A 10 week old baby girl was admitted to the hospital for vomiting, dehydration and failure to thrive. She was still only 3.5 Kg (about 7lb, 11 oz)! From the history given by the mother, there were no problems with the birth. About one week later, however, the baby started to vomit. She would nurse well, then vomit and want to nurse again. She had been admitted to another district hospital for 2 weeks, but saw no improvement, so she was brought to BMC.
We resuscitated her by giving her fluids intravenously and monitoring her ability to make urine.
On exam, her abdomen was soft, not severely distended and no masses were felt. We followed up the exam with an ultrasound. I found that her muscle around the pylorus (the special channel between the stomach and the first part of the small intestines) was much larger than it should be. The pathway between the two organs was limited to a trickle.
The condition is called Hypertrophic Pyloric Stenosis. It is usually found by week 4-6 after birth, but sometimes, diagnosis is delayed around here. The problem arises when the pyloric muscle grows very thick and essentially blocks the pyloric channel, thereby causing the baby to vomit – even projectile vomiting.Read More
In a small community near the Ghana-Burkina Faso border stands one of the only two remaining slave defense walls in Ghana. This historical monument in the Ghana’s town of Gwollu is a reminder of the dark history and dangers of the slave trade in the remote northern “hinterlands.” Read More
A boy was bit by a snake on the shin and the bite developed into a large abscess with significant loss of tissue. As the healing began, about 75% of the anterior tibia was exposed. The infection was now gone, but now the problem was healing an exposed bone.
As wounds heal, granulation tissue covers the wound. Colloquially, it is called “proud flesh.”Read More
One caring for a field won’t fear rain: fear rain and eat what?
Our three-year-old’s favorite Bible story is – no surprise here – David & Goliath. She loves the part where he swings the sling and tosses the rock, hitting Goliath. Here she is narrating it at the dinner table:
Slingshots are common in northern Ghana but are usually the “Dennis the Menace” type with a forked branch and a rubber sling tied between them.
In the old days before rubber was introduced, the Mamprusi made and used slings much like what David would have had in 1 Samuel 17. Occasionally, I find someone with one of these traditional or “old-school” slings.
In eastern Mamprugu they call these slings “kalɔbiga” meaning ‘millet thrower’ because they are used to throw stones at birds trying to eat sown millet seeds in farm. I had always assumed the intention was to hit the birds with the stones. However, the release of the stone also makes a loud popping sound as the rope snaps back. This sound scares off the birds even if the stone comes nowhere near them.
Here’s a short clip of a Mamprusi boy using one to scare off birds from his family’s farm. Notice the snap or pop sound when he hurls it. If this were are leather sling and not just woven vines, it would have been much, much louder.