Monday, 27 August 2012

Back Home

Hey everyone! As I have already eaten McDonald's, drove my car, washed clothes in a washing machine, and brushed my teeth with tap water, I am officially back in America. This will sadly be my last post.

Again, I am just so thankful for the whole experience that I have had in Africa. People here at school have already asked me about it and I'm amazed at how big of an experience it was every time that I talk about it or explain what I did over there. It's still a little hard for me to grasp the fact that I am not going to wake up tomorrow in Africa and be able to do this again. I really would like to go back again someday, hopefully when I have more knowledge and can actually help a lot more people. I have always known that I wanted to do things like this when I finally become a doctor, and this really strengthened that conviction. One person who actually cares over there can make a world of difference.

Looking back at the trip, there are so many things that I wish that I could have done. I wish I could have spent more time at the orphanage with the kids especially. However, I do realize that there is never a way to do everything because there is always more to do in cases like this. I'm very happy with how much experience in the health care field I received over there and how much life experience I gained. I feel like I'm not just a sheltered South Dakota kid anymore, that I actually have some life skills under my belt.

I'm working on getting all of my pictures onto my computer and then onto facebook, so be patient! I'll try and get them up by tomorrow.

Thank you to everyone for your love, prayers, and support for the last 3 weeks. I really couldn't have done this without the people helping me.

Friday, 24 August 2012

Last Day and Last Night

I don’t have very much to report for today. We slept in because we stayed awake pretty late last night (but we didn’t quite make the sunrise). Then we all sort of hung around the compound and this afternoon we all packed our bags. It was a really emotional time for me because I am really sad to be leaving right now.

There are so many things that I will miss from here. I will miss being able to do so much hands on work in the hospital. I will definitely miss the fact that we are truly making a difference here, caring when no one else really seems to care about these lives. I have learned so much here about the value of life. I have a much greater appreciation for doctors and our healthcare system. I know that it isn’t perfect, but at least doctors are still doing their jobs and caring for patients despite these problems. I have learned that the money a patient is paying for a service has no relation to the quality of service that patient should receive. Also, no patient who truly needs a service should ever be turned away because they can’t pay. I’ve seen too many injuries that will never properly heal because the patient couldn’t afford to get a bone set or to have surgery.
I have become much surer of myself working in a situation like this. I feel that I could go anywhere now and be able to perform the job that I needed to confidently. We all really learned how to take control of situations, even when we weren’t totally sure if we were doing the right thing. Healthcare is really all about using what you know and thinking of a logical solution. I also learned how to work well as part of a team. We all worked together and cooperated both in situations where we were helping a patient and situations where we had to compromise and take turns in certain areas of the hospital. We also learned to share our knowledge with one other so that we could all be more effective providers. I’ve learned so much more than these things, but it’s really impossible to put it all into words. I feel like I have grown up so much here. I’ve had to get beyond my personal feelings about a situation and just do what needs to be done. The lessons I’ve learned I think transfer to any part of my life, not just a job in healthcare and that is really what has been most valuable about this experience.

Tonight we went out to eat one last time as a group at a really nice seafood restaurant. I had the best fish that I have ever tasted, red snapper with a champagne sauce.
A couple of us girls went to the hospital one last time tonight. It was really bitter sweet because I felt like we were saying goodbye to everything. We did get to do a dressing or two and hang some IVs. There was also a lady with a really, really gruesome arm wound who had been in a car accident. That was pretty cool to see. Otherwise, we mostly took vitals and just hung around trying to be useful.

I will probably not update my blog anymore until I do a quick update when I make it back to Brookings. The plan for tomorrow is to finish packing and any other last minute details in the morning and then to leave for the airport around 12:30. Our flight leaves at 3:30 and hopefully, if all goes well, we should be in Minneapolis by about 1:30 on Sunday. I am excited to be home and to see everyone again! I’m not excited that we are starting school the next day, but I guess that’s how it goes. 

Thursday, 23 August 2012

Last Day at the Hospital

The hospital today was more exciting than yesterday. Right away in the morning, I went up to Millennium Theater, which is where they perform all of the C-sections. They do a lot of C-sections each day because they prefer to do that over natural birth, since it reduces the risk of the baby contracting HIV if the mother has it. They also have less complications with C-sections. Anyways, preparing the mother for the C-section took about an hour, during which Angie and I were just sort of hanging out with the nurses. Once they started the actual procedure, it took about 5 minutes to put her under anesthesia and 10 minutes from the first cut to the baby’s cord being cut. It was so fast!! This was actually much more gruesome to watch than the natural birth, so I’ve decided to have my babies naturally. Yes, I realize this isn’t really up to me. It then took about a half hour to finish stitching the mother back up. The baby was a healthy baby girl and mommy and baby are both going good.

After the C-section, I went up to Major Theater to watch part of a cardio-thoracic surgery. The gentleman needed part of his esophagus removed because of cancer. The surgeons were trying to get to the esophagus from the belly, but were unsuccessful so they ended up just stitching everything back together and then trying to go in from the side. The spread and cracked ribs 5 and 6 and went in from there. We had to leave before the surgery was completely, but it was pretty cool to see. I’m very surprised how okay I am with surgery because I always thought I would be squeamish when it came to that stuff.

One thing that I don’t think I have mentioned yet is how weird they are about cell phones here. There is absolutely no inappropriate time to answer your cell phone. The surgeons answer in the middle of surgery, the doctors in the middle of an evaluation, the drivers in the middle of traffic, you name it. It must be really rude to let a call go to voicemail here.

Before we left for the day, we went down to Casualty to see what was all going on. It turns out that there was a lady in there who was a victim of the Tana River massacre. There are two tribes in that region that are fighting over land and water rights. One tribe attacked the other last week and burned down some houses. I think 5-10 people were killed. Then that tribe attacked this lady’s tribe yesterday morning. There were 100 armed warriors attacking this village. They killed 48 people, only 6 men and the rest were women and children. It is a remarkably sad story that these two tribes are so willing to kill each other. This lady in Casualty had lost her whole family in that attack. It was really a miracle that she was still alive. She had a deep gash in her head and a deep gash in her check, exposing her maxilla. It was crazy. Her jaw was so broke that her mouth wasn’t even under her nose any more. She also had a long, deep cut in her arm, wrist and palm. That cut had severed all of the tendons in her hand and exposed her ulna (her arm bone for those of you who don’t know you anatomy). It was by far the worst injuries I had seen yet at the hospital. They thought they were going to have to do extensive surgery, but I’m pretty sure they just reset her jaw and stitched her all up. It really is a miracle that she survived the attack with just that.

This was probably our last day at the hospital. We are going to try and get our sleeping patterns closer to what they will be at home by going to the hospital and working a night shift Friday night.

After the hospital, we ate lunch and then went to Old Town to complete our souvenir shopping. I probably spent more than I should have, but it all goes so quickly when it’s just a couple dollars at a time. That should be my last major expense though (how crazy is that?) so I’m telling myself that it’s okay. After all, I don’t know if I will ever make it back to Africa, and if I do, it may not be to this region.

Tonight we are all hanging out as a going-away party. We are hoping to make it until sunrise and then watch the sunrise on the beach, but we’ll have to see how that goes. I can’t believe this is one of my last nights here! This time really has gone by incredibly fast. I’m so thankful for this experience. It has taught me so much, but I won’t get into that right now. I’ll save it for my last blog.

Wednesday, 22 August 2012

Henna Day!

Today, we started at the hospital in maternity. We got to watch another live birth. It was a lot less shocking today, and actually pretty amazing to see. It’s a lot of waiting in that ward and the actual birth only ever takes a couple of minutes. We also tried to go see a C-section, but they told us to come back tomorrow. Hopefully I get to see one before the week is done! I also spent some time in Minor, where I cleaned and dressed wounds and got to remove my first sutures. That was a little intimidating, but everything went okay. There really wasn’t anything too exciting happening today, except that we had to do a dressing change on a prisoner. When we do anything on a prisoner, there are always several armed guards in the room at the same time. It’s a little scary because these are not small hand guns, they are big automatic weapons.
The room that they give birth in. It's not big on comfort and there are no monitors.

Yesterday, I had the genius idea that we should all get henna tattoos before we left here. We talked to one of the doctors who had a bunch of henna on her and she recommended a lady (her aunt) who lived close to the hospital that we could go to. So, this afternoon, 8 of us went and got our henna tattoos. They are very intricate and beautiful. We talked to the lady about her culture, she’s Hindu, and when they usually get tattoos. She told us they do it once a year on a special holiday that was last Friday and then the girls do it for their wedding day. The brides are usually pretty much covered in henna for their weddings. I think that is a very pretty tradition.  Her daughter was also around and very cute. She brought home a kitten today that she found, so her mom wasn’t very happy but she loved it.


Tonight we are just hanging out at Café Mocha again. Everything is winding down this week and we are trying to find enough time to do everything.

I’m sorry, but that’s really all I have for today!

Tuesday, 21 August 2012

Safari, Part 2 and A Camel

The second day of the safari, last Saturday, we went out about 8 in the morning and stayed out on the game reserve until about 3:30. It was really awesome to spend the whole day out there. Everything was so beautiful out there. We got to see a lot of the same things that we did the first day, especially the zebras and wildebeests. We also got to see some more giraffes and elephants, some hyenas and warthogs (Pumba!). The best part of the day was when we found our first lions, a male and a female. It happens to be mating season for them, so we actually got to see them mate. We were all a little shocked to see that. They were so beautiful though, even though we didn’t get very close to them. We also caught a glimpse of a lioness hunting, but she went away from us as soon as the vans started getting close so we couldn’t watch for very long. We also saw a cheetah, which was really awesome. Again, we couldn’t get very close. We also found vultures, some more deer, and a rhino! It is apparently very, very rare to find a rhino, but Jenna ended up spotting one. The only animal of the Big 5 (rhino, lion, water buffalo, elephant and leopard) that we didn’t see was the leopard. It is also very rare to see leopards so we didn’t feel too bad about missing out on that. At one point, our van ended up getting stuck in the mud in the bottom of a crick. It was quite the ordeal to try and get it unstuck.

That afternoon after we got back from the park, we went into a Maasai village. This was really shocking to see. There were about 15 homes, set in a circle, with a fence around it. Every night, they bring their cows and goats home from grazing and put them in the middle of the circle so that they can protect them. The men take turns patrolling around the fence, watching for wild animals mostly. The homes were made of cow dung, mud, grass, and sticks. Each woman is required to make her own house and it usually takes about 4 months for them to do that. They took us into their homes and showed us how they live. They keep their baby animals inside the house. They also talked to us about how they live. They are polygamists and each man has about 4 wives. The men still have to pay to marry a girl and they pay about 10 cows. However, if they can jump the highest or if they kill a lion, they only have to pay 5 cows. Each age group of men has to kill one lion. It’s really strange. Also, jumping is a big thing to them, which I don’t understand. They also jumped and danced for us and sang songs in their language. The boys joined in with the men’s dance and the girls joined in the women’s dance. The boy’s dance was a lot harder than ours. They were both songs of welcome. It was shocking to hear how they live. They are nomadic people and move about every 9 years, because that is the longest that the houses will stand.

After we left the village, we just went back to the camp, ate, and went to bed early. We woke up about 5:30 the next morning because we wanted to get out to the park to watch the sunrise. It was very, very beautiful to watch the sunrise. I unfortunately couldn’t get very good pictures of it. We were trying to take pictures and then our driver told us we had to hurry because we had to get to the lions. We quickly sat back down and sped off. We got to the place where the lion was and pulled into the circle of vans around this lion. It was absolutely shocking how close the lioness was to us. She was probably 15 feet away from our van, eating a wildebeest. It was amazing how comfortable she was with the amount of people that were around. She just ignored us and did her own thing. We watched that for a long time and then just spent a lot of time driving around the park, looking for leopards or other animals and enjoying the views. We left the reserve at about 8:30 am and spent an hour at the camp getting breakfast and our stuff packed up. Then we were on the road again, that terrible awful road. Our driver then informed us that we had to lie for him and say that we had only been at Maasai Mara for 1 night so that he didn’t get in trouble and fined for driving on the grass when we found the rhino. It was actually a little frightening when we got questioned by some officials, but they were nice and apparently believed us so everything worked out fine. They take the grass on those game reserves very seriously. We got back to Nairobi around 3.

That night in Nairobi, we decided to go out to a restaurant called Carnivore. It was a very expensive, nice restaurant that is famous for what they do. We had a flag in the middle of our table and as soon as we sat down they started serving us every kind of meat that is legal to eat. We had pork ribs, ostrich meatballs, just ostrich meat, crocodile meat, ox testicles, frog legs, grilled chicken, just pork meat, beef meat, pork sausages, just turkey, and prime rib. When I say “just __ meat” that means that they had a giant slab of meat skewered on a sword that they set on your place and sawed you off a piece of the meat with a giant knife. It was really awesome and so filling! Everything was delicious and it was so hard to give up and stop eating. They literally kept bringing you meat until you surrendered and put the flag in the middle of the table down. Needless to say, we were all miserable when that was over. We just went back to the hostel and hung out again that night. We ended up really liking that place, which is funny because we were so appalled when we first saw it.
Just a side note, none of us ever has any idea what day it is here because time seems to pass so differently. Our weeks blend with our weekends and none of us can believe that we have been here over two weeks and that our trip will be over soon. That fact really hit us on the bus ride home when we were trying to plan our week so that we can get everything done that we want to. I’m going to be really sad to leave Kenya, especially knowing that I may not ever make it back here. However, I’m also pretty homesick at this point, and I am excited to be back home. I miss a lot of things that I really took for granted in the US. I also am missing everyone there an awful lot. Those are two very conflicting emotions that I am trying to deal with at this point.

The next morning, Monday, we again loaded onto a bus and spent 8 horrible hours driving back to Mombasa. This was especially horrible for me because I really didn’t feel good on Monday. We got back to the compound at about 6:30 last night and went to Café Mocha to use the free wifi. On our way there, we were very confused because there were at least 5 times as many people out as there usually is after dark. We asked our driver and he told us that Sunday was the last day of Ramadon, the Muslim holy month, and so almost every Muslim was out last night celebrating. It was pretty to see them all out and dressed up because most of the women had sparkles or shimmery outfits on (I’m not sure what their tradition dress is called, but that is what they were in).
So finally, today. Today at the hospital Angie, Jenna, Megan and I went to the Maternity ward right away because we hadn’t really been there yet. When we first got there, we walked around with the doctors checking on the women who were in labor and who had just given birth. One women has PPH (post partum hemorrhaging) and had to be taken up to surgery. Another woman was anemic when she had given birth and so was just getting blood until her hemoglobin counts were back up to normal. The last woman in the ward was in labor. She was dilated to 8 cm when we got there. She was an HIV positive mother and so they were taking extra precautions with the birth. We got to watch her deliver (slightly disturbing, I’m glad it will be awhile until I have to go through that myself) and they took a lot of care not to get any of the mother’s blood on the baby. It was a healthy boy! They will do an HIV test at 3 weeks to test if the baby is HIV positive or negative. That part of being in the maternity ward was pretty cool. However, I was also very sad and disturbed to be there because in the room where the babies go after they are born, there were just two dead babies, wrapped in totally in cloth with tape on the cloth with the babies’ information on them. It was so absolutely terrible to see that they just leave those babies in there, on a shelf, for however long. The two babies there today had died yesterday morning. It almost made me sick to see that. Anyways, after that we went to Minor and did some dressing changes. Nothing too exciting happened there. I also went into Casualty and followed along with a doctor there. He let me do some physical examinations and try to diagnose people. It was really cool to be put in that situation. I didn’t really know much, but he helped me along.

After the hospital, we spent the afternoon on the beach. It was a really nice day and the beach was beautiful. I am hopeful that I am at least as tan as I started out here, but I don’t think I’m any darker. It’s funny to me that I am even writing that, as it is such an unimportant fact to anyone who is reading this. Anyways, it was a very relaxing afternoon.
Oh, and I rode a camel. Fun fact. It was awesome!! Now I can cross that off of my bucket list. J

Tonight, we went and hung out at Cafesserie, another café that we like to spend our evenings at. It also has free wifi, which seems to be a must for us.
That’s all for now. Have a good night!

Monday, 20 August 2012

Safari, Part 1

Hello again! So much has happened in the last 5 days that it is going to be hard to remember it all and to get it all down, but I’ll try my best.

We started off Thursday morning by loading onto a big charter bus to take us to Nairobi. It was an 8 hour drive and honestly, a little scary since our driver drove really fast and swerved in and out of traffic a lot. It was really cool to be able to see a lot of the country side. It was mostly grasslands, but there was a surprising number of hills and mountains too. There were a lot of little, very poor looking towns along the way. The roads were not very good, but were all paved. By the time we got to our place in Nairobi, it was about six. The place we stayed at was not what I was expecting. I thought we were staying in a hotel, first of all, but it was a hostel. It was just a shock at first to realize there would be 8 of us sleeping in a room smaller than my bedroom at home. The gender shared, open concept bathroom took a bit of getting used to also. However, it was clean and a lot nicer than I thought it was at first. We all we starving at this point and so we went to a recommended Italian restaurant in town. We were definitely underdressed in our jeans and sweats. The food was really good though, and it was a really fancy place to eat for not very much money. After that, we went back to the hostel and hung around the bar that they had there. It was a really fun time hanging out with everyone. However, they did have a guard dog at the hostel (there was a sign saying not to pet the dog), but one of the guys (Lee) ended  up ignoring the sign, trying to pet the dog, and got bit. That was a bit of an ordeal, but the dog apparently had its shots, so everything was okay.
The next morning, we loaded into our Safari vans and started the drive to Maasai Mara, the Safari park. The first 2 ½ hours were good because the road was pretty smooth. However, for the next 2 hours after that, we were on the worst gravel road I had ever been on times at least 3. It was awful. We were also going fairly fast down the road which made it a lot worse. By the time we got to our camp, we were all very grateful to get out of that van. The camp we stayed in had some permanent tents and some cabins. Alexa, Chelsea, Angie and I stayed together in one of the cabins. It wasn’t the cleanest or most modern place, but it did have warm showers so we were happy. The electricity was only on from 5:30 am to 7 am and from 6:30 pm to 10 pm. That took some getting used to. We arrived at the camp around 4 and after dropping our stuff, immediately went out on an afternoon drive in the park. We were so excited!! The first animals we saw were zebras. We were all in awe of them and so excited to see them in the wild. However, our fascination with the zebras sadly soon wore off because there were thousands and thousands of them everywhere. You couldn’t drive anywhere in the park and not see a zebra or a wildebeest. There were also thousands and thousands of wildebeests around. However, we loved them all the first day. We were all so happy to be out there and kept relating everything we saw to The Lion King, which was really fun. We even broke out a song or two from the soundtrack. J The first day, we also saw giraffes, elephants, water buffalo, impalas, and gazelles. It was very cool. However, I have to admit, I did not really know what a safari would be like. I had vision in my mind of the animals always being around and always in action, when reality was that we often drove for almost an hour with very little to see and the animals we did see were usually just grazing or hanging out (except for the lions).

We headed in from the safari about 6:30 that night and it was really cold outside by that point. We were not expecting the temperatures to drop as much as they did, and so quickly! We ate supper at the camp (it was the usual noodles, beef stew but there was also butter bread and a good soup). We were all very tired after the long day so we headed to bed pretty early.
Well, that's all I have time for tonight. I'll update about the rest of the trip and my day at the hospital tomorrow night!

Wednesday, 15 August 2012

Surgery Today

Chelsea, Angie and I went straight up to Major Theater (surgery) this morning. We changed our scrubs, put on the big rubber boots that you have to wear into the surgery rooms, hairnets and masks. We were a sight to see. We could pick whether we wanted to see an osteopathic surgery, a gynecological surgery, an ophthalmology surgery or a general surgery. We decided to sit in on an osteopathic surgery. After waiting for awhile for the doctors to get started, they brought the man in. They put him under anesthesia and put in a breathing tube. He was there because he had been walking on the side of the road and got hit by a matatu (the sketchy public transport vans).  Because he didn’t have enough money for the surgery, he waited for several weeks before scheduling this surgery. All of his external wounds had already healed. He had broken his left femur, left tibia and fibula, and right tibia and fibula. Just looking at his legs you could tell how bad the breaks were. The bones had already started healing together wrong by the time he got scheduled for surgery, so the surgeon had to break all of the bones again with a bone saw. The whole operation was really bloody and gory, for lack of better words. However, it was also fascinating to see. Again, I have lots of pictures if anyone wants to see them, but I won’t put them up there. It took 3 and a half hours for them the repair the femur alone. They ended up screwing a plate to the bone to help it heal correctly. I had never watched a surgery before, not here or back home, so it was a really interesting experience for me. I wasn’t sure I would be able to handle all of the blood and cutting, but it’s surprisingly easy (even just watching) to forget the context and just to focus in on the job at hand. It sounds so bad, but it makes things a lot easier if you sort of forget that you are working on a living, breathing person. I’m not sure if I’m explaining this correctly, but what I’m trying to say is that you sort of detach yourself from the patient and just focus on the situation. I was surprised at the tools they used. I’m not sure if it’s just here, or if it is in orthopedic surgeries everywhere, but the surgical tools honestly just looked a lot like shop tools. You had your specialty saw, your screwdriver, your screws, hammers, and plates that look very normal. They also used a lot of clamps and things that looked like wrenches. They started on the tibia and fibula repair, but we ended up leaving before they started that because it was close to the time when our driver was going to pick us up. We also went down to Minor for just a second and saw a guy whose hand was getting stitched up after an accident.

We just hung out by the pool here this afternoon, trying to get a tan (and sadly, possibly failing). It’s still shocking to me that the sun is stronger and hotter in South Dakota than it is here where we are so close to the equator.

Tonight, it’s time to pack for the safari! I’m getting really excited about that trip tomorrow. However, it is nearly impossible to pack for this as we have to fit everything for 5 days into a backpack. We also need to bring snacks and water. Needless to say, we will have to carefully pick what we need to pack. It should be really cool to see all of the animals. I’ll try to take as many pictures and videos as possible! Until Monday… J