Day 15 - My kinda place

Now this is more like it! My first patient of the day was stabbed. (Not that I want people to be stabbed, but I certainly want to be there to fix their hemothorax if and when it does happen.) Today, I started in “casualty” or the “accident and emergency department”, and this is where I will remain for the rest of my time for this rotation in Kenya. Totally looking forward to it! I’ve already gathered that affordability of care is still going to be an issue even here, but it does seem like there will be more for me to do regularly.

I actually got to draw blood and start a handful of IVs, including one on a 2 day old baby. What? Awesome… I know! And I did it with only 1 stick. Kind of amazing, if I do say so myself especially since he was dehydrated to start with. Now that I have been overly congratulatory to myself, I got to see about 20 patients and a great deal of variety. Presenting patients included sepsis, trauma (stabbings and lacerations), and regular run-of-the-mill ER stuff like confusion and syncope.

I did find 2 things to be quite shocking and disturbing. First, there was a 3 week old baby  that was brought in because he was “sick.” On first glance, it was clear to me that something was horribly wrong with this child. He was green, not like the “green” before someone throws up, but really and actually tinged green. Certainly not a normal color for a baby, or well anyone really. Plus, he was breathing like a fish out of water. I don’t think the child’s mother understood the seriousness of the situation because she asked if admission to the hospital was really necessary. I don’t know that anyone really explained to her how incredibly sick her child was, and I suspect that this child won’t make it through the night as intubation isn’t an option because ventilators aren’t readily available.

The other thing I was introduced to and found disturbing was the BID form. At one point, Dr. Bule talked to a police officer (speaking in Swahili so I didn’t understand) and said to me that we have 2 BID forms to fill out and that I was to follow her.  Upon seeing 2 bodies unceremoniously laid in the back of the truck the police officer led us to, I started to deduce that BID stood for “brought in dead,” the Kenyan equivalent of DOA. Dr. Bule was just called out to certify that these people were, in fact, dead. These 2 were involved in a road traffic accident (or RTA as they call it here) and had clearly exsanguinated at the scene. I was surprised by the way they were brought to the hospital… just put into the back of the truck, nothing covering them, and shown to Dr. Bule in front of patients waiting by the lab.

I also noted a distinct difference today because it is a holiday here, Easter Monday. Apparently, it is standard to give people both Good Friday and the Monday following Easter off here. The hospital was pretty quiet compared to the chaos it usually is. I went in because I am going on safari next weekend and will have some scheduled days that I am to miss going to the hospital.

After the hospital, Caroline and Charley joined me by the pool for some relaxation from the weekend trip and cassava chips with chili powder. Soooo  yummy!