Hot Potato

Clinic day on Wednesdays! My favorite. It’s nice being busy and also getting to spend time with patients. We saw some of the cutest children and most delightful people. One kid cried when he saw me and his mom said he had never seen a white person before. Apparently I represent poorly. I apologize. A young pregnant lady came in with her husband. She hadn’t felt the baby move in a week, and sadly the fetus wasn’t viable on the ultrasound. The doctor was able to pray with the parents which was neat. The mom said she had lost several children in pregnancy, but did have 2 living children. I think I’ve mentioned before, it is quite common here for women to have multiple unsuccessful pregnancies and to lose infants or children. A man came in with a very high blood sugar. He lives out in a village and it costs him 2 weeks wages to travel in to the clinic to get his medication prescriptions. We prescribed him double the usual amount. He had nail clippers on his keychain. One old iron key and nail clippers. Just the necessities.

 

My friend who wanted me to take a picture of him roaring like a lion. There's no HIPPA here.



Thursday was interesting. We didn’t do rounds on Wednesday because of clinic, so the wards were a bit messy. Apparently without constant reinforcement things do not get taken care of the way they should and there are no consequences for jobs poorly done. However, there was a group of nursing students and nursing assistant students there that followed me around and laughed at my Swahili, but were willing to learn. There doesn’t seem to be a great deal of direction for their clinicals, they stand around until the nurses tell them to do something. They do a lot of cleaning and a lot of unsupervised work. The doctor suggested while they were unoccupied that I do some teaching. With much stumbling through Swahili and English, we actually did spend a good while on a variety of subjects. Two of the nursing staff, two medical students, and one of the nursing students spoke good English. Topics of discussion included: turning patients to prevent pressure ulcers, how to take vital signs correctly, why taking vital signs are important, what normal and abnormal vital signs are and when to report them to a physician, how to weigh a patient, why accurate weights are important, etc. They were largely unaware of all of these topics, even those who were in their later years of school. I would understand the nursing assistant students not understanding the pathophysiology and why we do things certain ways, but nursing students? Very different from our schooling.

How does one go about trying to help in a way that will last? It’s a very difficult situation to try and figure out. I don’t work here, I’m not a manager. I’m a short term volunteer who can hardly communicate and don’t want to be overbearing with my western ideas of how a hospital should run. I want to obey God foremost, but I also get very caught up in thinking about how everything could be so much better “if they only did this.” I’m praying a great deal and would appreciate yours as well.

On the pediatric ward there were 2 patients that had 2^nd degree burns. It was strange, they were very similar. One was 4 years old, the other was 5. Both had burns on their butts and upper thighs posteriorly from boiling water. I don’t know if it was from bathing or playing near the cooking fire, I did not ask. The one kiddo was screaming, the other was fine. The poor screamer only had Tylenol equivalent ordered every 6 hours. I got some ibuprofen and we rewrote the MAR so he was getting something for pain every 3 hours. There’s nothing stronger available for kiddos. The medication administration papers are handwritten here, no fussing about scanning your meds.

The wards were not very full so after rounds the doctor did several ultrasounds and I did some more English/Swahili with some of the students. They’re very interested and want to meet next week for “English lessons.” We’ll see if that works out, but I’m perfectly willing to try and glad for the opportunity to build relationships. Should probably brush up on my English over the weekend. A sweet lady that the doctor did an echocardiogram had an absolutely massive heart, she was 32 and had peripartum cardiomyopathy after her last child was born. I checked her O2 saturation out of curiosity, it was 86%. Apparently 1/3^rd of women with peripartum cardiomyopathy get better with meds, 1/3^rd stay stable, and 1/3^rd never improve. She has 4 children. I hope she improves. The doctor adjusted her meds a little bit and sent her home.

Interesting facts: Healthcare for women is free for all prenatal care till 42 days after giving birth. Healthcare for children is free till 5 years old. Healthcare is free after 60 years old.

Started off Friday with a riotous staff meeting. The hospital is out of gloves. Someone ordered a wrong dose of medication. Everyone had an opinion about every topic. I went to my happy place. It is amazing to me how many people they can fit on these small benches. These are well-nourished, fully grown adults, squeezing 6 of them on a bench that comfortably fits 3. I suppose many of you are aware, but there is no concept of personal space here. For example, the pediatric ward was completely full today. As in we had more patients than beds. Since the moms stay with the children, a few of the beds had 4 people on them. It got a little confusing, almost like a large game of hot potato going on with the charts as well as the babies.

The 2 boys with the burns were so much better today! They were limping around with little canes and were all smiles. They both had their wraps are tied over one shoulder so it wouldn't touch their burns and they look like miniature old men, it was so precious.

We were crossing the street and someone told me to “look out, because sometimes people forget that we drive on the left side and look the wrong way for traffic.” As she said this, a goat bumps my legs, 2 children with brooms run past my right arm, a man with a basket of fruit on his head passes me on the left, and 2 bikes, a motorcycle, and a van drive in front of me not really following any type of rules. Cars on the left side are not what are worrying me.

 

 

 

It's not a monster, it's a man carrying grass on his bike



 

Now for this very reason also, applying all diligence, in your faith supply moral excellence, and in your moral excellence, knowledge, and in your knowledge, self-control, and in your self-control, perseverance, and in your perseverance, godliness, and in your godliness, brotherly kindness, and in your brotherly kindness, love.  For if these qualities are yours and are increasing, they render you neither useless nor unfruitful in the true knowledge of our Lord Jesus Christ. 2 Peter 1: 5-8

Pray that these qualities will be mine and increasing so that I will be useless nor unfruitful in the true knowledge of our Lord Jesus Christ.