Last week I saw my first case of malaria. Kisoro is over 6000 feet above sea level and it is quite chilly at night and in the morning. Despite that the mosquitoes still thrive. Older boys and men do not usually show up in the clinic unless they are ill. This sixteen-year-old boy was robust and looked his age that is he was well nourished and not stunted like most adolescents in this part of the world. His job was to herd cattle all day long but took time to come here because of fever and feeling unwell. He reminds me not to forget to put down my bed net at night even in the cold nights of Kisoro.
The Ugandan nationals came promptly around nine o'clock while the refugees took awhile to appear. There were two ladies with evidence of filariasis/elephantiasis, infection transmitted by infected mosquitoes and causes blockage of the lymphatic system. Their symptoms had been present for years and we have no medicines in the clinic for it.
One DRC refugee brought in her first baby and she could not tell how old the baby was or even her own age. There was a soft fleshy glob just sitting on top of the baby's fontanel, the soft spot on the baby's skull. This was applied by a Congolese herbalist apparently to protect it. Neither my Ugandan nurse nor the patient could clarify this further. The baby apparently had been crying at night but my examination did not reveal anything untoward with the exception that the baby seemed eager to breast-feed. Mom's breasts were engorged and we encouraged her to breast-feed in the clinic whereupon the baby sucked vigorously and the breast milk came fast and furious, the baby choked as it could not swallow fast enough, while the other breast was dripping milk freely. We referred her to the nutritionist in the camp for some breast feeding education.
Our driver was called in to transport a sick refugee from another transit camp three hours away to the Nyakabande Transit Camp and because of that our day at the clinic was cut short as we lost him to transport us back to our lodging.