physical exam was almost entirely normal and there was no sign of ear infection (although there did seem to be a little fluid behind one of the ear drums).

I ended up examining her grandmother as well - the first time I have done a physical exam on someone over 21 in two and a half years... I suspect she has peripheral vascular disease as well as other ailments common to folks over 60, but besides being unable to test for most of it, I am unable to treat most of it as well. I prescribed a daily aspirin and tried to reassure her.

I also examined one of Luna's brothers. He is the only one of her siblings who lives with her. The others live in another village with the aunt who spent most of her time caring for Luna when she was in the hospital. This boy has an impressive cough, but no evidence of pneumonia or other serious infection.

Part of me wishes he did have something I could treat with an antibiotic so I could help him to feel better. This boy is almost two years old and his mother just died a couple of months ago. He no longer has the comfort of the siblings he knows and his losses are visibly profound. It was a pretty big damper on an otherwise happy visit full of laughter and smiles.

As for the boy I found in severe pain the Sunday I went to the hospital several weeks back - he is doing much better. He eventually went to surgery and had a large abscess drained. He is the one I found on the surgical ward experiencing a severe allergic reaction several days later. I visited him again on Monday and found that I was only doctor to have visited him since his surgery. I was able to stop all the treatments I had started for his allergic reaction, including the steroids. Although he won't abduct his hip very far, I have reassured myself that the joint was most likely not involved in the infection. His father says he is eating well again. And I encouraged him to get the child up out of bed and walking around daily. So he brought him over to our medical ward yesterday to watch TV. It was great to see him playing with the other kids.

And the girl with the finger cellulitis/osteomyelitis is doing better as well. She is a joy to have around the ward, always smiling and playful. She has finally become comfortable enough to practice her English with me. She does not know many words, but is eager to learn more. And because of her efforts some of the other children have started eking out a few words of English as well.

Her finger is not yet healed to the point where I would be comfortable sending her home on oral antibiotics. I would really like an orthopedic surgeon to take a look at it, but that is a pretty much impossible wish. I guess at this point I must simply remain patient and hope that her immune system and the antibiotics will be sufficient.