Saturday

After rounds today, some of the physicians who are working here long-term took us to the escarpment at Nakpanduri. We had an amazing hike with some gorgeous views of the country (visibility was lower because of the dust still hanging in the air after a dust storm last week, but it was astonishing nonetheless). Later we visited a woman named Denise, who moved out here after serving in the area with the Peace Corps. in the 70s and runs several humanitarian missions, including one to promote reforestation, one to provide donkeys and carts to local women, and one to help amputees acquire prosthetic limbs. She was very kind and happy to show us around her farm, which included over 25,000 saplings, donkeys, chickens, one old dog, a monkey, and many white pigeons (or doves? I can't really tell the difference).

Once we came back, we had dinner with one of the Ghanaian physicians and her husband. We learned a great deal from them about Ghanaian medical training, and the customs and food of the Northern region. We discovered that in Northern Ghana, it is tradition for the groom to pay the bride's family with cows before he can marry her. The bride's family can then use those cows to pay for their sons's marriage. So it pays to have a lot of daughters here. 

At rounds tonight, I was given the folder of a patient I had seen and discharged two weeks ago. He came in for epistaxis and anemia then, and had returned for the same symptoms. We had discussed his need to see a physician in Tamale, the nearest town with a teaching hospital, because we had exhausted the amount of tests for a clotting disorder that we could run, and he needed further work up in order to prevent future bleeding episodes. Then something on his admission note caught my eye: a chronic iliac wound! How had I missed that during his last admission?! I found a translator and went to speak with him. Turns out he had had the wound less than one month, and when I asked to see it, everything made sense. He has cutaneous anthrax! The first case that I've seen in person! He had already been treating it at home with gientian violet. It must've looked like an old wound to the MA who admitted him tonight, but on closer exam you could definitely make out the eschar. It was overlying a superficial wound he had received while in a motorbike accident on his way to the hospital during his last admission. Cutaneous anthrax is very treatable, by the way (unlike the inhaled anthrax that was sent to Rockefeller Center in the early 2000's). I was pretty excited about it. It's the little things, I guess. Today has been one of those days when I can't believe I get to come to Ghana and do what I do.