In southern Sudan, an Australian ER
doctor follows local advice when a child is bitten by a mysterious
Name: Christopher George Tiley
Profession: Doctor (family
doctor and neurologist)
Episode: "The Compromise"
SUDAN | INDONESIA | CAMBODIA
In the Afghanistan section of this episode, a woman is suffering from a mitral valve problem. What is this and what causes it?
Mitral-valve prolapse (MVP) is usually a congenital
malformation and generally harmless. Most people have no symptoms.
The mitral valve controls the flow of blood from the left atrium
into the left ventricle of the heart. Normally, when the left ventricle
contracts, the mitral valve closes and blood flows out of the heart
through the aortic valve and into the aorta. When MVP is present,
some blood can leak back into the left atrium. This is called mitral
regurgitation, and can cause the heart to “murmur.”
This in itself is not dangerous. However, mitral regurgitation increases
the risk of bacterial endocarditis, an infection in the lining of
the heart. Bacterial endocarditis occurs when bacteria in the bloodstream
lodge on the compromised heart valve. This is likely what happened
to the woman in Afghanistan. Heart failure can develop if the infection
breaks off in little pieces, resulting in a series of strokes. At
this point, surgery is necessary to replace the heart valve.
In the Sudan section of this episode, an infant
has a congenital condition that results in a swelling of the head.
What is this and how would it be treated in a modern hospital?
The brain normally makes approximately 16 ounces of
cerebrospinal fluid (CSF) every 24 hours. This CSF needs to circulate
so that it can be absorbed. Hydrocephalus, which is the ailment
the MSF doctor in Sudan suspects this child of suffering from, is
a condition in which a child’s brain cannot adequately circulate
or absorb CSF. This leads to increased pressure in the brain and,
in advanced cases, swelling of the head. In a hospital setting,
a permanent shunt can be surgically placed to allow the CSF to flow
from the brain into the belly and be absorbed.
In the Cambodia section of this episode, an
engineer is building a well for a local hospital. What else can
volunteer engineers do for MSF?
Clean drinking water and sanitary facilities are essential
to preventing the outbreak of epidemics in any situation. During
emergencies and among displaced populations, the urgency of providing
water and sanitation increases considerably.
MSF employs specialists who construct wells, water pumping systems
and sanitary facilities using existing water sources, piping, plastic
water tanks, tank trucks, and other assorted logistical supplies.
In acute emergencies and chronic conflict situations, hospitals
and clinics are often devastated through armed violence, wear and
tear, or looting. Where necessary, MSF assumes the task of rehabilitating
and re-equipping these buildings.