Leopard on the move, click to zoom

in ngorongoro highlands

photography heaven

Masai  cattle barons

Abdullah's Arm

 Abdullah is a nine yo boy who  had been bitten on the arm by a snake some time back.  The exact story is is unclear and seems to change depending on the translator. One iteration is Abdullah was treated by a local witch doctor with herbs ( or “erbes” as they say here). Another was a toriquet was left on his arm for too long  and too tight and he developed gangrene after his brachial artery clotted off. Sort of like a heart attack of his arm. Whatever the story, he he got screwed. Maybe he would have died with out the lousy care he got. Maybe the snake  was a Black Momba and since he is only 30 kg it would have finished him off quickly.But I bet if I asked him the day I met him if  he wished he had rather died he would have said “ndyio” (yes).

     I had been asked to see him the 1^st wk I was at the hospital but when I went to find him on the pedi ward ( aka bedlam) his parents had taken him home. I have been thru that before. Many patients just “abscond”  with their kids never to be seen again. This seems particularly true of bad limbs that will never heal. The idea of amputaion doesn’t sit well here in  Kagera. You can’t blame  them really. The chance of a prosthesis is next to zero. And if you’re a growing kid in need of several prosthesis over your growing years…well that’s impossible. Facing a life of being crippled, the village “gimp”, the incomplete man or women, the stigma of imperfection, well its impossible. You can write off a big chunk of you life including facing the fact that you may never find a mate, a job, friends…. Well, you can see this can go on  and on.

   To stay  on track, Adullah’s parents brought him back. And when I did find him in the crowded, 2 or 3 kids to a bed, pedi ward Abdullah was in  a bed by himself!  He had been placed in  a relatively quiet room at the end of the ward. Later I realized the reason why  and thought to myself “ these nurses really do know whats going on”.    Abdullah was put in relative isolation not b/c he was infectious ( which he prob was) but b/c the nurses knew he was trying to hide his hideous arm from anyone looking his way. When I first met him he wore 2 kangas. One wrapped his lower body and a second one wrapped his right arm. I almost lost my professional cool when I peeled the stinky pussy kanka back and saw his mummified necrotic  arm. It looked like something from a 1950’s bad horror film. But this was real.

  From his wrist to his elbow was just skeleton, no muscle, like parana had attacked his arm and eaten all the tissue off the two bones of his forearm. From his wrist to his fingers was dried gangrene mummified tissue. Above his elbow was 2 to 3 inches of  stinky infected tissue.  Abdullah cried when I got near but never looked up at me. I am sure I terrrified him; a tall white man. Maybe the first to touch him or see his wound.  I have a love and facination for pathology and usually the grossier the better but this one  made me mad. Sure he was going to loose his arm and be crippled and stignmatized for the rest of his life. But  this was cruel torture  and psychologically damageing to this little kid. Why hadn’t this arm been removed before and who is so insensitive to leave this dead limb on this little kid for so long.?  If this was in the U.S. Abdullah would be on the front page of the Boston Herald and the N.Y. Daily News. “Boy Mummy Back From Dead” His parents would be arrested for cruelty to children. Social Workers would go nuts!

 But quess what? This is not the US. This is Kagera. There is no money for medicine or surgery. There is just passive acceptance of bad things happening to innocent people.

  We finally got Abdullah to the OR. My guess this surgery should have been done 3 months ago…at least. The first thing I did after we draped him was take the dull saw and cut through  the the 2 bones ( radius and ulna) of his forearm just distal to his elbow. His bones, completely stripped of tissue and muscle,along with his leather gangenous wrist and hand dropped off into a bucket. I asked the runner to “ get that arm out of the room”. Next, we found a suitable clean level on his upper arm, cut down to his humerus, cut that in half and removed his distal upper arm and elbow. Then we created a nice round wrap of tissue to cover the bone and sewed his arm up to create a stump. Time of operation, skin to skin: 60 mins. Timing of operation: very late.

    I followed up with Abdullah every morning in the hospital. He never complained of pain . His dad, a muslim, was there every day at the bedside. We got more comfortable in time even though we had few words in common between us. Forget about words, we had nothing in common except that he came to believe that this mzungu was helping his son. I  brought Abdullah a pad and pen on post op day 2.  I’m pretty sure he use to be right handed. I wrote the alphabet out and then he did the same with his only ( left) hand. Then I tried to write the alphabet out with my left hand.  That was the first time I ever saw him or his dad laugh.  Then I wrote “ practice makes perfect”  I hope they get that translated someday.  The next day he was up and about and his wound looked clean. Against the better wishes of the nurses, I sent him home. I’m betting his house is cleaner then the hospital and  I know his dad will be at his side.

  Abdullah, with any luck and no signifigant complications will have an upper arm that is about 7 inches long. It won’t be beautiful but it won’t stink and he doesn’t look like a walking horror movie. His chance of a prosthesis…next to zero.

His chance of enjoying his life as a handicapped but otherwise possibly normal person…much improved.

in the heavy weight division

On a lighter note....this is my first upload, doubt it will work, not much else does,  but here goes. More to come.
This is from day 3 in the Serengeti we had just left a mother leopard with cubs, very rare to see and came upon a big herd of tempo (elephant) These  young guys were just wrestling. The BIG bull was nearby, nobody messes with him. Despite what you here the elephant population here and in Ngorongoro seems to booming, babies everywhere. Hope it works,

First Post

05/04/2013: "Karibu Sana "to my next blog.  You are" very welcome" to this new place with pictures I take and stories that I write. I am glad to share them with you. Like the first blog " Barabaraandlarry on Safari" this one includes some Kiswahili. And, like the first one, this includes a dedication. When we dedicated the first blog in 2008 to Pat Euphemia Cavanaugh, a fabulous one in a million person, neither of us ever thought that some day one of us would be dedication material. Pat died, for no apparent reason from lung cancer. Not that you have to be dead to be dedication material but that seems to be the trend here.
  So this blog is dedicated to Barbara Broda Adrian who died, for no apparent reason, from breast cancer.  Barbara was my wife, my lover, my better half who became my better two-thirds who was too young, too smart and too valuable to the world to die. But she did. I would argue she was too beautiful to die but beauty has never been proven to be associated with longevity. Barbara was a mother, a teacher, and a budding geologist who believed like me and like the address of this blog, in one flat world. I think we both correctly believe (d) that we were lucky enough to be in a position to be able to actively work towards that goal. So she worked on knocking down figurative mountains that separate people. She  worked on erasing the old nomenclature of first world, second world, third world. She did it through education. By working to level the world, to bring the poor up and create not 3 worlds but one flat world. I know neither of us were nieve enough to ever think that one flat world was a reality. But we weren't cynical enough to believe improvement was impossible. My personal belief is we are here to make things better. That is what I do. It's utterly simple. I don' t achieve my goal every day but that is my goal. So when Barbara died I felt like I lost 2/3 of my self. I felt like I lost my legs, I felt truncated. And with out legs I wasn't sure I wanted to continue onward toward my goal. My children lost their compass and we all lost our home. But we are growing new legs, we will get on a new course and we will find our way home. And I will travel again.
One last Swahili link. It is no coincidence to me that the Swahili word "Barabara" has  two meanings.
1) road  2)excellent. So this blog among other things is about my traveling down an excellent road.
I am sure Barbara would want that.
Karibu sana.