Elisabeth Hesse’s Blog

2-9-09: Last full day in Kikori

Today was not bad for my last full day at Kikori.  I started the day
with laundry (fun and exciting, I know), so that the clothes I give
to the hospital tomorrow will be at least somewhat clean.  Ward
rounds were not terribly exciting.  Leprosy Man will be losing his
last little toe on his right foot tomorrow in the operating theatre;
unfortunately, I will be packing/going to the “airport”/getting on a
plane, so I won’t be there.  The little baby weighed in at 2.5 kg
today; however, the nurses don’t seem to grasp the concept of
weighing babies without their clothes on, so I don’t know how
realistic of a weight that really is.  We had two new patients–a
woman with a 2 week old infected injury on her foot, and her
daughter, who has burns on her arms, legs, and backside.  Not to
pleasant for either, I’m afraid.  We ended up taking the woman to
theatre this afternoon for a debridement.  It was probably the most
disgusting thing I’ve ever seen, and I’ve seen some pretty gross
things in the course of my training.  We were removing dead tissue
down to her muscles, and at one point, I hit bone, the lateral
malleolus (ankle bone).  I don’t know how much of this will heal or
if she’ll ever have use of her foot again.  She’ll definitely need a
skin graft, but other than that, I don’t know.

I got an update from Kapuna on the sick mystery patient (the one who
was sick and we didn’t know why).  Dr. Archer attempted to do a lymph
node biopsy, but every node she checked was full of pus.  He has also
developed very thick skin that feels wooden, as well as necrotic
ulcers.  The new working diagnosis is pyoderma gangrenosum.

Anyway, back to my day.  After our adventure into this infected,
necrotic foot, I went back to the house and proceeded to pack,
separating things into “goes back to America” and “stays in PNG”.  I
wasn’t planning on running today on account of having washed my
running clothes (to be donated to the hospital) as well as my shoes
(so I’m not completely disgusting on my flight back to the States),
but it cooled down right at six, and I couldn’t resist one last run
in PNG.  The weather cooperated; it didn’t start raining until after
we got back to our houses.

In the evening, I decided to sit in on Sarah, the hospital matron,
giving a talk about HIV counseling to the nurses and CHWs.  Most of
it was about basic counseling techniques, such as confidentiality and
building trust, and she didn’t really get into how they actually
counsel for HIV testing yet, which was too bad.  I was interested in
seeing how they do it here, compared to home, but I guess I won’t get
that opportunity.

I’m excited to begin my journey back tomorrow.  I’m a bit weary about
my Airlines PNG flight back to Port Moresby; I’m hoping it’s on-time
without any problems, so I can get checked in for my flight Wednesday
morning and get to the guesthouse with enough time to go souvenir
shopping.  Failing that, I’m just hoping that I get to Port Moresby
with enough time for me to get on my flight Wednesday.  I really
don’t want to deal with having to find alternative transportation
back to America.