Broken bones + Traditional Medicine = Disaster

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A tragedy commonly seen here relates to broken bones. After breaking bones, patients unfortunately go to traditional doctors first. The “treatment” from these traditional doctors often result in either the blood supply to be cut of to the surrounding tissue, misalignment, or severe infection from manura applied over open wounds where the broken bone sticks out through the skin. The patients then finally come to the hospital long after ideal. The people then unfortunately are crippled or loose limbs that they shouldn’t have had to if they’d come to the hospital immediately. One story is of a 38 year old man who had dislocated his right knee several weeks ago. It was “reduced” (put back into place) inappropriately by a traditional doctor resulting in compression on the blood vessels and nerves to his lower right leg. By the time he came to the hospital the tissue (bone, muscle, and skin) of his lower leg was dead and dieing and he needed an amputation. Dead tissue allows bacteria to come into the body and grow. The infection can get into the blood and cause the patient to be “septic” (meaning infection of the whole body which people even in the US have a 50% chance of dieing from. Here obviously the chances are even higher because of the limited resources in the hospital). The man refused amputation for 3 days. The day after the amputation he died of sepsis (whole body infection). A lot of what the doctors fight here is lack of education. They’re slowly making a change one patient at a time, educating as they’re able but the people are plentiful and the physicians are already so overworked. We saw one girl in the OPD (out patient department. Kind of like a clinic/ER. All the possible surgical patients are sent to the surgical part of the OPD to be seen by one of the surgeons). She’d broken her ankle a while ago. But the skin around the outside seemed to be breaking down and have fistulas (passageways in the tissue formed by the body so that pus from the bone can drain out to the skin). Sometimes because of the traditional treatment with inappropriate splitting or misalignment chronic osteomylitis (bone infection) often times would form. Or if part of the bone (sequestrant) completely broke of f from the rest and never grew back together, it wouldn’t have a blood supply, so would die and get infected. This infection: chronic osteomylitis would eventually have so much pus form that it would create fistulas that would drain the pus. (See posted picture of this girls xray). The treatment for chronic osteomylitis in this resource limited setting is antibiotics orally (by mouth). If there was a sequestrant then the surgeons would do surgery and remove the rotten chipped off piece of bone. This is so common here due to their cultural beliefs/ treatments. We probably saw 5+ new cases in a half day.