Screening for stroke risk

This brother and sister with sickle cell disease were the first patients that I saw during my last trip to Mali and also the first to start taking the controlling medicine hydroxyurea.  They have done much better since starting the medication and traveled to the hospital today for evaluation of their risk of stroke by ultrasound of the brain.  This is a standard test in the US for sickle patients from 2 to 16 years old and when it is abnormal shows that the child has a 30% risk of stroke per year.  We were blessed to have an ultrasound machine donated for the clinic and I packed it in for this trip.  Joseph, the Malian nurse in charge of the program did a great job starting to learn how to perform the procedure.

Three brothers with sickle cell disease.

Kristen, one of the peds nurses, with Chaka who lost both legs from a severe infection.

 Adama (Burkitt lymphoma) with his green Mercedes truck

 Getting all of the TCD equipment together

 Dr. Sumila!

 Teaching Joseph the brain ultrasound technique

The baby in this picture was diagnosed with sickle cell through the screening program and then her older siblings were screened afterwards and also found to have disease as well.

N'Torosso

The man with the big smile on his face is Pierre and he is the chief of the N'torosso rural clinic.  He was very happy to receive his very first otoscope for the clinic from Brett.   

Gathered around my Mac to watch a sickle cell video in French.

The literacy rate in Mali is only 17%, so info through hand painted pics seems to be the best way to get the point across.

This is the screening kit that we delivered to each rural clinic.  It included the cards, glove, pens for writing the patient info, lancets for heel sticks, and dessicant bags to keep everything dry in the rainy season.

The remote clinics desperately need solar to provide a reliable source of power for basic medical treatments such as albuterol nebulizers.  Brett is working on a plan to raise funds for solar power to each one of the rural clinics supported by Koutiala.  It will cost around $10,000 per village to accomplish this.
This is what severe reactive airway disease (basically asthma) looks like in the remote villages.  This little girl had a heart rate of 170, could be heard wheezing across the room, and was rail thin from the chronic lung problems.  Brett recently donated a nebulizer for albuterol to this clinic but they had not yet tried it.  She was started on steroids and received albuterol with improvement in her breathing.

On the road to Somasso

"I ne ce" (pronounced In nee chay)=  hello in Bambara

Hello from Somasso!  Today we travelled from Koutiala to Somasso, a village northeast of Koutiala.  It almost feels as if you are traveling back to the days of Jesus when you see the mud dwellings of these remote villages.  Animals roam free, things move at a very slow pace, and people spend time caring for each other in a way that is refreshing.  These are all so foreign to the way that we (meaning I) spend our days.  The other morning we started our daily prayer time at the hospital with a look at 1 Timothy 6:6-8 which reads: "But godliness with contentment is great gain. For we brought nothing into this world, and we can take nothing out of it.  But if we have food and clothing, we will be content with that."  I was listening to this message from a Malian worker at the hospital who lives in conditions not much better than those seen in these villages and what I realized is that no matter what your standing in this world, you will never be satisfied unless your contentment is grounded in the goodness of Christ.  

This morning started with a short talk to the nursing staff at Koutiala about the basics of the pediatric cancers that are common in Mali.  We then packed up the car for our 1.5 hour trip to Somasso.

 The courtyard of the Somasso clinic... built around the shade of a large tree.

 Life in and around Somasso....

 Reverse baby bjorn!

 School kids excited to see Tubabu (white people)

 Protection from the animals.

 A time to mend... the hot season is the time to make your mud brick and ready your house for the rains of August and September.

 A small oasis garden that requires constant water and tending in this hot/dry climate.

 Play time.

 "fast food" on the road to Somasso

 Patrick dwarfed by the baobab

 Collecting newborn samples and teaching the nurses.

 Our gift for the road from the Somasso team was several bags of roasted peanuts, which were amazing!

 Public transportation...

 The team asked us to bring them back a copy of this picture... I hope to be able to do that one day

 An old church near Samosso

 I know that we have all complained that the delivery room was not nice enough at the birth of one of our children.  What do you think about this?  This woman is nearing time to deliver on this tile slab.

 This would be my worst nightmare... the guinea worm!  This is the one that you have to pull out very slowly so that it does't break off in your foot.  We are trying to get one out of Patrick right now.

 Local kids glad that we have arrived

Visiting the Samuel School

This morning started with a teaching session with the pediatric nurses on childhood cancers and then we traveled to a YWAM (Youth with a Mission) supported school in Koutiala.  The school is run by christian staff and has around 450 students (mostly muslim).  The kids at the school always start their day with play time in the morning so that they can stay inside during the heat of the day.  They were very excited (hugging Patrick, doing cheers, etc) about the 10 soccer balls that we presented from Give a Kick for their program and wasted no time getting into the action.

 These kids took me to school on the soccer field!