November 2011 Archives

Dr. Tundun Williams - Week 1 In Lagos, Nigeria

Lagos is home to over 7 million people who call themselves "Lagosians". They are kind of like the New Yorkers of Nigeria. They dress to impress, drive... how shall I put this...purposefully, and are all vying for a bit of the wealth that is for the making in this city which remains the business capital of Nigeria.

Lagos is inhabited by the uberrich, who live in sprawling mansions on gated estates, as well as the destitute, who make do in shacks that house up to four families and have one communal bathroom.

To say that the wealth in this city is unequally distributed is stating the obvious.

I spent the majority of my time this week at the Massey Street Children's Hospital, a government-run pediatric hospital in inner-city Lagos.

I soon learned that the action at Massey was in the ED, a two-room facility on the second floor of the outpatient building, which was located across the street from the inpatient department.

After nearly losing my life trying to cross the street while dodging public minivans (danfos), three wheeled cabs (maruwas) and motorcycles (okadas) on my first day at Massey, I mastered the art of road-crossing in Lagos, which consists of venturing forth at a time when the road is relatively clear and then holding your ground in the face of any oncoming traffic until you are given the right of passage. You must show no fear.


The in-patient building at Massey


The busy street between the two buildings at Massey

The doctors in the ED were glad to have me on board. Part of the art of practicing medicine in the developing world is learning to improvise, and improvise I did. I performed an LP on a 6yo with a 20-gauge needle (stylet, schmylet), used the elastic band on the bottom of a pair of gloves for a tourniquet and did many other things that would never have crossed my mind in the US. 

I saw several cases of very classic kernicterus, a case of cholera and malaria galore.

Since Massey is a government-run facility, basic supplies like gloves, IV cannulas, syringes and needles can be obtained for free from the hospital pharmacy with a doctor's written prescription.

If the pharmacy happens to be out of stock, however, patients are responsible for purchasing their own supplies and bringing them to the hospital. The cost of medical care can be mammoth and is one of the factors that prevents the average Nigerian from seeking timely treatment.


Inside Massey's ED


A toddler at Massey with left lower lobe pneumonia. The cuts had been made in his village when he started coughing and then complained of abdominal pain.

When I was not at Massey, I pitched in to help Tina (Slusher) with her sunlight phototherapy study. At the end of this week, I will head to the small town of Ogbomoso, where I will be spending the majority of my time.



Dr. (Henk) Vreman and his helpers setting up the sunlight phototherapy tent frame


Down time at an ice cream parlor