CASE RECORDS OF THE MERU DISTRICT REGIONAL HOSPITAL

Case #1: An 8-Year-Old Boy with Extensive Burns

Abraham (name changed for privacy) had already been an inpatient at Tengeru for a few weeks before I arrived. He had sustained full thickness (3rd-degree) burns over his upper back and most of his right arm in a kitchen accident. His treatment required regular debridement of the burn, in other words, a vigorous scrubbing of the wounds to remove accumulating dead tissue, which, if left in place, would be a medium for infection. Unfortunately, the anesthetic medications and monitoring needed for Abraham to be sedated during the debridement are not readily available at Tengeru. There is also, I believe, something of a cultural preference in Tanzania to avoid painkillers and anesthetics, as stoicism is prized. Abraham’s screams could be heard across the outdoor campus on the days when he underwent debridement. His older sister, who was his caregiver, had to help the staff hold him down.

Nonetheless, Abraham and his family, typical of the average Tengeru patient, persevered and did not feel ill-used during this treatment. He submitted to regular painful stretching of the burned area, which would otherwise scar very heavily and limit the range of motion of his dominant arm, and was beginning to use the arm purposefully by the time I left.

Cheers to Cameron McAlpine and Sara Catto, Australian medical students from the University of Western Australia in Perth, who contributed a great deal of thought, gentleness, and time to his care and who shared this photo with me.

Please consider a donation to help patients like Abraham through the GoFundMe that I have set up. Thanks!

https://www.gofundme.com/f/karibu-tengeru-hospital