Encounters with Ghana’s (Not So) Sexy Spanish Fly

This post started out as a simple post about the annoying blister bugs we have around our home in northern Ghana. On many occasions they have caused horrible blisters on Heidi and myself and I wanted to learn more about them. I got lost for hours following rabbit trails as I research the subject and it just continued to get more and more interesting. Nothing is ever as simple as it seems. And I kind of love that.

Northern Ghana’s Green Blister Beetle

Lytta vesicatoria

My first step is always to find out what the locals call it. No one I talked to was familiar with the phrase “blister bug.” This particular bug – actually a “green blister beetle” – is known locally as abdulatanka. That’s not a word in an indigenous Ghanaian language but Pidgin English for “Abdullah’s Tanker” – a reference to a Muslim guy driving a fuel tanker. Why? Because the green blister beetle leaks a toxic fluid and has a tanker-shaped back side. Plus the stereotypical big-rig driver in Ghana is a Muslim man with an Arabic name.

There’s a whole scientific family of blister beetles name Meloidae with around 3000 species. One genus in that family is Lytta and the offending blister bug in our encounters seems to fall in that group. Read More

Intussusception

In the past several months, I have operated on three six-month old babies for intussusception. Intussusception occurs when the bowel telescopes into itself and cannot exit back out again. Once the bowel is stuck, it begins to swell, the blood supply to that portion of the intestines becomes compromised and it can lead to strangulation of the bowel.

In infants, this disease process often occurs when the lymph nodes become inflamed around the junction between the small and large intestines. The infant has episodic abdominal pain, bloody-mucoid stool, and sometimes an elongated mass can be felt through the abdominal wall. The ultrasound finding is called a “target sign” due to the multiple layers of intestines and the edema in the bowel walls.

Sometimes, if intussusception is caught early enough, a pressurized enema (given by interventional radiologists) is all that is needed to reduce the bowel back out. Here, we don’t have that specialty, therefore, surgery is the only option for treatment. Sometimes, it only requires a little manual pressure to push the bowel out, but more often than not, a resection of the affected bowel is required.

** WARNING: GRAPHIC IMAGES **
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Removing a 7kg Ovarian Tumor

After several months of noticing that her abdomen was increasing in size – looking like she was pregnant but knowing she was not – my 16 year-old patient finally presented to the hospital with abdominal pain.  She was admitted by the medical assistant with the presumed diagnosis of a typhoid induced ileal perforation. One look at her abdomen and I knew that it was a more chronic problem that was causing her pain. Instead of a generalized distention and tenderness of the abdomen which comes from having intestinal contents pouring into one’s abdominal cavity, she looked more like she was 6 months pregnant. On examination of the abdomen, I could feel a large mass that moved when I pushed it and then bounced back into position. The mass was tender. Otherwise the patient appeared healthy. We did an ultrasound to confirm our suspicion and found a large mass with both solid and cystic components. We explained her condition to her and asked for her and her family’s consent to take her to surgery.

** WARNING: GRAPHIC IMAGES **
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Animal Names in Mampruli Medical Terminology

We often forget that the fancy medical terms we use in English usually have their roots in Latin and Greek and are actually just simple descriptors. Epilepsy is a classic example coming from the Greek epilēpsia, which is comprised of epi ‘upon’ + lambanein ‘take hold of’.

Mampruli also does that with several sicknesses. For example, stomach issues are described as pukpeeŋŋu  – literally, “hard stomach” – and malaria is called dunsidooru or “mosquito sickness.”

There are also several diseases that are simply named after creatures believed to either cause the illness or that reflect the disease’s symptoms. In traditional African medicine, the preventative and/or curative measures can also be influenced by the animal namesake of the sickness. Read More

“Dr. Haun” by Dr. Melinda Roney

Syndactyly Repair with Dr. Taylor

When plastic surgeon Dr. Taylor comes to BMC as a Samaritan’s Purse medical volunteer, he is always met with interesting cases and puzzles to solve. This young girl was born with syndactyly of both hands. Sometimes, syndactyly only affects two fingers or toes that are fused together. This little one, however, had fusion of all the fingers. Dr. Taylor was able to separate the thumb from the rest of the fingers on both hands.

The wounds were healed nicely and the patient was finally able to grasp things in a claw like fashion with an opposable thumb. That simple ability will make a huge difference in this young girl’s life. She can now pick things up with each hand and will even be able to learn to write.