Bananas

       After an uneventful 3 days of travelling, I arrived at my final destination yesterday. I’ve been on many long journeys in my lifetime, but the 13 hour flight on Saturday has me now convinced that I never want to go to Australia. Besides, they have tarantulas there.

I’m staying with an American physician and his wife for a few days until the guest house becomes available. They have a very lovely home and a gorgeous view of the lake.

 

 The doctor also is a huge fan of coffee and has been making me amazing espressos, which has helped mask the jetlag.

Yesterday we went to the market to get some groceries. Typical African/Middle Eastern market, for those of you who have experienced one. For those of you who haven’t, hopefully I can get some pictures for you later. It’s basically tons of food and everything else smushed in with flies and space for 1 person which is being occupied by 3 people with a sack of grain in one arm, a baby on their back, and talking on a smartphone. However, these are some of the friendliest sellers I’ve ever met in a market. They weren’t pushy or yelling, and when they found out I didn’t speak Swahili, started teaching me words. “Sistah, sistah! Ndizi!” (Which means banana.)

OH! Speaking of bananas. Y’all. What we have in America are not bananas. These are the most bananay bananas I have ever eaten. Banana laffy taffy flavor x 1,000.

Also, it’s not humid here, it feels amazing. It’s warm, but the breeze makes it feel great.

So that was a bit of yesterday. This morning we went to the hospital and it was insane. If you’re not medical, the next bit may bore you.

This may be a bit all over the place because my mind is blown. I’ve never been in a hospital in a developing country as a nurse before… it was overwhelming. Don’t laugh at me. I’m just going to hit the high points because there was way too much to process. I rounded with the doctor today on all the patients except maternal infant.

This hospital has 50 inpatient beds, 24 maternal infant beds. By beds I mean metal cots. There are 4 wards. Pediatric, women, men, and maternal infant. A ward in this sense is a long open room with 10-20 cots lined up on each side. There is an outpatient department which functions as the ER and clinic and where patients get admitted from. Didn't go there today.

Peds- Saw maybe 8. Mostly malaria and acute gastroenteritis. 1 baby with 2^nd degree burns on abdomen, arms, legs from boiling water. 1 with seizures. All had IVs, but just INT’d, no one had any fluids. (No peripheral IVs, all in the noggin. Apparently IVs are one thing nurses excel at here because everyone’s a hard stick cause everyone’s dehydrated). I learned later that they just get fluids once a day, not continuously. Vital signs on peds consists of a temperature taken at 6am. That’s it. Blew my mind. Also, all the kiddiewinkies have little cards that have all their vaccine information on it and when they get weighed. So their most recent weight is whenever they last got vaccines. Which could be a month or could be 8 months. Babies grow fast. Looking at this 2 year old “Uh, he is not 6 kilos anymore.”

Women- malaria, HIV, acute gastroenteritis, sacral ileitis, CHF. They have PO lasix and spironolactone here. Another doctor had rounded on the CHFer the day before and written for morphine and isosorbide. They don’t have that here. They don’t have narcotics at all, they have Diclofenec, motrin, and Tylenol for pain control. Rocephin is their absolute strongest antibiotic. They reserve that for the most extreme cases because they don’t want to create resistance. Nearly everything is given PO. Few IV drugs

Men- Uncontrolled DM, tib-fib fx, juvenile diabetes, malaria, leg laceration, and a freaking tetanus patient. I’ve never seen someone with tetanus. Spasms, rigid, hardly able to swallow. Being treated with IV penicillin. The tib-fib guy had been there for a few days, they were going to have to transfer him out cause they can’t do ORIF here because they have no rods. They can do a few simple procedure.

Diagnostic: Simple lab tests: Urine, stool, malaria, CD4. Plain film xray and ultrasound. That’s it. The doctor says they do so, so many ultrasounds.

The charts are pieces of paper stapled together, vital signs written on the back of the MAR, progress note written on whatever space is available. Different physicians round every day. Some are actual MDs, some are assistant medical officers.

There was 1 RN on the floor today. There were loads of nursing assistant students. Every patient is required to have a family member stay with them. The family member brings food (hospital doesn’t provide), water, cleans up the patient, helps them go to the bathroom, and even takes the orders the doctor writes for meds down to the pharmacy and brings the meds back and gives them to the nurses. How does that makes you feel? Med times are 6a, 12p, 6p, 12a. The RN goes to each pt, pulls out the meds and tells them which ones to take. Not sure about how IV stuff happens yet.  Also, when we were rounding with the physician, he had a glucometer that he taught 2 med students how to use and they were checking blood sugars on the patients who had been admitted for DM. The physicians check blood sugars here. No alcohol swabs, no gloves, no safety lancets, they were just open needles after puncturing. There was a sharps box though, so that’s good. There were gloves present that the nurse put on at one point.

 I am overwhelmed. I don’t even know what I’ll be able to do or how much I can even help, but obeying God doesn’t always have results we can see. Please pray that I’ll be able to learn Swahili quickly and show God’s love to those I meet.

Oceans by Hillsong has been in my mind since I started this trip, take a listen:

 

 

Love y’all!