Fieldset
Daga village and the Maitikoulou bed situation

In my last posting I mentioned I would say how the village of Daga 2 fared in its completion of screening for sleeping sickness here at our HAT camp.

In my last posting I mentioned I would say how the village of Daga 2 fared in its completion of screening for sleeping sickness here at our HAT camp. Hopefully, this will be illustrative of the procedure to diagnose and treat sleeping sickness, along with the other main pathologies in this region.

Of the 60 villagers screened in Daga, 18/60 had a positive blood screening test for sleeping sickness. The 18 walked together yesterday and all came en-mass to Maitikoulou and spent the day outside our lab under a tree. They joked around, I talked with them about how the day would unfold, and they shared food. They looked with curiosity as other patients of all ages and degrees of severity arrived and Dr. Placide and I took care of them.

The 18 from Daga who arrived here in Maitikoulou all received a lumbar puncture, lymph node aspiration and blood smear. 9/18 had the more serious neurological stage of sleeping sickness (stage 2) and 9/18 had the less serious blood-lymphatic form of the disease (stage 1).

Of the 9 in stage 2, 8/9 had a malaria coinfection as well which was no surprise given malaria is the top killer in CAR. This will need treatment before we can treat their sleeping sickness sick our treatment for sleeping sickness will depress their immune system.

Ultimately, we admitted all 18 villagers from Daga. Along with other admissions, yesterday was the heaviest admitting day since I arrived here. We had 25 admissions in total.

Like all our patients, the Daga folks will get a daily food ration here, a roof over their head and medical treatment entirely for free. If they are the severe stage 2, they will sleep on a fairly shoddy locally made bed with a mattress, good blanket and bednet. If they are the less severe stage 1 they will sleep on a mat in an open-air wooden hanger. There are just not enough beds for everyone, even though we are making more all the time.

So there is a snap-shot of our HAT camp in-patient ward bed situation if all the numbers are getting fuzzy:

Tent 1: all 12 beds filled with phase 2 HAT patients

Tent 2: 7/8 beds filled with malnutrition or severe malaria cases. 1 bed with 1 month old baby who has stage 2 sleeping sickness and severe malaria.

Tent 3: 1 patient only. A 1 year old from Chad in isolation due to measles.

Tent 4: 12 patients in 11 beds. Two newborn twins who arrived yesterday and I put them in the same bed. Their mother died in child-birth and the children have not breast-fed in 3 days. Until the family and I find a long term solution, I've got to admit them and give them therapeutic milk.

Tent 5: all 12 beds filled. 11 with HAT patients and 1 with a young man with a possible seizure disorder. This tent is close to the nursing station and allows easier monitoring of the patient.

Tent 6: 8 patients in 8 beds. 5 patients are HAT and 3 are other pathologies.

Hanger 1: 5 phase 1 patients and 1 patient with a rectovaginal prolapse I am trying to transfer out for elective surgery (she walked 60km so it's easier if she just stays here while I await a response from our MSF surgical referral hospital in Boguila).

New admissions: 18 HAT patients (17 go to the hanger, and 1 will go in the 1 free bed)

Total beneficiaries: 77

Free beds: 1 (soon 0 as the new HAT phase 2 patient who can start eflornithine treatment can go there).

That's all for now. Next week will be busy - we're planning our 2nd mobile activity and we will have a reporter, health advisor, communications officer and MSF volunteers from other projects here. I'll keep you posted on what promises a busy time.

Warm wishes from the Central African Republic,

Raghu Venugopal