Bugs, and passions that won’t let go

dhThese notes are about the CMF Developing Health Course 2014.

The focus of today is Tropical Medicine. I made notes on the whole course in 2012 – you can read about this day here.

Each day I’m just going to write about things that impacted me, and things I need to read later…

Two things made today different. Firstly, for the next two days, my mum has joined the course. It has been lovely: so nice to spend time with her; we are both doctors, and having a shared purpose and heart is a joy. We are in three families together; biological, professional and spiritual, and that makes me very happy.

Secondly, I got in from a stag do at 3:30am, and was not able to pay attention tremendously well today…

Tropical Medicine

One person shared about the fact that in some areas of endemic shistosomiasis infection, it is widely accepted that boys have a menarche. In other words, the parasitic infection causes blood in the urine, and it is so common, that it is thought that boys have a period, just like girls, in their wee. On many levels, it is amazing that something so wrong can be accepted as the normal.

We had some small group sessions where we talked about how to deal with hospital workers getting TB. There was a great idea bout offering hospital staff free healthcare (obviously more relevant in countries without free universal coverage), and of automatically offering an XR and sputum analysis for anyone who has had a cough for more than 3 weeks.

I’ve definitely been getting excited about the potential for community health development in Tonga, when we get out there, and some of these ideas are a big challenge.

Mortality and Malaria

The Malaria lecture ended with a shocking reminder: 1,000,000-3,000,000 deaths/year >90% among African children.

140,000 people died when we dropped atomic bombs on two Japanese cities in 1945. There is a memorial to these people in London. However, its important to remember that in 1945 in Africa, around 3,000,000 children probably died from Malaria. And in 1946 in Africa, 3,000,000 children died from Malaria. And in 1947… 1948…

Why do we not hear about this more? Because malaria is predominantly a condition affecting young african children living in absolute poverty.

Malaria LifecycleMalaria Lifecycle

  • 1 mosquito bite
  • 15 sporozoites
  • Each Sporoziote matures in the liver and releases 40,000 Merozoites.
  • The Merozoites join a red cell and become a Trophozoite.
  • These mature, and become Schizonts and release more Merozoites – 16 per cell.
  • Finally, at some point, Gametocytes are formed from Trophozoites.
  • They are then picked up by a mosquito drinking your blood.

Absence of fever DOES NOT rule out Malaria!

Interpreting a blood film.

Three things to know:

  1. Infecting species
  2. Density of infection – no limit to % – people have been known to survive 70%.
  3. Stage (trophozoites vs schizonts) – if there are lots of schizonts, its a sign that within the next 24 hours the density of the infection is about to massively increase.

You can bring about a 60% reduction in all cause mortality in under 5s by sleeping under a bed net.

Which is so much more effective than the value of statins, or extra antihypertensive agents. But we don’t hear about it.

Missions Fair

IrresistableRevolutionBeing surrounded by people on medical mission, I’ve noticed that almost everyone is going out with an agency or some sort of organisation supporting them. It’s important to have a church that sends you out, but sometimes they do not have the breadth of cross cultural experience that can be helpful in international mission .

Me and Katherine talked about it, and agreed we wanted to see if there was an organisation that would be interested in providing that support.

So I went to the missions fair, where there were 20ish organisations that provide training, support, finances, programmes to join, short term trips to fulfill. And I said

“Hi, we kinda want some sort of support, but don’t really know what… Can you provide that? Oh yeh, and we fly out to South Africa for a year in like 6 weeks…”

To say that people visibly recoiled wasn’t altogether inaccurate. Ultimately of the 20+ agencies, nobody really felt they could help us. Probably pretty wisely.

I spent the evening in crazily deep conversation with Jon (the collie dog owner from yesterday) and discovered that he and his wife are joining a fairly radical group of “New Monastics“, a concept I’ve previously come across through reading various books by Shane Claibourne (see right). In fact, its a passion both me and Katherine have both shared so passionately that we spent our first two years of married life living in community

So, long story short, I spent my last hour before sleep chucking emails at missional community based organisations, along the lines of Urban Neighbours of Hope, The Simple Way, InnerChange, Word Made Flesh. I couldn’t sleep until I read Ephesians 1 again either! Our email is below, a quick, honest missive to see if God has anyone for us…

Hey there,

My name is Chris Lowry. My wife and I, and our 1 year old and our 3 year old
are going to Africa for a year in AUgust.

We aren’t going with a missionary organisation (yet) but we do feel God wants
us to go. I’m a doctor, so we will be working in a hospital out there in
Tonga, in Mpumalanga (SA) and we have a wage coming in.

Err, would you provide (non financial) support to people like us?

C

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