Clinic and Lizards

Busy few days here. Staff meeting yesterday included the physicians as well as the pharmacist (who is the pharmacist for the entire region), and covered administrative issues as well as special cases of patients. An issue brought up was that there is no 2^nd line HIV treatment available in the area. Luckily, the HIV rate is only 6% here. A 7 year old with severe malaria and a hemoglobin of 4 after transfusing multiple times was the main topic.

Then we went on an official tour of the hospital and got to see the lab, the photo of which is on my phone and unobtainable. A counter, a sink, a vial rack, and a bottle of dye.

They can do malaria, urine dipstick, hemoglobin, Hep A, Hep B, and type and cross. They don’t have a blood bank. They usually type and cross family members after testing for Hep A and Hep B and just transfuse. Apparently it happens quite often.

That afternoon the doctor and I did his HTN/DM/Sickle cell clinic in a room about the size of an American bathroom. We stood at a tray table and there was a chair for the patient. It was so much fun. Sweetest patients ever. Compliant except for when the pharmacy ran out of their meds, grateful for help, open to teaching… fantastic. There was the most delightful lady that came in that could barely walk and was so grateful to have made it to 74 years old and so happy that someone could finally prescribe her medicine for her high blood pressure.

One lady came in with a history of COPD, was pretty drastically short of breath after transferring from the wheelchair. I popped my handy dandy oxygen saturation probe on her and she was at 76%. (We like people to be at 90-10%). I just looked at the doctor, he looked at me and said “We have 2 oxygen concentrators for the entire hospital and home O2 does not exist here.” I said OK and patted her hand.

A gentleman came in with history of high blood pressure and high cholesterol, complaining of sharp chest pain. He comes back in 2 weeks to get an EKG.

A sickle cell patient came in that was 37 years old and the best looking sickler I’ve ever seen in my life. Compliant with meds, said he just hurt a little bit sometimes and he didn’t need anything for pain, just coming in for a scheduled appointment. 1: That’s amazing, 2: The test that said he had sickle cell disease was done somewhere else and is unobtainable, so I suspect he might just have had sickle cell trait, but he just knew “sickle cell positive!”

We haven’t had a “normal” day so far because of visitors, but I’ll let you know what those look like when it happens. So far it’s been 7am to 3pm at the hospital, come home and run around doing errands and being busy, and then talking and then bed. No lunch and huge starchy dinners are not particularly good for you, but it’s cool guys, I picked up an oxygen concentrator today which was pretty heavy, jumped in and out of the back of the jeep multiple times, carried a mattress, and thought about doing pushups.

People here hate it when you take pictures. Some visitors were with us on the tour of the hospital and tried to take “cute African baby photos.” A few of the parents hated it and when asked would said “No picta, no picta!” Some were OK with it, but there will probably be a resounding lack of photographic evidence on my part. Sorry to all the people whose only request of me was pictures. I have some scenery photos!

 

But truly the people are beautiful and so traditionally African in dress and demeanor, walking around with stuff on their heads and everything. Oh, they totally cheat by the way, they have a stiff ring of fabric they put on their head that keeps whatever they’re carrying more steady. I feel like that would be a big advantage for people who have uniquely-shaped heads.

So I raved about the bananas, I did. Then I had pineapple. Someone could write poetry about the fruit here. Not me, but someone who can come up with something more creative than “bursting with flavor” and “best fruit ever.” The mangos taste like mango. The passion fruit tastes like passion fruit. The snozzberries taste like snozzberries. You do have to wash all fresh fruits and vegetables in iodine here to remove the evil germs. Which is my favorite thing to do, 1. Because then I can eat it. 2, Because iodone turns the water a lovely shade of lavender!

If you have a phobia of lizards, do not come here. They not only have thousands of regular lizards, they have huge geckos, and freaking monitor lizards longer than my arm. I’m not saying we both had a heart attack, I’m just saying this particular monitor lizard that I encountered and I probably both need to see a cardiologist.

Today I spent nearly the whole day on the wards. It was insane and overwhelming and super frustrating and once I’ve been able to process I’ll write about it. Malnourished kiddos, minimal universal precautions (as in there is no soap in the hospital except to mop the floors and sharps are left everywhere), and general lack of knowledge. Not very many cares are given here. Huge shout out to my dialysis and drug seeker patients from home, thanks for making me skilled at IVs in people with no veins. Came in handy today.                                                                                                                                                                                                          

Trust in the Lord and do good;
Dwell in the land and cultivate faithfulness.
Delight yourself in the Lord
And He will give you the desires of your heart.
Commit your way to the Lord.
Trust also in Him, and He will do it.

Psalm 37:3-7

Still trusting that I’m obeying God and still unsure of how much I can even help here. Prayers would be appreciated that I would be useful medically, build relationships with the staff and patients, and to learn Swahili quickly.

Love you all!

-K