Yesterday’s rounds

Thought I’d give folks a taste of what I am seeing here

·         Disseminated TB in HIV+ patient sufficiently severe to cause shock and multiorgan system failure

·         HIV+ patient with cryptosporidiosis diarrhea and pancytopenia

·         HIV- older lady with hemorrhagic stroke

·         Severe headache in HIV+ patient. CSF analysis is negative, one of the services provided for free by the hospital. However, the patient cannot afford a CT scan, so it is impossible to conclude the workup. She remains undiagnosed

·         Post-partum cardiomyopathy with heart failure and multiple embolic strokes, HIV-

·         HIV- patient with cerebral malaria, temperature 42.7 C, which is 108.8 F. These were not typos. She died shortly after I saw her

·         New HIV+ with AIDS defining illness cryptococcal meningitis

·         HIV+ woman with a case of condyloma acuminate from hell

·         Elderly woman with lymphangitic carcinomatosis from breast ca, large pleural effusion

·         HIV- patient with recurrent pericardial and pleural effusions. Probably post-TB but not definitive.

This is not cherry-picking to make it look bad. This is a fair cross section of what I see.

It is hot here, and the rains have not yet come. It is supposed to be rainy season, and we’ve only had occasional sprinkles. Not good. However, it allows families to sit out on the grass and spread their laundry out to dry over bushes and over the lawn.

Below are some pictures from near my apartment. The storks are Marabou storks. They are ugly as hell and noisy. They stand easily a meter tall and roost in trees around my apartment. In terms of ecological niche, they are half pigeon, half rat—ubiquitous scavengers.  One sex has this big globby thing that hangs down, like a turkey wattle on steroids. As I was writing, I heard this thumping around on the roof and one of the critters was up there. He's the guy standing on the corrugated roofing material. 

The street is a major street that goes into town (we are on the outskirts). The big yellow thing in the middle is an overpass from one side of the campus to the other.  More local pix this weekend.

Note wattle on front.

In a tree. Nests are these big, sloppy affairs.

Another picture of our seriously ugly friend.

Street outside my window.