Bullet Wound from "50" years ago

This patient presented to our clinic today with a chief complaint of non-radiating lower lumber pain and pain in bilateral knees. (Typical presenting symptoms). So when the student was doing her physical exam, she discovered what looked like an infected wound on his lower right leg. There was a 2 inch opening in the skin, surrounded by a 3 inch demarcation of redness and warmth. Inside the wound was a puss filled cavity. Upon further examination, when flexing and extending his ankle, you see through to the tendon which would move with each ankle movement. Turns out, the guy described this wound as a result from a bullet shot occurring "50 "years ago.  He said he periodically goes to a local hospital to get antibiotics. Either there was something wrong with our translation, or the medical care is even worse than expected. Either way, we decided that his original complaint could wait, and we needed to start the treatment of this wound ASAP and get him the best care possible. Without at least standard of care, within a few months he will have such a bad bone infection, that the only cure will be a below the knee amputation. Again, doing whatever we can, I put a surgical mask on and started to sterilize both Bac Si Ha's equipment and got the wound cleaned and prepped for debridement. We then started to cut away the dead skin, and immediately saw fresh blood supply that will bring healthy blood cells and nutrients to the wound. This will begin the healing process. We provided him with 2 weeks of a strong antibiotic. We are going to see this patient again in 3 days to check the efficacy of the antibiotic and perform another debridement. At that point, we will provide him with a 2-3 month course of antibiotic and will refer him to a local clinic. This is an example of why it is vitally important to provide care for more than 3-4 weeks a year in this area of Vietnam. As frustrating as it is, currently we have to provide the best care possible, but ideally we would stay here longer and provide better, more sustainable care.