The last time I did pediatrics was ...

Did I mention they don't have a Pediatrician or Neonatologist here? Well, that's not completely true, there is someone who does outpatient pediatrics, but apparently unlike back home, the Obstetrician is responsible for all the Neonatology as well. Today on rounds we have 3 babies in the one isolette keeping warm, with a net to keep the mosquitoes out, and being fed with a cup or a nasogastric tube.

There is also one baby with a high bilirubin being treated with phototherapy.

I know very little about this, and as well, we have minimal other methods of treating neonates. We do have some antibiotics, and the Sage Femme are good at starting IVs. I am learning on the job, and coping with the limited resources here.

There are also some diagnostic dilemmas as we call them. I was asked to see a lady today who was passing blood in her urine. A common cause unfortunately is a fistula (a hole) between the bladder and the vagina. It happens if the woman has been in labour for days without delivering. The pressure of the baby's head cuts off the blood supply to the tissues and the walls between the bladder and the vagina die leaving a hole. I was able to do an examination and prove that there was no such hole, and it did not look like it was related to her reproductive organs. I did an ultrasound, and it looked like a mass in her bladder. Fortunately there is a urologist here who was able to look in her bladder and determine that it was just a big clot. We still don't know where the clot came from, and that is part of the problem – not having an answer at the end.

This evening was a church service in the community centre. I packed along my flute so I got to play in the worship music at the beginning. The church service was more of a bible study using Dietrich Bonhoeffer 's book “life together” Today we were looking at Roman's 12:1-8. It is a good reminder of what living in community is all about.

Romans 12:2

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.