Update on the Koutiala Hospital SCD screening program

Even though it has been a while since I have given an update, the sickle cell disease newborn screening program at Koutiala Hospital has continued without any problems.  Not even a coup d'etat or a French military operation in the north of Mali could stop us from screening these babies!  We have screened over 4000 infants since the program started in August of 2011 and over 120 new cases of sickle cell disease have been diagnosed.  Joseph, the nurse coordinator of the clinic, is providing life saving treatment for these children with sickle cell disease including penicillin prophylaxis, immunizations, and anti-malarial therapy.  I am looking at the last of the screening results from 2013 at this point, and we will soon have 2 years worth of data to report on the incidence of sickle cell disease in this area of southern Mali.

I am very thankful for the continued support from PerkinElmer as they have donated all of the filter paper cards for the screening program.  10,000 screening cards have been donated so far and they just agreed to continue this relationship with an additional 5,000 cards!

   I will update soon with more photos from the clinic and with results from the first 2 years of the program.

Coming Home

I arrived back in Greenville around 6pm yesterday afternoon and I was very excited to see Allison and the kids.  They survived without me, but Allison was definitely ready for me to be home! 

These 2 pics are from the government hospital peds department in Bamako that we visited the day that my flight left.

 Babies in the hallway receiving blood transfusions and fluids.

 Reunited with the family.   They were excited about the gifts that I brought back from Mali. I lugged the drum through all of the airports on the way back, but it was worth the hassle.

 Bogolan artwork that I brought back to be framed.

Paris

I arrived on Paris at 8am this morning after a smooth flight from Mali. There was a lot of security at the airport in Bamako but no issues with our bags. On our final evening in Bamako we had dinner with an amazing view of the Niger River... dugout canoes, local fishermen, and a great sunset. This was a perfect end to a great trip. Thanks to everyone for all of the prayers for safety during our stay. We really felt safe and comfortable the entire time.

Safely back to Bamako

We arrived safely back in Bamako earlier this afternoon just in time to make a 1:30 appointment with  Professor Diallo who is the head of the National Sickle Cell Center.  We presented the data from the sickle cell screening program at Koutiala Hospital and they were very excited about the numbers and all that has been accomplished since the start of the program in 2011.  They agree that the data is ready for publication and hope that we will be able to collaborate on future publications as well.  The goal will ultimately be to convince the government of the importance of sickle cell screening and proper treatment in the future.  

We are in a hotel in Bamako tonight and then tomorrow we will visit the government hospital to meet with the head of pediatric cancer treatment.  The rest of tomorrow will be free time and then our flight to Paris leaves at 11:50pm tomorrow night.

 I have included some representative pictures of traditional Bogolan artwork.  These were done in Koutiala, but the process of using mud, bark, and leaves to draw/paint on fabric is common throughout Mali.

The Baobab tree is a symbol of unity throughout Africa and this piece represents people coming together around the tree, which is particularly important at this time in the history of Mali.

Thanks to everyone who has followed along with this trip to Mali.  My hope is that you have been able to see a different side of Mali than what is depicted in the media.  The people of Mali can teach us a great deal about supporting and relating to one another.  The needs here are great and the hope for improvement in the near future does not look good.  If you have a desire to support the work at Koutiala Hospital, feel free to ask me for more information.  The quickest way to donate money is through several different secure, tax deductible links.

http://tinyurl.com/macleanworkfund  This is the Dr. MacLean's general work fund which includes the sickle cell screening and management program.  For as little as $30-$50/month you can support the screening and proper treatment of a child with sickle cell disease.  If you are interested in donating to the sickle program, use the link above and send an email to Brett MacLean at brettandsheri@gmail.com to let him know that the money will be earmarked for that purpose.

http://tinyurl.com/khcancer  This is the fund specifically earmarked for treatment of cancer patients at Koutiala Hospital.  To give you an idea of relative costs of treating cancer in Africa:  Acute Leukemia $5,000/ patient ; Burkitt lymphoma $1,000/patient ; Wilms Tumor and Hodgkin Lymphoma $2,000/patient.

Bokar's new house

Bokar is the MacLean's night guard who has a great personality and a kind heart.  He has been working on a new house in Koutiala and invited us out to see the progress.

 Bulls headed up the road beside Brett's house.

 Garden at Bokar's compound... small banana plants, okra, mantioch

 Local kids excited to see us in their neighborhood.

 Jeremy (Brett's houseworker) with his son Brett (in the UNC shirt).

 Jeremy's property

 Separate kitchen room with dinner being prepared

 The new camera for the microscope is installed and working great!

 Telepathology is now available for Koutiala Hospital,

 Adiara wearing Patrick's hat.

 Bokar's new house

 Brett examining a small child from the village who was brought up during our visit.

 For all of the Buckeye fans!

The little kids seem most afraid of the Tubabu.  This boy did not like having his picture taken.

Final day at the hospital

It is hard to believe that today is our final day at the hospital.  We were involved in various projects including finishing the teaching of transcranial ultrasound for the sickle patients, setting up the camera for the microscope, and helping out wherever needed.

 Patrick jumped in to help with removing casts from a little baby with club feet.  In Mali, the mothers do not like to stay around while you are doing things that make their baby scream, so I found Patrick covered in dust with the little baby going nuts!  The saw looks pretty rough, but the baby came out mostly unscathed.

 Much better without the casts.... P's belly button sweat stain shows you how hot is is in the hospital.

 Hanging out with Sumila in front of the pediatric building.  Sumila has been our friend and helper during this trip.

 The sickle program medicine cabinet restocked with penicillin, folic acid, and hydroxyurea.

 Preparing the bar and shoes to slowly fix the club feet.

 Our home away from home during the time in Koutiala.

 This is what it looks like after the MacLean boys take a bath during hot season!

 Patrick with Kadia, a little girl who is finishing treatment for leukemia and was in need of a transfusion to treat her anemia.  Patrick is O+ and donated a bag for her yesterday.

 Francois and younger brother Acas are part of the sickle program and were in for their ultrasound today.  I visited Francois' village (Zamblala) the last time I was in Mali.

 Francois showed us his leg ulcers during the visit.  Leg ulcers are seen in young adults with SCD in the US, but present much earlier here.

 Courtyard area at the hospital.

 Main lab and surgery buildings.

Pediatric waiting area.

Early morning run

This is the start of the hot season in Mali where the days are over 100 degrees but the nights and early mornings can be pleasant. This morning I got up for an early run to listen to Koutiala waking up. It was neat to hear the sounds of the animals and see the early signs of life with the smoke lifting over the mud dwellings from the morning fires. I did not miss the sounds of the mottos!