BMC 60th Bike Race

This year marks the 60th anniversary of the Baptist Medical Centre in Nalerigu, Ghana. Since May, they’ve been celebrating with events each month. September is the “entertainment” month and one of the activities was a bicycle race sponsored by the hospital.

They announced the race on the radio for a few days and had 22 people register. William was traveling but folks know his love of cycling and added him to the list since the race was to occur just a couple days after his return.

On race day, trucks carried all the competitors and their bikes out to Nyingaari, a village just past Gambaga on the main road. They raced from there back to the hospital. While the distance of 7.5 miles wasn’t great, the cyclists had to climb three massive hills.

William has been riding a lot, especially to Gambaga and back (11miles total) so he was ready. His training paid off and he took first place by well over a minute.

All the participants received a bar of soap and a malt drink for completing the race. The first four will be awarded prizes on November 8th, the day of the final 60th Anniversary celebration.

Winners from right to left

Peak Rainy Season Creek Visit

William is off traveling in Europe for a few weeks and I’m holding down the fort with the two kids. This weekend we made a little excursion down to the creek. We’re at the peak of rainy season now and there was much more water than last time. Everything was so green and colorful.

 

Saanditigu kunni la yuŋŋu.

The guest who waits to eat goes home in the night.

Mamprusi Proverb

Breast Cancer Mass

A woman in her mid-thirties came to BMC with a large tumor of her left breast which she said had been growing for only 5 months. The mass was so large, in fact, that she wore a cloth like a sling to help manage its weight. There were no external wounds. The nipple and areola (the area around the nipple) were flattened and stretched out. She had enlarged lymph nodes in the axilla (armpit). She had no difficulty breathing and her lungs sounded clear with good air entry. She had no signs of distant metastatic disease.

I performed an ultrasound and found that inside were areas of solid mass and pockets of fluid. Clinically, the tumor appeared to be what is called a Phyllodes tumor or cystosarcoma phyllodes. These tumors can grow very rapidly. Some of these tumors are benign, some are malignant. Either way, the only treatment I could offer was a mastectomy.

After discussing the risks of surgery versus the benefit of a mastectomy, the patient agreed.

** WARNING: GRAPHIC IMAGES **
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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

Rainy Season in Nalerigu

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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