Report from Surmang

Since our first day open after I arrived on June 30th, we have seen near 450 patients, including 25 housecalls. Adults are 390 patients and children 53. Of the adults 60% are male. Of the children 70% are male. Not including the 50 patients Poonsuk saw while I was in Yushu ( he only kept statistics of numbers not details), we saw

• 139 gastrointestinal problems including 63 patients with presumed helicobacter pylori, multiple cases of presumed giardia, nonspecific gastritis or esophagitis,gastrointestinal bleeding, gastroenteritis, esophageal stricture, gall bladder disease, worms,etc.
  
  
• 79 respiratory problems including 3 cases of pneumonia, 1 case of TB (presumed), bronchitis, occasional asthma,the common cold, whooping cough like illness, sinusitis, nosebleeds etc.
  
  
• 42 patients with cardiovascular disease including 31 patients with high blood pressure ( we have started them on medication and will need more to get them through the winter, 4 patients with heart failure ( they will also need medication through the winter), angina, non specific chest pain, heart murmurs.
  
  
• 62 patients with skin problems, including one child who was covered with impetigo and had a temp well over 102 degrees; his head and arms were a crusted mass of weeping sores (we probably saved his life, he had been sick for over two weeks, was weak and totally listless. The skin problems included other cases of impetigo, eczema, dry tching skin from inadequate cleanliness, seborrhea, acne, warts, fungus, bites burns and cuts and abrasions.
  
  
• 20 patients whose primary problems were eye related including two patients with vision threatening retinitis, eye infections, cataracts, corneal opacity from infection and refraction problems. We have seen 17 ear related problems including 3 patients with chronic pus draining ear infections, 2 of those in children..
  
  
• 12 patients over 80 and most of them cannot hear. The dental situation here is pretty much disastrous -- we have treated about 30 people for toothaches and a couple for gingivitis. We hand out toothbruches whenever possible ie, there are significant teeth left, teach oral hygiene, and we actually pulled three teeth. I have never seen so many broken decayed teeth.
  
  
• 82 patients with orthopedic complaints, 36 with osteoarthritis, 2 with rheumatoid arthritis, 11 sciatica, 19 backaches. Two patients who had had displaced lower extremity fractures. Poonsuk treated by setting the fractures, closing the open wounds and treating prophylactically for infection, pretty impressive. You can imagine how grateful these patients were.
  
  
• We have seen 3 cases of Bell's palsy, 1 patient with vertigo, the usual headaches and dizziness and one young man 21 who I am sure has a spinal cord mass (disc, TB, Tumor) in excruciating pain with a classic neuro exam. Not sure if they can get him to help. He will have to go to Xining to be treated as there is no CAT scan here.
  
  
• We have seen five patients with pregnancy related problems, including one woman with a severe uterine infection and pneumonia we saw lying outside her tent. She was 11 days postpartum with a fever of over 102. We just happened to see her across the river lying on the ground in the spot where the people who are sick lie. It is pretty amazing what we see.