Infectious Disease in Galmi

At Galmi a number of infectious diseases are pretty common, depending on the time of year. The rainy season is due to start in July through August/September, and with it bring malaria. Currently 30+% of the hospital patients probably have a malaria, but there will be more patients and they’ll be sicker then. Most of the year is typhoid season, except right now they’re not seeing very much of it. It’s a bacterial infection spread through contaminated water. The bacteria comes through the intestinal tract and then gets into the body through lymphatic tissue lining the gut a several locations called Peyer’s patches. Once in the Peyer’s patches it can spread throughout the body and cause inflammation everywhere. One common surgical issue that comes with it is perforated bowel (meaning a tear/hole in the intestine wall forms). What happens is all the infectious focuses in the Peyer’s patches iniatially and a large amount of the peyer’s patches are located kinda near the appendix at the junction between the colon and ileum. So that bowel gets inflamed/dies and ruptures. The can get multiple holes. Even after the surgeon repairs these holes, the infection is so wide spread that mortality rate is still upto 40%. Here is a picture of a girl who had typhoid two months ago. It’s a wasting disease and you loose a lot of weight. Because of the inflammation of the bowel, holes/passageways can form between the skin or other parts of the body, called fistulas. This girl has a fistula between her bowel and her abdominal skin which is now infected. So stool and pus comes out. She also has one starting to form between her bowel and vaginal, so stool comes out there to. She’s so miserable and her mom wept because there’s nothing to do. She needs improved nourishment and time for her body to heal. Her insides are still so inflamed that any attempted surgery would be disastrous and she would probably die. There’s also a lot of TB here. One of the American doctors said his annual PPD (TB skin test required to be taken by healthcare workers in the US) was positive after working here. I saw a lot TB in India and thought for sure mine would be positive. But I just had it done and its negative. Maybe next year it will be positive. There’s also a lot of HIV/AIDS here. We double glove on every surgery consequently. My hands are going to feel naked when I return to the US and only wear one pair during surgery. There’s also a lot of tetanus. There’s a room back at the end of a long hall way that is quiet for them, because they do better with low stimulation. And they just what it out. We have oxygen here but no ventilator.