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.
Drilling
 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.

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