Sometimes, things seem really hard at Kijabe Hospital. We see a constant stream of really sick and badly injured patients. We talk and pray with them, give them the best medical care we can, and hope for the best. Most patients thrive, heal up well, and go on with their lives. Others suffer greatly, and not all of them survive. Kijabe can be an intense place to work.
Which is why it is so important to celebrate victories. We have had two small children with really unusual problems this week, but both should go on to have normal lives.
The first patient is Ahmed. You wouldn’t know that this child lives in a famine plagued corner of Kenya, in the largest refugee camp in the world. Dadaab is known as an arid, hostile, often violent place where Somalis flee to escape the war and terrorism in their home country.
So imagine our delight when this fat, happy, funny baby arrived from that awful place. Ahmed is six months old, and born with an unusual condition. He was born with his urinary bladder incompletely formed and outside of his body. A part of this problem is that the bones of the pelvis don’t form completely, and so don’t come around to meet in the front. Thus, there is nothing to “hold his insides, in.” So I got to work with my good friend, Erik Hansen, a paediatric surgeon, and our amazing anesthesia team,
to fix this problem. Erik’s assignment was a long and difficult process of forming a new bladder from the tissue available, and placing the new structure inside of the pelvis. My smaller part was to cut the bones of the pelvis on each side so we could fold them inward, containing the structures on the inside. I hadn’t done this exact procedure before, so it took a little longer than it should, but it seemed to turn out alright in the end. Ahmed is doing well, recovering comfortably in his new turtle shell of a cast.
We’ll plan on removing the cast in about six weeks, and Ahmed can go on his way.
Today, I saw a beautiful two day old girl named Elizabeth. She is a health, happy, peaceful little thing, but has a couple of problems with her legs. The right knee has a fairly rare problem called “congenital dislocation of the knee.” For reasons not fully understood, occasionally a child is born with their knee joint dislocated, bending the wrong way, with the foot up near the face.
Though this seems like it should be painful, it isn’t. Her other foot has a common condition called calcaneovalgus foot deformity, which resolves over time, sometimes with a bit of gentle stretching from the parents.
The treatment for congenital knee dislocation usually requires some manipulation and casting, once a week, for six or eight weeks. Most babies then develop normally.
Elizabeth’s mom was delighted and relieved to know the treatment was so simple, for a condition which looks strange and potentially disabling.
Thankfully, the family lives in a village not far from Kijabe, so it shouldn’t be too much of a burden for them to come once a week. It’s really nice to be able to help these babies, hopefully give them a normal life, instead of one of shame, poverty, and disability. Patients like these help remind me of the ministry of Kijabe, to show God’s love to people in this part of Africa.