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February 13 - 17, Every day we see new and astonishing things, as well as familiar and interesting activities. We're very pleased to see so many villages that now have water pumps, like the one pictured below. This is where the dollar does the most good and the investment in potable water spares the lives of so many and enhances their health and protects them from morbid diseases, like the Guinea Worm, numerous enteric diseases, giardia, amoebae and other parasites.  Yes, the familiar site of giving the polio drops. We take advantage of the immunization clinics and provide information regarding the detection of AFP as well as the importance of completing the immunizations.

Please click on the thumbprints to see them enlarged.

The Buruli Ulcers might be something new to a western doctor, but in certain areas of Western Africa it is a very familiar problem that the local doctor deals with. It starts as a painless, but itchy nodule, which after scratching and traumatizing produces an ulcer. The edges become indurated and then the ulcer extends itself. Here is one that is just starting on the scalp, another one that's almost taken over the arm and has been debrieded, now awaiting skin transplant. The last picture demonstrates a leg that had an extensive ulcer, and like the arm was totally debrieded and then closed with a skin graft, much like is done in a burn unit. A physician, plastic surgeon, from Holland is at this small hospital for three years and is working day and night. Today I ran across a case of Yaws, Onchocerciasis and Schistosomiases, along with tons of malaria.

    
Please click on the thumbprints to see them enlarged.

In spite of all the possible distractions and other serious diseases, we are keeping focused on the polio issue and working on detective assignment to look for any possible AFP case. I was pleased to see one of the Disease Control Officers wearing a T-shirt that had a large Rotary wheel in front and "Kick Polio out of Ghana" on the back. Even in the most remote area of Ghana it seems that all the health workers are aware of Rotary and the Polio Eradication Initiate. Of course, the villagers know little about the eradication goals, or WHO or Rotary, but they are getting the message day in and day out that they need to immunize their children -- and its happening.

         
Please click on the thumbprints to see them enlarged.

Emmanuel Mensah
Victim or Victor?

Emmanuel was 3 years old when his mother took him to a medical post for treatment. He had fever and was weak -- couldn't even walk. The nurse gave him a shot, but this didn't help. He became well, in that he didn't have any more fever and regained his appetite, but he didn't regain the strength in his legs and still couldn't walk. This was obviously a curse of the spirits, so his mother took him to the traditional healer in the village. There was a ceremony with chanting, an animal sacrifice and blood sprinkling. Emmanuel was expected to walk again with time -- his mother had paid dearly for his treatment and she was confident in the power of the healer. Unfortunately, Emmanual did not walk again, even after many months-- in fact he simulated a spider crawling of the filth of the ground with his atrophied, spindly, contracted and crooked legs.

Fortunately his uncle, who was in the Ghana Army, recognized the problem -- POLIO -- and took him to his military hospital. There he remained for 11 months as doctors operated multiple times, releasing tendons in an attempt to straighten his legs. Together with physical rehabilitation, braces and crutches he learned to walk again.

Today, Emmanuel needs only the help of a cane to walk. He works for the Ministry of Health as a Nutritional Officer organizing nutritional clinics, where mothers are taught which foods help their children become strong and remain healthy. Yes, he was pleased to see us and is a partner in our efforts to eradicate polio. He is also on the lookout for children who might be acutely afflicted with the same evil poliovirus that wanted to end his life. Emmanual, today, is no longer a victim -- he is a victor.

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