Learning about leishmaniasis

                We had some excitement on the medical side of things this week. There is a (lovely) American couple working here full time named Kevin and Tammy Groder. Getting to know them has been an expected joy on this trip. Tuesday morning Pastor Kevin mentioned to me that he had a sore on his right forearm, it had been there for a couple of days and was getting worse. What would I recommend? Honestly that kind of thing happens all the time here. Unconcerned, I put him on an antibiotic and assumed it would be clearing up by the morning.              

                Well, that isn't what happened. Wednesday morning, Pastor Kevin’s arm was swollen with redness and inflammation with redness and inflammation creeping up above the sore. The sore itself had at least doubled in size. No one was happy about it. He consulted with some other American nurses and we ended up at the local hospital, looking for a doctor and some more powerful antibiotics. We got prescriptions for antibiotic shots and pills and instructions to return if the infection got worse. Brushing up on my injection skills, I gave him a couple of shots Wednesday. We also traced out the redness on his arm in order to have a reference point to see if it was still spreading Thursday morning.

                Thursday morning, his whole arm was decidedly, alarmingly worse. The redness had spread past Wednesday’s marked out area in two directions, his entire arm was more swollen and his fingertips were tingly and slightly purple.  Slightly purple is not an appropriate skin color ever. At that point we were all getting very alarmed and began pursuing more intensive options. It was a national holiday here in Haiti which meant that the clinic we would normally have gone to was closed. We ended up going into Port Au Prince to be seen at a reputable hospital there, with the backup plan of flying him to Miami if necessary.

                We got in almost immediately at the hospital’s ER (practically a miracle in and of itself!) and were seen by an American doctor. He tentatively diagnosed it as a parasitic infection called leishmaniasis with an accompanying bacterial skin infection. After prescribing some meds, he gave us some instructions about what to watch and hope for if the diagnosis and treatment were correct and what would happen if they weren't. He also had an amazing handlebar mustache.

                After a few tense days and a lot of prayer I am delighted to report that Pastor Kevin’s arm has begun to heal. The secondary bacterial infection is clearing up nicely and the swelling has almost totally resolved. We are looking at weeks or months for the leishmaniasis to heal, but things seem to be improving. To those who heard our prayer requests and acted quickly, thank you so much. Feel free to continue praying as we wait for the primary lesion to heal! Thanks everyone!