Snake Bites and Portable Ultrasounds: Thoughts from Dr. Aaron

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I arrived in Uganda few days ago. After a brief stop in Imvepi to drop off supplies and medications, at last I reached the Odubu health center.

Dropping medications and supplies at the Imvepi Health Center

Dropping medications and supplies at the Imvepi Health Center

As usual, I’ve been treated graciously and patiently by the Ugandan staff as I try to reintegrate myself in to the clinical mix. I was last here 3 years ago and it’s been a treat to see familiar faces who have continued their strong work in this austere environment. Rhone, a clinical nurse, and I are hoping to resume our morning runs as soon as the dirt track firms up after yesterday’s surreal, practically apocalyptic, thunderstorm.

Despite the mud, we saw 150 patients in the Outpatient Department (OPD) and additionally managed the half dozen inpatients, mostly severe malaria cases, pediatric pneumonias and assault/trauma victims. Dinner last night was interrupted by shrieks of pain, so we put down our food and trotted over to manage a ten year old just bitten by a snake. She was in extraordinary pain which we eased with medications and a splint. She was then monitored for the complications of snake bites-neurotoxicity, coagulation disorders and limb threatening swelling. Fortunately, none of these ever evolved.

My aim during this trip is to add to the training of the Field Medical Representatives (FMRs) and assist in more advanced training of the clinical officers. They are already talented and have an enthusiasm for the never ending work that is rarely seen in our clock-punching economy back home. Naturally, I find myself learning as much from them.

View from the staff quarters at the imvepi health center

View from the staff quarters at the imvepi health center

Portable ultrasound technology has recently seen startling improvements in compactness and cost (now just $2000), and I brought my device (the Butterfly IQ) to evaluate its usefulness in this environment. It is a durable, cost effective and low risk technology that has already shown great utility in austere settings. So far here, it’s been a success, helping us identify an abscess, ovarian cyst, gestational trophoblastic disease as well as screening a number of trauma patients for severe injuries.

This is a hard place to work, and I have to remind myself that the refugees left a place that was even harder. The material resources here can be scarce, but the dedication and spirit of the staff is not.

-Dr. Aaron Scott, MD

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