Another VVF

I saw four new VVF (Vesicovaginal fistula) patients in clinic today. Some VVF patients come from a dispensary or health facility with a referral letter requesting further management. Other patients simply come with the complaint of leaking urine. Sadly there are thousands of new VVF patients every year. For more information about VVF just 'google' VVF. Photo above is courtesy of bop.nppa.org.

The five patients I operated on on Friday were all doing okay this morning. And there were no seriously sick patients in the gyn ward. In Maternity we had a new case of ecclampsia and a mother who just arrived with severe anemia after delivering her baby at home.

I requested a consult from a medical doctor on one patient with presumed "tropical splenomegaly syndrome"... And I consulted medicine for another patient with a significant amount of ascites. The patient with ascites is a young girl who came with a distended abdomen and nausea vomiting. The etiology of the ascites has to be "worked up". I think we would be able to do a paracentesis although the lab would probably not be able to analyze the fluid.

On a separate note, I "fired" my plumber after two and a half months of aggrivating arguments about leaking faucets and water pumps not working. Fortunately my security guard knows another plumber who he recommends. And there is no real "urgency" to get the plumber here because now that the short rains have begun, I can use the rain water to cook, clean, shower, etc......everything except drink!

Tomorrow is a teaching day at the COTC (Clinical Officer's Training College). Our topic is cervical cancer. Definitely an important subject to teach Lindi's future doctors. There are definitely a lot of patients with cervical cancer and we are fortunate to have enough funding to help these patients get to Dar Es Salaam for treatment or if we catch the disease early enough to treat the patients with surgery.