• Rapid rehydration in severe acute malnutrition; an RCT.

    A review of some of the latest low-resources emergency medicine evidence Rapid rehydration in severe acute malnutrition; an RCT. Randomised trial showed that rapid rehydration of severely malnourished children with dehydrating diarrhoea was as safe and effective as slow rehydration Alam NH, Ashraf H, Ahmed T, Jahan N, Gyr N Acta Paediatr. 2020 Jul;109(7):1473-1484. doi: 10.1111/apa.15134. Epub 2020 Jan 9. PMID: 31828841. Aim To assess safety of faster fluid administration (6 hours rather than 12) in children with severe acute malnutrition(SAM) and severe dehydration.  Rationale SAM is unfortunately still common. These patients are vulnerable and get sick often and frequently present with dehydration. Not only is this dehydration difficult to…

  • Addis, I Like you

    I sit on my rooftop, the sounds of construction intruded slightly from behind me, the strain voices from a speaker turned up too loud from below; it has a religious tone to it; I couldn’t tell you if it Islamic or Christian. The non- distinct buzz of the streets can be heard, too faint to be delineated but I can imagine the minibuses shouted out their destination even before they have pulled to a stop, the ladies selling there 25 cent traditional (but still excellent) coffee from ever available alcove, doorway and empty patch of pavement and the ever present shoe shine boys pointing at your feet as your walk…

  • White saviours, global health and aeroplanes.

    White saviour. I am glad I am aware of this term. I am definitely white and may have actually saved a few lives in my time. But the term is mostly meant to derogatory. A dismissive term for those who come from the Europe or the global west to Africa or the global south without understanding the context. Who seek to impose there own solutions onto the problems of a continent. Who often refer to the diverse continent as a single entity and whose primary goal is the self-satisfaction that comes from perceived altruism. Does my experience and qualifications exclude me from this group? As a relatively experienced doctor with…

  • Ceremony, departure and limbo

    Last night, after our compulsory return to the capital so we can leave the country and renew our visa, myself and a colleague sit outside at an upscale cafe, browsing a menu full of salad with prices that would be fairly low in our home cities but are high enough that I forgot to bring enough cash with me, so used to having less than a dollar’s worth of small notes in my back pocket being enough for anything I would need to buy around and about the camp. The contrast is so cavernous it’s surreal. I feel like I am in a dystopian novel, walked through the gateway into…

  • Challenges, Crises, and the slow grind to improvement.

    My previous team leader answered most my questions about problems we had would be solved by the new hospital. A beacon of hope which could shine a light on the all the many dark grimy corners that existed in a newly built field hospital. But first we had to move. A challenge to be sure. But at 7am, when I discovered that my emergency room was already in boxes and if I had an acute case I would have nothing easily accessible I released we had to get a move on with this move. But, once again, the full team came to the fore and whilst the logistic team were…