Day 11 - Doing a C-section

After another pretty unproductive ward round (there are just so many people, usually 20 or so on rounds so it is hard to get much done), I actually got to be 1^st assist on a c-section today! I helped a doctor who is actually specializing in OB/GYN. He called himself a resident but the system is structured differently here. In asking questions, it is my understanding that after you become a medical officer (the equivalent of doctor) you go and practice for a few years without a specialization. The hospital can just assign you to any ward and you have to be able to handle it. After a few years in practice, you can go on to get additional training to become a consultant is a particular field. This doctor I worked with is in the process of becoming a consultant so he is pretty high up the food chain. Anyway, it was cool to actually do something.

I have asked about low transverse incisions and why they swear that it is everyone’s preference and a standard practice here yet, every c-section and c-section scar I have seen thus far is vertical. (I do understand that if a woman comes in for a repeat c-section with a vertical scar you wouldn’t want to give her a new one… but other than that, still all vertical incisions.) This is still a mystery to me since I’ve been doing some reading and the complication rate (the only saving grace that I could have imagined for the vertical incision) is actually lower for transverse cuts. Maybe it has to do with the medical officer performing the surgery and his/her comfort with trying something they haven't seen before or have only seen a few times, despite the evidence?

Then after rounds today, we (Charley, Caroline, and I) were thinking about going to a craft workshop but decided against it because we got out considerably later than usual and didn’t think we would have time before it got dark. So, we just checked out the local market, got in a couple of errands (I had to get out more money in Kenyan shillings and buy a few items), and then plan for the extended Easter weekend. We are planning to go to Malindi, a city about 1.5 hours up the coast of Kenya. There is supposed to be spectacular reefs there and this really cool natural sandstone gorge that I’m excited to see.