September 24th and 25th

The last two days have been so incredible!

First thing yesterday morning David, Rick (the visiting prosthetist) and I went to Good Sam to pick up Kelly. After giving out peanut butter and jam cracker sandwiches we started to get him ready to go. Not surprisingly we were held up when we tried to leave but the resistance didn't come from Madame Lucien but from Kelly himself! He didn't want to go alone, so we (happily) brought Widley back with us as well for some company and to check on a fever and fungal infection in his ear as well as do some follow up as he's not been thriving since a near fatal visit to our ER back in July. Neither of them were all too sure about coming along but like any typical kid they happily kipped out on ride back to the compound.

When we arrived at the clinic Kelly was still fast asleep, so I took Widley up to the medical clinic while Rick finished up fitting one of the above knee patients that was due to back to the tent city in the afternoon. The clinic was completely packed but thankfully Andrew (the paramedic from Canada) spotted us and had Widley seen to as soon as a bed was free.

Kenley and Widley

On the way back down from the clinic I ran into Kenley who is one of the kids who comes to Good Sam with me on Saturdays -he's a huge sweetheart and very kindly offered to help watch them for the afternoon. As soon as I got back with Widley we casted Kelly who had just woken up was still not too impressed with the whole thing but with the smell of beans a rice in the air he reluctantly obliged :)

David and Kelly

Category 4 Radial deficiency

At the orphanage Kelly always hid his hand from us and the other children unless he was using it to eat so when we finally got a chance to look at it a little closer we figured out that the apparent contractures in Kelly's wrist were actually due to the absence of a Radius!  This deformity puts the wrist into severe ulnar deviation (you can see it in the x-ray) and accounts for the limited muscle control in his wrist and for his missing thumb.

David filled the cast while Kenley and I fed Widley and Kelly their much anticipated lunch. After a whole plate and a half between the two of them we had to cut them off as their bellies looked like they were going to burst and they were nearly falling asleep after every bite! Then, after a lot of moving about to get comfortable (because they couldn't sleep on their tummies) they both fell asleep on the examination table.

Rick hadn't been out of the compound much all week so I sent him along to drop the patients off at the tent city while I stayed back to finish up with Kelly. The cast didn't need much in the way of modifications as he corrected so well statically but I added a bit of a build up around his ulnar styloid process (so he’ll hopefully not end up with any skin issues there later on) and put a bit of a flare on the proximal end to stop it from pinching when he bends his elbow. After cutting the molding plastic and sorting out the best spot for his new thumb I roughly shaped a thick piece of plastic into a thumb then put them both in the oven. David helped to drape the sheet while I placed the thumb and molded it into a functional position. The power was due to go out within the hour so we hand no choice but to quench it in order to get it ready to fit.

Bribery is not usually my style but the promise of chocolate made the fitting move a whole lot faster and after a little heat out at the distal end and a bit of finishing work on the thumb we embraced the darkened clinic with smiles.

Kelly holding a marker with his fingers and new thumb!

As we cleaned up the clinic and started up the hill a big storm blew in so I made an executive decision that the boys should stay in the spareroom in the guesthouse rather than in the patient dome. Unfortunately that got me into a bit of trouble with the coordinator but with the help of about 20 cooing Texan women who were smothering them with cuddles, I managed to talk her into letting them stay there just for the night. They played and lapped up all the attention from the groups until 6 o'clock rolled around when they got down to business and focused all their energy on stuffing themselves with corn, potatoes and chicken.

After a whole lot more playing and cuddles they finally fell asleep about 10pm... I managed to wriggle my way out of the cuddle puddle for a couple hours so I could made up sandwiches and frozen bananas for today then nestled back in a little while later and didn't hear a peep from either of them til 7 this morning!

The best part was when Kelly asked me to put his brace back on before he went to bed :)

Before yesterday I'd never actually seen Kelly smile to know that he had these amazing dimples!

Once they were finished with breakfast they played soccer and coloured with the teams while Andrew and Eimear got a wound care kit together and I put together some soap, toys and books. All the vehicles were in the shop today so we settled for a the school bus which arrived about 12. The boys said their goodbyes and not long after leaving the compound they were, once again, both asleep on my lap.

When we arrived, all the kids came running out to meet us at the bus and were shouting Kelly's name. He was absolutely beaming and as soon as he had his feet on the ground he was right smack in the middle of the group, proudly showing off his thumb to the other kids :)

Success!

After giving out some frozen bananas (which went down really well) we started up a mini clinic -Eimear worked her way through the line of  kids and managed to clear up a pretty bad ulcer and a few other skin infections while Andrew played with the ones who were waiting to be seen.

Later on, while everyone else was distracted by the sandwiches, I sat down with the older girls and tried my best to talk to them to see if we could do anything to help as they tend to bear the brunt of the work there. I managed to get a few things down on paper but the language barrier is still very much there. My creole is getting better bit by bit but not fast enough, especially for them -at one point Ollie said to me with obvious frustration "ou pa konprann anyen" which means 'you don't understand anything'. So, with a huge smile and what little I know of Creole I said that I understand that she has a big heart and a strong mind and a beautiful smile. The girls burst out into uncontrollable laughter! 

To be honest, I'm still not quite sure if it was because of my terrible attempt at speaking Creole or my ridiculously cheesy choice of words... in any case it got the reaction I wanted :) 

Leaving the orphanage is never easy but today was made even harder as most of the kids were crying when we boarded the bus. Now that Eimaer and Andrew are here I'm going to try starting up a mobile medical clinic for them once a week so that means that there's a good chance I'll be able to pop in to check on them sometime before Saturday. 

Rev dous!