An African Sting

There is a thin line that separates laughter and pain, comedy and tragedy, humor and hurt.
Erma Bombeck 

I know some of you may be wondering if I actually do any medicine at Haydom Lutheran Hospital (HLH), but don't worry I do. Up in till now I've largely steered away from telling cases from the hospital, and I'm not about to start. Instead I have a little story to tell from yesterday, with some added education.

If we start right back at the beginning, yesterday felt like the first actual normal day for me in Africa. I started the normal routine of practicing medicine at HLH, with the minor change that I had moved from General Surgery to ICU. But alas, you can not have any normal days in Africa.

In the afternoon, a group of us consisting of myself, Amin (Medical Student from the Netherlands), Tea and Anna-sofia (two Danish Medical Students), thought it would be nice to go for a walk around the sunny hillside of Haydom. Having run the route several times by myself, it was nice to finish off the day with a relaxing walk with a few of the others. On the way through the town we met some local kids, who as always seem to have great fun checking out the Mzungu. There was even a little girl who ran up to each of us, just to touch us like we where some sort of good luck charm. Two of the kids followed us on our walk past the airport, until even they sped off on their bikes.

It was then that something strange happen. The kids quickly semi-crashed/jumped off their bikes and started doing what looked like to us weird dances and running all over the road. Having just talked to them a little, we thought this was odd, but couldn't help laughing, thinking that they must be doing some funny local dance thing.

So at this point just imagine a few happy Mzungu going for a walk and seeing some kids do a funny dance. We were in ignorant bliss. We were ill prepared for what was about to happen, and in retrospect we should of gotten right out of there.

But we didn't turn back. No, for we thought everything was fine until we started to hear this buzzing sound. Our ears pricked, we turned to look at each other, and a sudden realization of what we had stepped in to and what the kids had been doing only a minute before.

 An African Bee Swarm

 

African Bee via Wikipedia

Now for those who know little about African Bees, let just say they are very similar to European Bees, just add an extra dose of aggression and about 50 more of them. They are quick to perceive a potential threat, send out more bees to any one threat, and follow victims for a much greater distance. For victims is what we were about to become. Just like the kids we had seen earlier, we ran all over the road, sprinting like most of us had never done before, just to try and shake these bees. Being persistent little Bees (not to mention venomous) a collection of them followed us a distance well over 500 metres. And whether we liked it or not, the outcome was fixed the moment we didn't decide to turn back when we saw the kids acting strangely.

Fortunately, for us we suffered only a total of 6 stings being the four of us. Somehow I don't think the kids were so lucky, and I can only hope they didn't get swarmed to death.

Bee Stings 
So to make the most out of this experience, I thought I should at least impart some medical knowledge about bee stings. For anyone who seen my Medicine in Small Doses series over at IVLine.info, I'm going to use a similar format here.

The most important thing to remember with bee stings, is that you can have different reactions each time (from mild swelling to anaphylaxis), and more stings (i.e. more venom) can lead to worse symptoms.

Clinical Features: 

• Nausea, vomiting or diarrhea 
• Headache 
• Vertigo 
• Feeling faint or fainting 
• Convulsions 
• Fever 

Management: 
In general, management can be reasonable conservative for the vast majority of bee stings.
The following is reccommended;

• Remove the stinger 
• Wash the area with soap and cool water 
• Apply hydrocortisone cream or calamine to the site
• Take an oral antihistamine
• Elevate the extremity if swelling is increasing.

 Lessons Learnt

1. No such thing as a normal day in Africa, each day is full of surprises. Arguable there is no such thing as a normal day back home, we just forget to appreciate the little things that happen around us.
2. Bee stings hurt.
3. There can sometimes be a thin line between laughter and pain, and it's important to remember that each of us draws the line at different places.