Email medicine

Our clinic has a close relationship with New Tribes Mission here in the Philippines. One of the ways that we try to help is being available to answer medical questions whether about themselves or about someone in their ministry area. This is always an interesting situation, some of the situations are quite difficult, especially when the person managing them off in the tribe somewhere likely has little, if any medical training.



I thought I would include one of my recent emails from a NTM missionary. The medically trained among us can give a shot at how they would answer. This email had one of the best possible inclusions . . . a picture.



From the email:

We have a little girl in our village who was involved in a truck roll over back on the 22nd of December. It appears that the parents took her to the hospital and she had as much treatment as they could afford. The doctor said that this wound on her head needed skin grafting but they could not afford the cost of the operation. So they just brought her back to the village.



We [the NTM missionary] arrived back into the tribe in mid April. just over a week ago we put her on 250mg amoxicillin t.d.s. for a week and also had the mother applying flammazine once a day to the wound. The photo attached to this email was taken after she had been on the amoxicillin for a week. Prior to starting the antibiotics the wound was very pussy and red and swollen all around it. So after a week on the antibiotics it did look a bit better. So we have continued the antibiotics for another week. The mother is also applying the flammazine twice a day for this coming week. We will check her again this Sunday.



Can you please tell us if we are on the right track as far as treatment goes? Should we continue the antibiotics after she has been on them for two weeks or just stop them and continue with the flammazine? Should that be put on once or twice a day after it has been applied once a day for a week and then twice a day for the following week?



Will the wound just eventually heal up even if it never has skin grafts? It seems a long time to us to still look this open and raw? It is coming up for nearly five months since the accident.Is there anything else we should be doing for her to help it heal up quicker? It appears it is going to scar her little face terribly, but maybe if she grows her hair long that will eventually cover it when she grows older. She is about five years old. Do you think that area will ever grow hair from it again?



Could you also let us know what would be the next best antibiotic to prevent burns getting infected if we have run out of amoxicillin. Is cefalexin or ampicillin the next best choice?



We had a little boy with burns all to his face from hot water come today, but we have run out of amoxicillin and were wondering what other antibiotic would be good to prevent infection of his burns.Looking forward to your reply,

- End of email.