Off and Running

HBB Entrance

One of David's hematology consults

Monday, October 4 was our first day of work. Hospital Baptiste Biblique (HBB, also known as Karolyn Kempton Memorial Hospital), has about 40 inpatient beds divided into areas of : maternity (8-10), men's ward (8-10),

women's ward (8-10), pediatrics (8-10), intensive care (4), and observation(2). ...Intensive care means that there is oxygen available! There are 2 operating rooms. Radiology services include plain xrays and a nice new mobile ultrasound machine which the fulltime docs here have learned to use by experience. The lab is in the process of being expanded into a large new area under construction. The national lab techs are receiving additional training from Bob Adolph, a lab technologist who served for 40 years at Memorial Christian Hospital in Bangladesh before retiring 6 years ago - he and his wife are here for 6 months to help with the lab upgrade. We can get blood counts, malaria smears, some electrolytes, kidney function tests, some liver function tests, stains for infection and TB, and stool exams for parasites.

Three short termers doing a spinal tap-success!

Typically, the surgeon (HBB does not have a fulltime surgeon but has nearly continuous coverage by volunteers who rotate in for variable periods of time - our current surgeon is from Petoskey, Michigan). The primary care docs round together on the medicine and pediatric patients which promotes good discussion and sharing of ideas.

After hospital rounds, we head to the outpatient clinic where we work until noon. From noon to 2 PM, everything stops and people eat and rest in the heat of the day. Clinic picks up again at 2 PM and goes until everyone has been seen, typically 5-6 PM. Besides us, there are usually 2-4 Physicians' Assistants and another doc also seeing patients.  One area where we have really been able to help is the night call - the 2 docs here have been on every other night but now can get more rest.

During the first couple days here, we have already seen cases of malaria and parasites, a couple patients with suspected TB, a boy who might have polio, and a young woman with acute leukemia. (David did a bone marrow test on her to confirm the diagnosis - sadly, there is no treatment here or elsewhere in Togo for this young woman)

HBB Nursing Station