Episode: "The Compromise"

SUDAN | INDONESIA | CAMBODIA | AFGHANISTAN

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.

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