Wednesdays are a special day at Kijabe: the big orthopaedic clinic rolls into town. We see a huge number of complicated patients in our cramped, eerily lit exam rooms. The clinic is amazing: patients from infants to the very elderly come in with fractures, deformities, birth defects, infections, and tumors. Our team of senior doctors, trainees, clinical officers, nurses, and technicians settles in at 9 am and usually depart about 6 pm. We do the best we can with the resources at hand. Two patients jump into my memory from today’s clinic. The first patient I saw was a guy healing up from a broken leg. What startled me was his sweatshirt: a bright green Notre Dame hoodie! He was very familiar with Notre Dame (American) football, and unceremoniously reminded me that Notre Dame had a pretty good basketball team, but they lost the tournament!
The other patient who really made an impression was Caroline. I saw her with our very competent, professional clinical officer, also named Caroline. Caroline (the patient) suffered from a bone infection in her forearm when she was two years old. To eradicate the infection, one of the two bones, the ulna, was partially removed. While this did cure the infection, it left her with an unstable forearm. Essentially, there is no boney connection between her wrist and her elbow. As a result, her hand floats around, and one of the forearm bones has migrated out the back of her elbow. This causes pain, and the deformity you see in the picture.
Caroline is a serious, bright 14 year old young lady. I described to her and her mother the surgery we could do to reconstruct her arm. I recommended we do this at the end of the school year, so as not to interrupt her studies. To my surprise, her mother replied that we could do the surgery anytime, as Caroline was not in school. Apparently, her teacher had told her not to come to school, as her arm caused her pain when writing. For a teenage girl in rural Kenya, education is the difference between real poverty and dependence, and a chance at a life with professional opportunities and choices.
Caroline and I then came to an agreement: we will do the surgery to fix her arm, but she needed to get back in school immediately. I wrote a note to her teacher, and she is delighted both to be getting her arm fixed and getting back to her studies.
I was so pleased that Caroline our clinical office was there to be a role model of a professional woman for this young lady teetering on a watershed moment in her life. I’m looking forward to getting Caroline’s arm fixed, but even more grateful that our Caroline was there to support this young lady in her education.