bones joints muscles!

On Tuesday I got to spend a busy day at CURE International Hospital, which specializes in orthopedic surgery. 80% of CURE patients are disabled children, who receive free evaluation, surgical care, and rehabilitation, along with three meals a day and housing for themselves and a guardian. The remaining 20% are paying adult patients, mostly wealthier Malawians, who help subsidize the childrens' care with elective surgeries like hip and knee replacements.

During the morning, I worked with the two U.K. med students, Daisy and Sian, doing a physical therapy/play group for the kids, both pre- and post- surgical. Our first session was for children 1-6 - most of these children have congenital deformities like club-feet, cleft palates, or hip dysplasia, or have missing or extra limbs/fingers/toes. A photo of our second session, with the older kids, is shown here. Many of them are disabled due to trauma, osteomyelitis, polio, or spinal TB. During the therapy sessions we tried to get the kids engaged in songs with lots of motions, games with balls and streamers, and even finger painting! (Always a good time, in any country!)

The children's ward at CURE is a large room with 60 beds, partitioned into the ICU (shown here), main ward, and infectious ward, for children with osteomyelitis and spinal TB. Two British surgeons, Dr. Harrison and Dr. Cashman, perform most of the operations - each day one is in the surgical theater, while the other rounds on patients and sees new patients in the clinic. I followed Dr. Harrison on ward rounds after lunch, and spent the afternoon with another physician in the clinic.

Because patients and their parents often have to travel very long distances to get treatment, many children's conditions worsen for years before they make it to CURE. So I saw some really tough things I'd probably never see in the States. It was so painful to watch the clinic physician diagnose a 6-year-old girl with muscular dystrophy, and explain to the father (who had come from Mozambique) that the disease would probably progress rapidly and there was nothing the hospital could do. But I also saw hopeful things - a three-year-old with disfiguring burns regaining the ability to hold a crayon; a ten-year-old's x-ray showing hazy wisps of calcification where bones should be - both his femurs re-growing after surgery removed the long shafts.

Long bones re-grow! I did not know this. Amazing.