Tuesday, 28 August 2012

True happiness is giving it away..

My last night at Coast Province General Hospital was bittersweet.

Six of us decided to spend our last night in Mombasa at the place that brought us here in the first place—the hospital. It was 10 pm before we arrived and like always, casualty was busy. Tonight though, we were going to make the very best of our last night and with us we carried a dozen scrubs to give to our favorite tiny African nurse, Mya. We knew she wouldn’t be on duty but we hid the scrubs in her secret supply cabinet. I only wish we could have been there when she opened it the next morning. She asked us to leave her one pair of scrubs, so twelve surely left her surprised! Knowing her she won’t keep them all for herself either, that was one reason we liked Mya so much.

You may have recently read in the news about a massacre in a Kenyan village where 48 people, mostly women and children, were murdered. If not here is a link to an article: http://www.mercurynews.com/nation-world/ci_21374684/at-least-48-killed-mostly-women-and-children

A survivor of this was brought into Coast General the day before. Her neighbor found her and brought her all the way to Mombasa for treatment. That takes hours by car. Her condition was severe: her arm badly severed by the blade of a machete. Her face distorted in a way that made her teeth visible with her mouth closed. She waited hours to receive treatment and was suppose to be rushed to emergency surgery, but in the end could not afford the procedure so she was sutured and sent away.

Again it’s hard seeing people suffering on a gurney in the corner, forgotten, because they can’t pay or there are no medical supplies. You just don’t see this in America so it’s still hard for me to wrap my head around. After assisting with vitals, dressings, and speeding up the treatment of people in casualty we decided to call it a night. I found one of the nurses I liked in casualty and asked her if she wanted my scrubs. Her face just lit up. She is a little more chesty than I am so hopefully they actually fit, but either way she was really excited. I then looked down at my shoes and back up at her and said, “will these fit you?” I slipped one off and she tried it on smiling back at me. I told her to wait there as I went and changed into shorts and a t-shirt in minor. When I went back and handed her the two pairs of scrubs and new shoes she seemed very grateful and would not stop smiling. It felt so good knowing I literally just gave her the clothes off my back and the shoes off my feet.

Before this trip I would occasionally find myself wondering about the meaning of life. Why I live in America where women have a voice, education is taken for granted, and clean water is at our fingertips when there are people in this world who have to fear genocide, education is out of the question, and have to walk four miles one way for a bucket of water. After seeing it first hand I ask that question more now than ever. It doesn’t seem fair and I will forever live with the images of poverty in the back of my mind but I will never forget the people I met here, they are some of the most amazing human beings I have ever had the opportunity to know. After being home for a day I have already stopped multiple times to think about how grateful I am for everyone and everything in my life. I know I’ll go back to Africa again someday. I’m not set out to change the world, but if I can be a part of improving the life of one person there, just one, I can die a happy person because I’ve completed the purpose of the life I want to live.

It’s amazing it took traveling half way around the world to find a part of myself I didn’t know existed. There’s a whole world out there, don’t be the one afraid to leave the comfort of your doorstep.

Friday, 24 August 2012

Wednesday and Thursday!

8/22 and 8/23
The past two days have been relaxing. It was a great opportunity to catch up on the few touristy things we still wanted to do and spend some time at the beach. Wednesday, Joel, Trisha, Jenna, Megan and I went to get some supplies for the reconstruction of the orphanage. It was a 15 minute walk to a small town hardware shop. I really felt like I was in the middle of nowhere Kenya in this place! It wasn’t by any means threatening, we could just tell people here don’t usually, if ever, see mzungu’s (white people) here. After bartering with the owner for supplies, we came out with 4 buckets of white paint, 3 small one liter cans of blue, red, and yellow paint, 2 large paint brushes, and 5 small ones for about 3200 Kenyan shillings. That is about 35 or so US dollars, not bad! Once we arrived back at the orphanage we began the task of painting the newly cemented walls. Sevanas, an Elective Africa employee helped us get started. He kept adding way too much water to the primer though, so it took quite a few coats to get a solid base. There was no ladder to be found, so he improvised with stacking two benches vertically and climbing up them! There were quite a few times that I thought he was going to just come crashing down and spill all the paint. It was really nice to be able to help out more at the orphanage/school. I really enjoy the people who work there, they are so nice! As soon as we walk in they scurry around setting chairs behind us to sit down in. I have so much appreciation for all the time, money, and work Joel has spent here trying to make a difference in these children’s lives.
 Putting cement on the walls
He decided to start painting right above me :) notice his "ladder"
After spending half the day painting, it was time for the beach! Joel, Megan, Chelsea and I made the short trek down to Nyali Beach for possibly the last time. Megan and I really wanted to ride the camel before we left, so we did that right away. It was so much fun! I know I have a picture of me doing this when I was little, but that was at a zoo… and this is the Indian Ocean. The rest of the time was just spent lying in the sun. I was just about to doze off when BAM! Sand went flying and looking to my left I now had an African boy sitting sideways between Megan and I. He hit the side of Megan’s head and went flying over top of her to land right between us. He just sat there dumbfounded like he had no idea what happened either. Megan was ok and the boy kept coming back apologizing over and over. He kept saying, “Madam, Madam I am so sorry! I was doing exercises!” Needless to say he was forgiven and now it’s just another funny story to add to countless others this trip.


I didn’t go to the hospital today; I am waiting to do the evening shift on Friday. I’m hoping that staying up until 3am or so right before we leave will help put me back on a good sleeping schedule for home. I can’t believe I only have a couple days left! It’s truly bittersweet.



I was able to sleep in for once! At 9 am Jenna, Megan, Trisha and I rode the van to the hospital. There was a lady we found out about through a doctor at the hospital who does henna tattoos, so we wanted to get some done before we left. Her apartment was only about a block from the hospital so that was convenient! She was very nice and did such a great job for 200 Kenyan shillings! That’s only about 4 American dollars. I got my right foot and left arm done and the rest of the day was spent trying to let it dry.

At 1:30 pm we decided to go back to Old Town Mombasa to get some last minute souvenirs! I have gotten really good at bargaining—Dad you would be proud! Everything I bought was at least half of what they were asking for initially. For about 15 dollars I finally had all the gifts I wanted to bring home. While waiting for the other people in our group to head back to the van we ran into an obnoxious Kenyan “tour guide” right outside of Fort Jesus. I think he was attracted to the 4 white girls with henna tattoos and he would just not go away! Of course he was harmless, but kept insisting we hang out with him sometime. Yeah right. First of all anyone who introduces himself to you as Captain Midnight obviously isn’t sane and we might be tourists, but we aren’t stupid J

Thursday night was sort of our going away party before we fly back Saturday. It was really fun; I’m going to miss being so close to all the people on this trip. We will definitely have to have a reunion this semester! And Joel! You better come to South Dakota for pub crawl like you promised!

Friday will be my last day/night at the hospital, it’s almost surreal. I have so many mixed feelings about it I don’t even know how to explain. I will do one last blog post on Saturday morning and then back to the US it is!

Wednesday, 22 August 2012

Back to the Hospital!


Grapic Images, once again!

Back to the hospital! The day began in major theatre observing a surgery on a 15 month old boy with hypospadias. This is a birth defect in the opening of the urethra. The surgery was kind of hard to see from where we were standing, but its always amazing to see a broken body opened up and put back together again.
Going into surgery

Things were beginning to pick up in minor, but there were a lot of us down there which sometimes makes things more complicated than they should be. Trisha and I decided to go take a look at casualty. As we got closer to the gate we saw quite a bit of commotion. There were probably six people yelling from the outside of the gate which I’ve never seen closed, and two police officers guarding it from the inside. Once the officers saw us the immediately opened it to let us in. Inside on the male half of the room we saw three patients and another five police officers. It’s not uncommon for police to escort prisoners in who need medical attention, but this was different. These patients weren’t prisoners—well at least not yet. We saw Dr. Abdulhussein, one of our favorite doctors because he involves us in patient care and asks us questions to challenge our knowledge. We made eye contact and he motioned for us to follow him. Upon squeezing through the officers and onlookers, we arrived at the bedside of a male in his mid-twenties, severely beaten. Dr. Abdulhussein explained he was going to do a full body exam basically to check for DCAP-BTLS (deformities, contusions, abrasions, punctures, bruises, tenderness, lacerations, swelling). His way of performing this was somewhat similar to what we do in the American world of EMS—but not quite. I was surprised he did not expose his body and at how rough he was with the patient. They guy would be screaming out in pain yet the doctor would keep poking, prodding, and yanking. The officer in charge of him was also being very aggressive, slapping him hard in the face and yelling at him to scoot up in the bed. Upon completion of the exam the doctor concluded he did not have any broken bones, but without an x-ray I wasn’t convinced. The patient had a large laceration on the back of his head deep enough to indicate a possible occipital fracture. I was most worried about internal bleeding, and they said he was going to go for an ultrasound as soon as it was available. After finishing up at the bedside, Dr. Abdulhussein began to explain “mob justice” to Trisha and I. The patient we had just seen had stolen something earlier that day. When that happens in Kenya the people who witness the offense are allowed to chase after the theft and beat him until the police come and take him somewhere. This is legal here! No one gets persecuted for beating someone to death in the street.

I then overheard the doctor tell someone the patient had been struck by a tuktuk, even though minutes earlier he had told us about the mob justice scenario. Learning this switched on a light bulb in my head. We have seen a lot of people involved in some sort of motor vehicle accident, but how many of those were actually mob justice victims? It seems like every day new horrifying evidence of abuse is brought out into the light.

Trisha and I decided to go help out in minor while we waited for the mob justice patient to come back from medical imaging. Dr. Abdulhussein was going to teach us how to suture so we definitely wanted to wait around for that. As we were at a low point in number of patients, Jeff came in and told us if we wanted to see a really cool wound to come in the exam room. I followed him in and this is what I found:


This patient had been cut by an iron sheet used for roofing. His open, unclean cut had turned into this in a matter of weeks! The foul, sour smell of rotting flesh filled the room making it almost unbearable to stand. Jeff assisted an intern doctor in the cleaning of the room which included scrapping out the white infectious part of the wound. After spending some time in there it was almost time to go if we wanted our free ride in the van. I decided to call it a day, while Trisha wanted to hang out for an extra half hour to see if our mob patient would come in for sutures. I saw her an hour later and she said he had never gone up for ultrasound; he was still lying on the gurney where we had last seen him. After going to have a closer look at him, he appeared deceased. I cannot express how angry I am with how this case played out. I have gotten a thorough insight of Kenyan healthcare, but I don’t know if I’ll ever completely understand it. It makes me want to stay longer because things seem to get done and move faster when we are there. Even if our only contribution is pestering the staff or changing dressings, I still feel as though we are helping improve the wellbeing of patients at Coast General.



Our journey began on Thursday the 16th as we boarded the Coast Air bus to Nairobi. The 8 hour bus ride was impossible to sleep on due to the driver speeding up, slamming on the breaks, and passing every car we saw. That coach bus was not made for that type of driver; I don’t know how we made it to our destination alive!

Death wish?
Nairobi is so much different than Mombasa! It is in more of a mountainous region so it’s really hot during the day, but cold at night. I really wish I would have brought a pair of sweatpants! As fun and amazing as this trip has been—I miss American food! So much! The stew and rice isn’t really doing it for me anymore. As soon as we got settled in our 8 person room (with one random roommate) at the hostile, we were off to find a place to eat.

The next morning we loaded in to 3 safari vans and were off on another 6 hour journey to Massai Mara National Wildlife Reserve. The first 4 hours were long—there were a lot of speed bumps in which the driver, Solomon, no longer slowed down for anymore. I had already finished my book that I had started reading the day before so I was getting pretty bored. Suddenly quiet Solomon turned around and said “This part of the road, bad. Tarmac ends here.” Well… he wasn’t joking. The next hour and a half reminded me of the old days in high school offroading in the Burb on the logging roads.  I actually had a blast going 60 down the dirt road with pot holes everywhere! Then in the back of my mind I started thinking, if we crash we die. It’s not like there are ambulances or helicopters that can just come rescue us. Nonetheless, I still had a good time. Check facebook for a short, unjustified, video of it.
The vans!

We arrived at the Rhino Tented Camp around 3:30, took a 20 minute rest, and went straight to the reserve. It was amazing. Solomon put the top up so we could stand and take pictures of the animals. We saw zebras (which ended up being my favorite despite the fact that we saw thousands of them, literally), elephants, wildebeests, giraffes, buffalo, hartebeests, and different types of gazelle and antelope. We spent about 3 hours out there before returning for a shower (my first warm shower in Africa!), and supper. We were all exhausted and ended up going to bed around 9:30.

Day 2!

We were out on the reserve by 8:30am ready to see what the day had in store. My van included, Ali and Ben (the Canadian couple), Megan Sarvis, Megan Stuart, and myself. Megan Stuart had a really nice Nikon camera so her pictures turned out the best on this adventure. I wish I would have invested in a nice camera like that before coming here! The day began with more zebra, wildebeest, and gazelle. All the sudden we hear Solomon talking on the CB and before we knew it we were going 60 mph again on the sketchy dirt road in pursuit of a hyena! It was so cool; it was eating a wildebeest and fighting off the huge buzzards trying to steal the meat.
Taken by Megan Stuart

Our main destination for the day was the Mara River where we would be able to see the hippos and crocodiles. We eventually came up over this hill and there we saw thousands of zebra and wildebeests grazing in the sun. This was my all time favorite part of the trip! I could not get over how many there were! The whole time I kept thinking of the Lion King, I’m definitely going to watch that when I get home! We slowly rolled through the vast open field of these beautiful animals before speeding up again to see a black rhino! He was hard to see because of the bushes in the way, but still very cool. We also saw a cheetah and some mating lions before it was even noon!
Annual migration from Serengeti to Massai Mara
There was a stream of water to be crossed ahead and our van was the first one to go. I sat down finally because I knew this was going to be a rough ride. After crossing the water the embankment on the other side was straight up! We cheered when we made it to the other side because we honestly didn’t think it was possible. The next van wasn’t so lucky, I just remember seeing a split second of their front bumper and then back down the embankment they slid. They were stuck. Our van pulled them out successfully within a matter of minutes. These Kenyan’s are impressive! Then rolling up behind us was a huge truck, I don’t even know what it was carrying or why it was out there, it was very out of place. The driver smiled and waved at us before going straight down into the embankment! There was a huge crashing noise and yes, they too were stuck in the mud. Were we at some kind of circus? Again, the Kenyan’s were efficient, they pulled that huge truck out with just a little Toyota van and we were on our way.
Then truck number 2 came
The rest of the day was filled with more animals; we saw all of the “Big 5” besides a leopard. I would say we had a great experience overall! The Mara River was amazing; there were hippos and crocodiles all over. This river separates Kenya from Tanzania to give you a little perspective of how far we have traveled on this trip.
Hello hippos, and hello Tanzania!

When we finally made it back to the camp I was shocked at how dirty my face was! I cleaned it off when we got stuck before noon and now it looked like I had a spray tan gone wrong! I did stand up in the van with the top down for 8 out of the 9 hours we were on the reserve so I guess I deserved it. After 2 showers, I still was not completely clean!

To end the night we went to a Massai village, which was awesome! The people were so welcoming and gave us a great look into their culture. They keep all their livestock in the center circle of their village to keep the lions from attacking. If one does enter, it is killed. The baby animals are actually kept inside the tiny little huts the people live in made of sticks and cow dung! Along with the animals there is usually another 6 people living in there. I can't believe they crammed that many people into a house that is the size of my living room. The people sang for us and invited us into their homes. It was a great experience and amazing to see that people still live like this.
 The village
 Part of the singing
It was so dark in there! But this is the hut

Again, we went to bed early that night. The next morning we had to be in the van at 6:10 am! It was time to finally see an African sunrise! Of course, the pictures don’t do it justice, it was way more beautiful than words can describe or pictures can portray. We spent about 2 and a half hours on the reserve before returning to Nairobi. Before we left we got to see a lioness eating a wildebeest! We were so close to her it was crazy! I loved the safari, it’s definitely another adventure I can check off my bucket list!

About two hours into our journey back to Nairobi, Solomon began a speech, “The rhino grass from yesterday.”  We just stared at him confused. “You know, when we drove through the grass to see the Rhino.” Ohhhh, yeah. He went on, “The park rangers saw us do that and want to fine us. They have our license plate, but we convinced them it wasn’t us. If the stop us up ahead, tell them we were only here for a day. We drove in from Nairobi yesterday and we are leaving today.” The 5 of us just nodded in agreement, trying to digest the fact that we were on the run! A few miles down the road we stopped at a checkpoint and everyone was speaking in Swahili so I couldn’t understand. Felix, one of the other van drivers in our group came up and said something to Solomon then ran back to his van and sped away! We were right behind him. The other van got questioned, so some of the girls had to play along with the story and say we had only been here a day. This whole time I’m thinking great—we are going to get imprisoned in a foreign country for lying to park rangers! Ironic? J

It all seemed to turn out fine; we made it back to Nairobi later that night and ate at a restaurant called Carnivore. It was expensive, but very good! Probably the best food we have had the whole trip! They serve you as much meat as you can eat. I tried crocodile (disgusting!), ostrich (really good!) and an ox testicle (disgusting!). Everything else was pretty normal.

The whole safari experience was so amazing! I am extremely glad we decided to add this into our time here in Kenya. On the bus ride home we saw Mt. Kilimanjaro and it made me want to climb it even more! I’d love to come back and do that, see Serengeti, and do more medical work someday. My time in Africa ends in a few short days, but I know it won’t be forever. If I could stay longer I would, it feels like I have so much more work to fulfill here.

Wednesday, 15 August 2012

Day 8: Reddy Junior School

Day 8: Reddy Junior School 8/15

Orphanage day! The morning was spent at the market, buying food for the safari just in case it’s not “real” food. At around 1:30 pm we finally made the 10 minute trek to the orphanage. Once we passed through the short cut (aka the dump), we were on the main dirt road leading to our destination. As soon as we popped out onto this road a group of small children came running up to us! Each of them found one of our hands and didn’t let go until we arrived at the orphanage. It was the cutest thing ever, they are so sweet!

Once we entered the mud and stick structure of Reddy Junior School we met the coordinator and he invited us to sit. Despite the conditions these people endure every day, they are the happiest human beings I have ever had the privilege of meeting. We learned that Reddy is a community school in Nyali that is also home to many orphans who rely on the support of this safety net. Joel has done an amazing job fundraising money for them and construction of new walls and a well providing clean water will begin as early as next week! We will all be returning to help make this possible. Clean water is hard to come by in Kenya, especially if you live in a community like this. The biggest obstacle is not being able to pay the water bill each month; it is building the well itself. Thankfully, this long awaited necessity is going to be available to these children soon. From there it costs about 1,000 Kenya shillings per month to keep the water accessible. That is about 10 American dollars per month. The coordinators and the children are very excited to not have to worry about getting sick from the water anymore.

Once the four of us piled into the small classroom and sat down, we instantly were mauled by tiny fingers and bright white smiles. It was so much fun. One little girl sat on my lap the entire time the older children sang and danced for us. She grabbed both of my hands and wrapped them around her stomach tightly and despite the heat, sat there the whole time. I just wanted to take her home with me! Another little boy sitting next to me instantly had an eye on my watch. He was pushing all the buttons so the time on it was totally misconstrued. I gave in and just took it off for him to play with. Well of course there were about 30 kids and 1 watch, so they all argued about who got to wear it J One of the older children even presented us with a couple rap songs in English! One was about AIDS; the other was about his lifestyle in Kenya. The lyrics were really honest coming from an 11 year old boy. One line went something like, “My shelter is 10x10, other’s have homes with 2 stories and 10 rooms, but don’t worry about me-- I’m fine.”
 The infamous watch
 Trisha, Megan, Me, and Keisha with some of the kids
The girl in the white dress was at a conference in Mombasa today advocating for children's rights

These people don’t want our pity, they want to sing and dance, enjoy life, and be happy—always. A message a lot of people in this world don’t understand. These little fingers and bright smiles have changed my life already. Materialistically, they have nothing; but spiritually they have everything. They are amazing and I just can’t get enough of them! Yes, it makes me melt when all they want you to do is hold them, but I will leave here knowing they aren’t sad. They are happy, welcoming people who will openly show you their lives with no shame. Days like these are worth remembering. Materialistically we have changed their lives, but spiritually they have changed mine. There is no greater gift than that.

Tuesday Day 7 of the Hospital

Day 7 of the hospital! 8/14

It feels like I never left the hospital last night! Today began once again in minor theatre. It seems to be the best place to get hands on experience so if it is busy, that's where you'll find me! The first patient of the morning came in with a very large, very infected abscess on his back. Upon doing a sensation test, it was determined he had minimal feeling in roughly a 4x4 inch area of his back. The abscess needed to be drained so I had the honor of injecting the Lidocaine into the region to make absolute sure he wouldn't feel anything. Trisha immediately volunteered to do the honors of draining the pus, which was fine with me! The procedure didn't take very long, with so much infection and hardened pus; we got out as much as possible and dressed the wound. Unfortunately, the patient had already left before found a doctor to prescribe him some antibiotics! Since we are the primary occupants of minor theatre it’s sometimes hard to find a doctor to come over and prescribe medications or assess patients we don’t have the ability to.

Today was full of abscesses and breasts for some reason. It seemed like every patient had a need pertaining to those two categories. I was about to assist someone in draining another abscess when Mya (the sweetest nurse I found here), came barging in and asked if I knew how to remove stitches. Thankfully, Mia taught me that Friday so I was able to take on the challenge. A med student came with me to assist so I was 100% comfortable with doing it on my own. The patient, a middle aged male, had undergone some type of hernia repair surgery in his abdomen and was ready for his stitches to be removed. He plopped down on the table and lifted his shirt and I saw the weirdest “stitches” of my life! I’m not sure if this was just an Africa procedure, or if people actually do this in the States. All I knew was I had never seen anything like it. He had an obvious incision about 8 inches in length on his abdomen and there were only 2 stitches! I really wish I had a picture to attest to this mystery. After prepping, I used a blade to cut the thread. I looked at the med student for assistance on this one and he walked over to take a better look. He then began pulling, forcefully, on one of them as it crept out from inside his healed incision. The patient winced at this and I still wonder how sterile it really was to have such a stitch, especially with the high infection rate of Africa! The tissue had already healed around the thread inside of his abdomen, so pulling it out had to hurt!

We have a reoccurring issue with a matron in minor named Rose. She never likes the way we perform sterile procedure, yet refuses to do it herself. I assure you we don’t compromise the patients risk for infection any more than the rest of the hospital—Rose just has a bad attitude. Today, she held up a poster of garbage bins and the matching bodily fluid that is supposed to be disposed in it. As she stood in the corner holding it, Joel looked up from a wound dressing and in his already hilarious British accent said, “What would you like me to do about that Rose?” She mumbled something about how he was using the wrong bin, and how unsterile that was so he commented back, “Yeah, I don’t think that’s the biggest issue this hospital has.” With her unfriendly demeanor and lack of smile she rolled her eyes and left. Mya thinks we are wonderful and help so much but Rose—she has some issues. I can’t blame her for being unhappy with the working conditions she is in everyday, but hostility isn’t the answer to these problems.

To end the shift we had an extremely helpful doctor come in and explain the procedure he was about to perform on a breast. The woman had a small benign lipoma in her breast that was simply going to be removed. As we felt for it the doctor kept repeating, “It’s like a rock within a pillow, do you feel it!? Do you feel it!?” We felt it and as funny and weird as the analogy was he was actually right! The rest of the day was spent reading and going to CafĂ© Mocha of course. Tomorrow is the orphanage; I’m excited to go see the kids again!

 The incision on the breast for removal of the lipoma.
And it's out!

Tuesday, 14 August 2012

Day 6: There's no more gauze until tomorrow...

Day 6 at the hospital: 8/13
Graphic Images in this post!

The weekend was a great escape from the hospital. Saturday a group of us went to Old Town Mombasa, which is literally just the older part of the city. It was pretty cool though! There were some nice shops and it’s always fun to negotiate prices. The streets were really disgusting and there were a lot of people so I don't think it will exactly be our new hangout spot, but it was worth seeing once.

Sunday was a beach day :) There is a volleyball net outside the AquaBar so we spent quite a bit of time there. I still haven't ridden a camel on the beach though! It's a must before I leave.

I began my day at the hospital in minor theatre. It started out surprisingly smooth with catheter changes, wound redressings, and observing sutures. I helped change a dressing on a man who was in a bus accident. He ended up being the highlight of my day with his uplifting attitude and appreciative smile. Everything he had to say was positive. Through his thick Kenyan accent he told me, "if only people understood the good in one other. If someone is kind to you, be kind back." He thanked us a thousand times over and commented on how kind we were to him; he said it is rare to see such happy people in this place. Nothing could ruin my day after spending that short amount of time with him.

The number of patients escalated to a maximum around 10:30 am. The matrons bring in drums of sterile gauze that minor theatre has to share between two procedure rooms. It was mid dressing change that we realized there was no more gauze in the drum. We finished up with what we had and asked to matron to go get more. She said she had already checked and there was no way we were getting more gauze until tomorrow, the whole hospital was out. I felt like this story was similar to the one she told us yesterday about the Lidocaine. A few of us decided to go check with major theatre (major surgeries). They denied us saying they were running low as well. With that said, there was really nothing for us to do. Without gauze, minor theatre had to be shut down.

Both Megan’s and I decided to go up to major for an orthopedic surgery to conclude the day. It was fascinating! No one explained to us what they were actually doing, but from the x-ray in the corner and watching the surgeon I could interpret pieces of it. It was especially disturbing to learn that the patient wasn’t fully under anesthesia—only an epidural to shield the pain. He may not have been in physical pain, but having to listen to the scraping of his bone and the ear-piercing shrill from the saw would be mentally disturbing. His right knee was being reconstructed so the doctor began by inserting two pins through the patella and then reinforcing it with wire. I need to do a little more research on the surgery to fully digest what I witnessed.

 X-Ray, notice the patella in the one on the right.
 The drill with the pin attached

I found myself back at the hospital at 10 pm, hungry for more. Casualty was full as usual. Joel, Chelsea, and I peaked around a curtain to find a tiny little African woman squinting up at us from her gurney. She came in with a complaint of complications due to an “incomplete abortion.” She was also having a horrible headache, which explains the squinting. Upon further information we learned that her husband had sex with another woman (not uncommon among Muslims here) so she refused to have sex with him, leading to him forcing her to have sex with him. A disgusting mess that I have unfortunately seen more than once here already. After performing a vaginal exam and hunting the hospital for a piece of chewing gum for her, we took her up to ward 9. There, she was able to get some sleep and be seen by a gynecologist in the morning. She was so sweet and I was happy to see her comfortably settle into bed after having to wait so long down in casualty.

The night ended on a frustrating note around 12:30 am. Two men came into casualty with stab wounds. One was taken to emergency surgery after about an hour, the other was sent to minor surgery for sutures on his finger. Miraculously, there was sterile gauze in minor allowing Joel to perform the stitching. He got the first stitch in perfectly, but the second proved to be more of a challenge. As he was concentrating on this, the nurse came in and started freaking out because he hadn’t paid his bill yet. At Coast General, patients pay for the procedures before they actually receive them. With her discomfort and distraction, we had to just dress the wound and send him back to casualty. It was agreed that the complexity of the wound needed to be assessed by a doctor, but it was extremely disheartening to send him away after he trusted us to begin the procedure.

Patience. That is probably the most important trait to have at this hospital—besides a steel stomach. No matter how much I want to help speed up the process of treating people in desperate need, if there are no supplies or no one willing to help-- there is nothing I can do. As a whole, we fight for these patients every single day, but sometimes it just doesn’t feel like enough.