Days 11 and 12

After my slump of a Monday, the hospital was much better on Tuesday! I started out wandering as per usual, but ended up in peds rounds. Nothing too exciting there, but after it finished they did have some wound care to do. I decided it's about time I start being more proactive, so I asked the nurse if she needed any help and luckily for me, she did! I had to wait around a bit, but eventually we started on the first of two patients, a girl with extreme burns on both hands, both arms, one leg, and all across her chest. I've never done any sort of burn care before, besides the minor burns kids get in the iCook kitchens at camp, so I was pretty shellshocked and had absolutely no idea what to do. The nurses in the room were really willing to let me help and I ended up being able to help with a good amount of cleansing and dressing. First I started by taking off the gauze after the doctor would wet it with a saline solution. Her burns were so open and pussy that the gauze majorly stuck to her wounds and pulling off the gauze caused her a good amount of pain. After, the nurse would cleanse the burns with a cotton ball soaked in saline solution and when she was finished that, I covered the burns with a very elementary burn cream. Finally, we covered them back in gauze. The whole process took at least a half hour and the poor girl was such a trooper.

Our second patient had a massive bed sore but was originally hospitalized for something entirely different, probably malaria or typhoid. A bed sore forms over bony prominences in the body when patients are laying in the same position for an extended period of time. In America, we try to turn patients at least every 2 hours as prevention, however here in Kenya this knowledge isn't well known. This patient's bed sore covered her entire left buttcheek and up a portion of her back and looked awful (google a picture if you're really interested, I thought including one would be a little too gross). For her, I unwrapped the gauze first, then again cleansed the wound with cotton balls soaked in a saline solution. Different from the last patient, we used iodine soaked cotton balls to cover her wound as well before covering it with gauze. I know the procedures used here are definitely not up to standards of what we do in America and it's hard as a volunteer to be in this position. First of all the hospital obviously isn't equipped with the supplies to care for wounds as we normally would, but also the staff here are not receptive to any sort of critique. I think we've all taken the mindset that we should still try to educate the patients the best we can and make the most of a bad situation.

On Tuesday afternoon, two other girls and I decided to stop into the orphanage again where we're able to teach some classes. We were thrown right up there in front of class without any prep and were told to teach about the weather and the senses. It's just really interesting to me that we're able to stop in and basically teach whatever we feel like, whereas back home there's such a set curriculum I can't imagine unscheduled visitors randomly stopping in as we did. I'm not sure how much about the weather and senses these kids knew, but they seemed to pick up on it pretty quickly! We taught about some of the weather we have in the US too, like tornadoes and hurricanes, which the head teacher didn't even know about. Even though we didn't do such a great job at first, the kids are so welcoming and excited to have company it didn't even matter. Afterward they all talked to us, took pictures, and walked home with us singing songs. The kids here are so well behaved and sweet it's impressive.

Justin with all of the sweet kiddos!

On Wednesday morning, I started in maternity rounds again. I really like being in maternity here at the hospital even though I don't want to be a labor and delivery nurse because not only is the doctor extremely willing to teach, but also because I actually kind of know what I'm doing from clinical last semester. It's nice to feel kind of competent when the doctor asks a question and I'm able to answer! We saw a few patients who had recently delivered either via c-section or SVD, and then one other who had been brought in with severe abdominal pain and it was found that she had miscarried at 28 weeks. There were about seven of us in the room with her while the doctor led a conversation with us about the situation, not really involving the patient at all. You could see she was visibly upset and I felt really awful since clearly we weren't helping her emotionally in any way. It's so culturally different here and in some ways the relaxed nature is nice. Generally I think sometimes in America we get so uptight about small details that in the scheme of things really don't matter, but in Kenya all they can do is really focus on the important things. The same goes for medicine, but at the same time those small details can really make a difference to the 1% of people who care.

After maternity rounds, I headed to the maternity clinic, where pregnant moms or moms with their babies come basically for very simple check ups. Typically they just get weighed and then vaccinated (or given vitamin A, which according to some of the posters will heal about 6 chronic diseases. I'm skeptical). I was primarily in charge of weighing babies, although I'm hoping if I put in enough time over there I can start practicing administering injections. Even though I wasn't learning very much from a medical standpoint during my time in the clinic, it was nice to actually be doing something that was helpful; with the amount of patients there is no way the sister in charge could have checked everyone in and treated them appropriately. However after a few hours I got bored since it wasn't the most intellectually stimulating activity. We came home for lunch then spent the day relaxing mostly and going to the market to pick up more water (always more water).

I realized I haven't really mentioned what we do in our free time, which there is a lot of! In the afternoons I'm typically here at the house, since very little patient care takes place after 11 or 12pm, or sometimes we go to the orphanage. In the house we do have a TV and computer, but honestly we don't use either a significant amount. I was super lucky to fly into Kenya the same day as a group of 12 amazing people, so most nights and afternoons we all hang out together. It's kind of like when we have a power outage, there is a lot of card games, monopoly, talking, etc. It makes the trip so much more enjoyable to have people you enjoy being with, and I'm so happy about that!