Adventures in Kenya: Day 5: Made it through week 1!

It’s Friday: Day 5! 8/10

It was a hot sticky morning here in Kenya. I left for the hospital around 8 with only 5 other people! I think that’s the smallest group we’ve had yet, but almost everyone went in last night so they were sleeping in. Jenna and I went straight to casualty hoping that Omar would be in today, but we didn’t see him. What we did see though was a woman lying on the floor on a tarp just moaning in pain. I asked a nurse what was wrong with her and she said she had fallen off of her bed last night. She sounded absolutely awful and later we learned she had been raped and brought in last night, but was too combative with the staff so she was just being left alone. I also noticed a familiar face from last night; a woman diagnosed with psychiatric issues was still lying on a gurney. Yesterday she had been yelling “Yesu!” which means Jesus in Swahili. She seemed a lot more calm today, but was still waiting for care. I would have stayed in casualty except there was a long line of people waiting outside of the minor theatre waiting for wound dressings, catheter changes, sutures, etc.

There was no staff in Minor Theatre at 9 am so Mia, Alex, Jenna, Ben, Ali, and I decided to just begin seeing the patients we knew how to treat. We thought more nurses and doctors would show up as the day went on and they did, but we still ran the show in there. They spent quite a bit of time inserting a supra-pubic catheter into a man. He was completely coherent and wincing in pain as they preformed a procedure probably meant for an actual operating room. I asked if they had given him anything for the pain and they had, but it was just locally injected Lidocaine. The procedure was almost unbearable to watch! Meanwhile another patient had been brought in with a wound redressing need. He had an open wound on his chest where the stitches did not heal his skin properly; it had also become pretty infected. When Ali tried giving him Lidocaine to numb the area for cleaning he just cried out in pain. All I could do was hold his hand and tell him to let me know when he needed a break. It was patient after patient the entire time. We told Bernard, our driver, to be back at 1pm but there was no way we were leaving that line of people outside. Mia taught me how to take out stitches so that was fun! It was her last day at the hospital since she leaves Sunday. I’m really going to miss her! Even though I only got to spend a week with her, she taught me a lot!

At around 12:30 Jenna, Mia, and I finally got away to get some lunch. As soon as we got back in minor though, the chaos began again. I saw Mia leading a man back to a room, he looked like he came straight from some type of factory by the way he was dressed. He was also holding a reddish filthy cloth over his right hand. When he plopped down on the green exam table he immediately revealed the severed index finger he had carefully been concealing. It was literally holding on by just a thin piece of flesh! Obviously, we couldn’t do much for him with our skill level, but Mia and I gave him a sterile piece of gauze and applied pressure using the middle finger as a splint. It then became a waiting game until the doctor could evaluate him—he was most likely going to lose that portion of his finger at the middle phalynx.

Each wound redressing was a little bit different—you never know what’s behind that bandage until you remove it! I was really excited to learn how to remove stitches and basically improve my patient care techniques. I appreciate each and every opportunity and patient I get to see. Medicine here is definitely different from home, but bedside manner and compassion are always the same. Even though it’s frustrating and heart wrenching at times—I have fallen in love with a culture that is vastly different from my own. It’s hard to choose which patient needs help the most because they all do. Realistically, I have to realize I can’t save everyone. I think the deaths I have witnessed here have made me come to terms with that. I am really looking forward to this weekend to relax and spend some time at the beach! A few people were talking about a night shift Saturday night so I may end up back at the hospital, but a little R&R seems like a great idea for now. Love and miss you all! I’ve made it through my first week at Coast Province General Hospital!

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