medical care in Africa.

I've spent most of the last couple weeks focusing on the medical aspect of caring for thirty kids. That would be a daunting prospect even in the US, but throw in limited access to care, the need to transport kids to clinics and hospitals, a culture of kids that aren't really used to complaining about pain or discomfort, and limited funds - well, as you can imagine, it's a not a simple process. I thought I would document some of the specific things we've been working on, in order to give you a picture of what medical care is like here.

Sabrina is a 15-year-old girl with a heart murmur that was discovered a few months ago when a visiting U.S. medical team did physicals for all of the children. Her heart murmur might not require any extra care, but she needs an echocardiogram to be sure. We could get that done here in Libreville, but it would be very expensive. We could also get it done in at the hospital in Bongolo, where it is much less expensive, but then we need to arrange for transportation there, a place to stay, and supervision while traveling and at Bongolo. And all of this needs to be done by engaging local Gabonese volunteers, and by setting up a process that we can use as needed in the future.

Dorcas is an 11-year-old girl who came to live at Hope House in July, shortly before I came to Gabon. She wasn't here when the medical team did physicals, so I took her to the OSPAC medical clinic. One of the nurses, Paul, noted a crackling sound in her lungs, which indicates some kind of infection (bronchitis, pneumonia, etc.). Dorcas has never complained of feeling sick, so this is something we never would have discovered if it weren't for the physical. They gave her an antibiotic at the clinic, and then I took her to another clinic (SNI) for a blood test. The next day I picked up the results of that test (thankfully they were normal and her antibiotic is clearing up the infection), then I needed to take the results back to OSPAC to read them. For a Gabonese without their own car (and most don't have one), this would have been four separate taxi rides, in addition to the consultation fee (waived in this case because it was for a Hope House child) and the blood test fee.

Warel is 16 years old. A couple weeks ago, I noticed that he was keeping a little piece of bathroom tissue in his ear, and asked him about it. He explained that sometimes his ear leaked fluid, and that it had been doing that for some time. Like many of the others, he didn't actually complain about the problem, but I took him to the clinic anyway. When Paul looked in his ear, he saw a hole in his ear drum. We were able to get him medication for this, and give him some instructions for keeping water out of his ear. Without this, he could easily have lost all hearing in that ear.

Moussounda is 7 years old, and has been living at Hope House with his twin brother Boumba (along with several other siblings) for most of his life. Both twins were near death when they were found and brought to Hope House, but now they are smiling, active, and very typical boys. One day the other children told me that at some point during the school year (at least two months ago now), Moussounda stuck a blue crayon in his ear, and part of it was still in there. He didn't complain of pain or any trouble hearing, and Pastor Israel and Mama Nathalie didn't even know that he had done this. So much dirt had gathered in front of the piece of crayon, that it took quite some time to clean it all out, but luckily we were able to take care of it at the SNI clinic, rather than having to go to a hospital (again, very expensive).

Dental issues are also very common among the children at Hope House (and, I imagine, throughout the rest of the majority world as well). In June, a visiting dentist examined all of the kids' teeth and had to pull quite a few of them - in fact, he ran out of time and there are at least 6 children who still need to have that done. Like with Sabrina's echocardiogram, this work can be done here in Libreville or at Bongolo, but the cost is a huge factor. Luckily, all of the kids now have toothbrushes and are brushing three times a day (or at least as often as they are reminded to brush).

A lot has been accomplished, but there is also a lot still left to be done. Over the next few months, we're hoping to get the children that need it down to Bongolo, get full blood tests (including HIV) for all of the children, provide Hope House with plenty of first aid supplies to have on hand, and have a documented process for dealing with medical issues for both new and existing children.