Days 18 and 19

After a long weekend of safari-ing, Tuesday in the hospital was tiring! I started the day out on a run again (and of course, the people in Migori still think it’s hilarious) and then headed to the hospital, hoping for some sort of excitement in maternity. When we got there, there was one patient in labor at 4cm dilated so knowing that it can take hours before the labor progresses quickly I wandered around a bit. I went to peds first, but since they do rounds mostly in Swahili there wasn’t much for me to do so we went back to maternity, but the woman was still in labor. The way monitoring labor works here is a vaginal exam is only performed every four hours, so when they tell us a woman is at 4 centimeters she could actually be at four centimeters, or she could have been at four centimeters three hours ago but nobody has checked since. So since we couldn’t check and there was nothing to do for the patient since nurses essentially do no kind of monitoring of the moms in labor, we wandered around a bit more. You might notice it’s kind of a theme of St. Joseph’s Mission Hospital – there’s never actually enough to keep twenty volunteers busy. The thing is, the hospital is pretty wealthy relatively speaking, so they are not lacking in staff or resources quite as much as other hospitals in Africa. Although it’s so great there are hospitals here that are well equipped, it kind of sucks for us since we’re not too useful.

However, the one place always looking for help is the pharmacy, where I headed next. In the pharmacy, we help prepare baskets to take to the wards and prepare prescriptions for outpatients or patients staying in the ward. I think it’s cool to work there since I just took pharm so I recognize a good amount of the drugs, but also it’s just really nice to be able to help out! Moses, who works there, is really willing to teach and let us do what we can and it ends up being a really good environment! Plus I learned to count to ten in Swahili (kind of..) which is a good skill to have I suppose. Anyway, I worked in the pharmacy for the rest of the morning and then before heading to lunch, we checked back on the mama in labor who of course hadn’t been checked and was still, allegedly, at 4 centimeters even though her contractions were lasting 42 centimeters, indicating she was getting close to giving birth. They had performed their most recent exam at 10:00 that morning and didn’t plan to do another until 2, so we assumed if we came back by 1:30 we would make it in plenty of time.

If you’ve been keeping up with my blog, you probably noticed I’ve spent a lot of time in the maternity ward. I’m not particularly interested in OB, I’m much more of a peds girl, but we can actually get involved there and more importantly one of the other girls on the trip, Audrey, really wants to work in OB but had never seen a birth before. We’ve spent pretty much every day in maternity checking for patients and the ward is either empty or we literally just miss a birth; one day we walked in after the morning meeting just as the mom was delivering the placenta. Poor Audrey has been determined to see a birth, once staying in the hospital from 8am to 6pm, but still has missed every single one. We really thought this birth would be the one. However, once we got back from the hospital of course we walked into the delivery room and it was completely empty. You really can’t help but laugh at our bad luck, but still I felt so bad we missed yet another one! Instead for the rest of the day, I went back to pharmacy again and continued to help dispense meds.

At about 4 we came back and all headed to the market, which we decided is probably a mile away from our house. Since the water is not safe to drink here, we all have to buy large bottles of water to supply ourselves and lug them back up to the house (which is uphill, of course) multiple times a week. I go through water like a camel so I decided this time to go for the ten liter bottle so it would last me 3 or 4 days; never will I ever do that again. After the market we hung out, played mafia as per usual, and ate dinner. At the beginning of our experience here, we intended to debrief every night about our days but it never actually turned into an official thing – instead we all just kind of updated each other as the day went on. On Tuesday though, we had a really great and interesting discussion about a case presented to us in the morning meeting. A patient was admitted for the second time to the hospital – specifically the peds ward – with abnormally dark urine, a cough, an enlarged spleen, coughing up blood, and generally all of his blood cell counts were low. They did tests for all the typical suspects including malaria, TB, Hep B, Hep C, and HIV, but everything came back negative. Since the doctors rarely treat for anything besides these diseases, everyone was stumped and so were those of us in the meeting. We talked about it with our big group in the house and although we didn’t come to any official conclusions, it was a really cool experience. We have a really diverse group of volunteers here including med students, premeds, nurses/nursing students, nutritionists, physical therapists, and social workers, and it was awesome to see everyone use their knowledge from different disciplines to collaborate. Even though this trip wasn’t exactly as I expected, being able to work with so many different groups of people has definitely been rewarding.

On Wednesday, I decided to try out another hospital here in Migori, the Migori District Hospital. Saint Joseph’s is a Catholic Mission Hospital, so as a result it’s much wealthier and usually only more affluent patients can afford their services. District is a government  funded hospital meaning not only do they take a wider variety of patients, there are also a ton more people with a assortment of cases in a significantly smaller space. Since it’s so chaotic, District tries to be more structured too, so we were told they only wanted medical students to help out along with the one registered nurse, Anna, that is on our trip. Since I didn’t want to get in on rounds or do anything the medical students would be responsible for, I decided to go anyway and follow around Anna since she’s a pediatric nurse! I expected the hospital to be crazy, but seriously I had no idea what a completely different world it would be. We expected to be helping out the nurse, but for most of the morning she sits in a “triage” room handing out medications. Vitals are rarely taken since according to the nurse there’s no time and really the only nursing care done is medication administration. The pediatric ward has two rooms, one for patients who are relatively stable and the other for patients who need to be closely monitored. The docs were rounding with the more stable group, so Anna and I started in the other room at first just observing how everything is handled but eventually rounding with the intern and helping do examinations.

The rooms themselves are miniscule compared to the wards at Saint Joe’s and since there are so many patients there’s hardly any room. As a result, they have two or three kids to a bed, along with at least one of their parents there – as I’m sure you can imagine, it is crowded as all get out. It also became clear the hospital really isn’t equipped to handle some of the cases they are given just because their resources are so poor. One girl today was having major trouble breathing and when they did a pleural tap, they found a large amount of fluid in her lungs and decided they needed to insert a chest tube. Just with this patient alone, they were unable to provide her with oxygen because they only have two machines available and neither were in peds, and then they had use IV tubing and a catheter bag instead as a makeshift chest tube. I was really worried about the patient since she really was doing poorly and had been crying all morning, but despite all of the complications, according to Anna, this afternoon the patient was doing significantly better (thank goodness – she was my new favorite :) ). After doing rounds – which was exciting since I actually kind of know how to examine patients – there were a few kids who required procedures, so Anna, me, and two of the med students went in to help out. One little boy came in to the hospital yesterday after three days of convulsions along with hob (what they call hotness of body), and today he was still unresponsive even to a sternal rub. They suspected malaria, because that can cause convulsions, and also potentially meningitis, which they had to test for using a lumbar puncture performed by one of the medical students. We also had to flush his IV with a 10% dextrose solution, which is supposed to help revive patients from their comas, and insert an NG tube since he was hypoglycemic. I helped out with both procedures which was cool since I’ve been taught to do both of these in school but have never actually seen one performed in person. Still, after all of our interventions the poor kiddo was still out cold and burning up with insanely high respirations and heart rate. I wasn’t back at the hospital in the afternoon, but once Anna and the two med students came back they reported that he had unfortunately passed away since the parents had waited too long to bring him in.

We stayed in the hospital until 1:15 ish and the rest of the day flew by pretty quickly.  We had other patients  who needed IVs, blood drawn, or burns cleaned, but I wasn’t too involved with them. After lunch I had intended to go back to the hospital, but Harriet, our “house mom” told us the skirts we paid for were ready so we had to go back into town at 2 to pick them up. I forget if I mentioned it, but there’s a place in town where we can pick out fabric, have a woman take our measurements, and then she will make skirts for us! It took her about a week to make them for all of us so we were all really excited to pick them up today! Mine turned out pretty well and I’m excited to wear it around here and back in the US. Afterwards, we came back to the house and quickly got a call that there was yet another birth going on – obviously Audrey and many of the other girls jumped on it and I was more than happy to let them go, so I stayed home. They just got back and we’re all dying now because Tyler, one of the med students who was in the room, got the baby named after him! It’s just comical because there has been not a single Kenyan yet who can pronounce his name correctly…. So good luck to that kiddo. There’s still another labor going on now, so we may be able to go back tonight to see another labor! Hopefully with my next blog I’ll have exciting updates about the birth!

Days 15, 16, and 17.... SAFARI TIME!

My weekend started by waking up at 5:30AM on Saturday in preparation for our safari!! We had an evening game drive planned and it takes most of the day to travel, so we wanted to leave by 6 to get there in time (which of course, in Kenyan time meant we left at 7). For whatever reason, we took the long way to get to the reserve so including our stop for lunch we arrived at around 2:30 at the Maasai Hippo Lodge where we were staying. We quickly dropped our stuff and got ready to leave at 3:45 so we could get there by 4:00. Evening and morning game drives are ideal because not only do you get a great sunset and sunrise, but it’s the time when hunting and other activity most frequently occurs. Getting there by 4:00 didn’t give us a ton of time since the sun sets around 6:45 every night, but given that we only had about two and a half hours and we only stayed near the park entrance, we saw a ton of stuff on our first day. Aside from the animals, Maasai Mara itself is breathtaking. Again, I wish the pictures did it justice, but it may be the most beautiful place I’ve ever been in my life. Besides the mountains that line the park, you can see the plains for miles. Everything is so natural and pure and has the crispest, freshest smell; needless to say we were all loving the change from the crowded and polluted town of Migori.

 

Our lodging!

 

For the safari, we drove around in our usual Medics to Africa vans, which seat 9-10 people. The hood on the vans pops up which is not only great for air flow, but gave us all an incredible view as we drove around (and also gave us some incredible bruises since the drive was so bumpy).  Within the first few minutes of entering the park we saw zebras, which we learned are pretty common and look more like fake horses, dicdics, and impala, which are both types of gazelles. All of the vans in the park have walkie-talkie radios in them, so if one van sees something they can easily radio the rest of the vans to let them know what and where it is. Our first call came a short time into our nighttime drive, but for us, the English-speaking passengers, we had no idea what the drivers were saying since they spoke to each other in Swahili. Our driver, Martin, would instead hear a lot of excitement on the radio and start speeding like a madman to wherever the animal was, leaving us confused, excited, and bumping into everything and each other as we stood on the lookout. When we got to the location of the call, we sat with at least 7 other vans and saw our very first lion! It was a female, who we learned sleeps for 18 out of 24 hours in the day and spends the rest of the time hunting or caring for her cubs. At first, the lion was just wandering, but then she sighted a few impala in the distance and for a while, we thought there was going to be a kill. Unfortunately, she took too long and the impala were too aware of her location so she lost interest and so did we.

 Just the fam hangin out at Pride Rock

Half of our gang in the van

The rest of the night we saw a herd of elephants (herd? What are multiple elephants?), a family of lions including mamas and a few cubs, and then a male lion. We learned that male lions are actually super lazy and are only awake for 23 hours of the day, not even to hunt but to eat whatever their female counterpart could find. Obviously my car full of girls took an immediate dislike to their lifestyle. By the time we saw everything, it was getting pretty dark so we headed back to the lodge, looking forward to warm showers, good food, and a comfortable bed. Back in Migori, we really don’t have it too bad in comparison to what it could be. We at least have running water, even if it’s not always hot and definitely not sanitary. Our food at first when we were in the hotel was pretty bad, “carbs on carbs on carbs” as we like to say; lots of fries, rice, potatoes, and hardly edible meat. At the house, it’s considerably better (still carbs on carbs) where we have beans, actually edible meat, and fresh fruit with every meal. Even so, it’s considerably different from what we’re all used to so we’re always talking about food and what we’re craving from home. Our beds in Migori could be worse too, but they’re definitely less than comfortable. So knowing all this, even though in America our hotel is not one I probably would have picked to stay in, we treated it like it was a five star resort. The first night, my roommate and I came back and had the most perfect, warm shower then headed off to dinner which had edible meat, pasta (real pasta!), and a new variety of veggies. The bed was the most comfortable I’ve been in since we arrived here in Kenya, so needless to say we all thought we had died and gone to heaven. We were all asleep by 9:30 half because we had such a long day, but also probably half because we were so excited to sleep on something that didn’t have imprints from where people in the past had slept.

We woke up the next morning in the best mood, happy from our night’s sleep and looking forward to our safari and visit to the Maasai village that day. Breakfast again was incredible; we had omelets instead of fried eggs and actual crepes so we filled up expecting our picnic lunch to be not so exciting. We were meant to start our day on our safari then later go to the Maasai village, but since we were still waiting for our card to pay for the park entrance fee to get reloaded, we decided to visit the village first. The Maasai is a tribe specific to the Maasai Mara area in Africa and they are the typical tribe you would expect to see with traditional robes, long earlobes, and shaved heads. Our visit to the village included an introduction, including their traditional dances, a visit to their schoolhouse, and a tour of the village. They have a ton of livestock in the area, so I guess since it’s an easy resource, their huts are made of mud and cow dung and most of the ground is completely covered with poop. Thank god we all wore our sneakers. They of course also have their own traditions, which as Americans we were all a little shocked over. For example, at sixteen years of age, males are circumcised in the center of town but are not allowed to show any sign of pain or emotion; it is only then that they are considered men and are able to grow their hair out and become warriors. At 21, the men marry and shave off of their long hair but women are typically younger, sometimes only 16 or 17. Also, the villagers main diet is rice, meat, and animal blood (I was real worried they were going to offer us some to try, I think I probably would have passed out).

 Maasai tribe dance

 Huts made of cow dung and mud

After our little intro to the village, we were split into groups and brought into a Maasai man’s home (made of cow dung). The Maasai tribe do practice polygamy, so saying the men only have one home would be incorrect. Each wife of a warrior gets her own home, and then the husband alternates between the houses. Anyway, the house we saw only had two rooms and of course had no lighting, so it was very dark, and there was a small fire in the middle, so it was ungodly hot. The warrior, his wife, and children all sleep in one of the beds in the main room, and then the second room is made up of beds for the goats and cows. We got to meet our Maasai man’s children and talk about the village, and then it very quickly transitioned to trying to sell stuff to us. As a grand finale for our visit, all of the families in the village have a stand in their marketplace of sorts, and aggressively try to sell bracelets, blankets, wooden figurines, etc. It was seriously the most overwhelming and frustrating experience of our lives – and other people agree with me, it’s not just me being uptight. People grabbed us, pulling us toward their stands, trying to force jewelry on us and following us around the entire marketplace trying to bargain with us. Of course there are no set prices so they majorly tried to rip us off thinking that since we’re white, we have lots of money to spend on them. At some points, we were stuck in a huge circle of people putting bracelets on us, pulling us, or yelling, asking us to buy anything they could pawn off on us. It was frustrating for most of us because we all knew this was a great and cheap place to get souvenirs, but the way we were treated made us all want to leave immediately. We were all pretty upset afterwards, so we were happy we had the safari to look forward to. Even though it was incredibly frustrating, I got a really nice Maasai blanket that the Maasais wear and the pattern on it distinguishes what family you’re a part of, so in the end it was kind of worth it (but only kind of). 

 The terrifying village marketplace

 

We headed out of the Maasai village all cursing how much we got ripped off and headed over to the Maasai Mara reserve for our second day on the safari. We had ours to spend, from about 9:30AM to 7 at night, so we were able to cover a lot more than we had the night before. The reserve itself is 1800 square kilometers (roughly 1080 square miles) so even if we tried, I would think it’s near impossible to hit every part, not that it’s necessary since most of the animals hang out very close to the entrance of the park. Maasai Mara also extends into Tanzania and becomes the Serengeti, which is easily twice the size of the Kenyan side of the park. We saw lots of zebras again along with water buffalo, some hyenas, impalas, dicdics, the usual. Our first call on the radio led us over to another pack of lions (maybe the same ones from the night before? Who knows), two mamas and lots of cubs, who were resting in the grass. They were super cute, but not too exciting since they were sleeping the whole time. We drove around a bit more, passed some giraffes, and then got another call on the radio so we sped over to whatever was awaiting us. Turned out it was a leopard, which are really hard to find since they hang out in trees and mostly out of view. Even though we could hardly see it, it was really exciting for us because at this point we had almost found all of the big 5! The Big 5 here are considered the five most deadly animals in Maasai Mara: lions, leopards, elephants, water buffalo, and rhinos. We only had rhinos left to go, but we didn’t expect to see one because they are super rare with only 15 total in the entire park. 

Elephants!

 See the leopard? Yeah, me neither.

Since we couldn’t see the leopard very well, we left and headed over to a massive pack of 16 giraffes, who were all walking around our van; it was incredible! I think giraffes are my favorite of all of the animals we saw just because they’re awesome and look really cool when they walk (ostriches are my least favorite, in case you were wondering. Their knees bend backwards and it’s real freaky). After our multiple giraffe spotting, we had a pretty long lull in seeing animals as we headed south into the park. We got to the border of Kenya and Tanzania, which is marked by a rock, so I got to stand in two countries at once! It was basically like A Walk to Remember, besides the love story since the only man in my life is my dog. We took a precious family photo with everyone from our group, then moved on about five minutes down the road (and by road I mean the dirt) to have lunch near the Mara River. Lunch was not so filling, but we got to hang out with the monkeys that hung around the area and sometimes stole our bananas. 

After lunch we took a walk to see the hippos in the Mara River and finally stretched our legs a little. We stood for mostly the whole ride on Saturday and got banged around a lot so by part way through the day our legs were sore and we had some bruises forming. There were tons and tons of hippos and they were way bigger than I expected. I can definitely understand why they are so dangerous since on top of their size they can run really fast. Although they can hold their breath for 7 minutes at a time, generally I wasn’t too impressed by them since they must get pretty bored spending their entire lives under water. After our hippo adventure, we had another pretty long lull while driving back closer to the gate. We did see a pack of zebras mid-migration, which was pretty cool, and later on we saw a family of elephants including a baby, so obviously all of the girls freaked out since it’s so darn cute. We were on our way out of the park when Martin got another call on the radio and immediately started speeding away, being followed by another set of like seven cars. We knew it had to be big. Martin was driving so fast (and dare I say it, recklessly) that we were all flying around the van, running into each other and into the sides of the van. When we eventually got there, we saw…. A BLACK RHINO!!!! Well, only kind of saw. The rhino was apparently shy so she was speeding away from all of our vans, but Martin was not having it. We were the only van to aggressively (stress on aggressively) follow the rhino around, but as a result we got a great view and some great pictures. I personally only got one picture of a rhino butt because I got either a thorn or small branch stuck in my eye, so I spent half of the ride being thrown around the van and crying – don’t feel bad, it was pretty hilarious at the time. So even though I was clawing at my eye for half of the chase, we completed the big five!!! Allegedly, only 3 or 4 other groups in the history of Medics to Africa (ten years of the program) have seen all five, so basically we’re famous… and incredibly lucky.

 Black rhino butt

After the excitement of the rhino, we got yet another call and sped off again, only to find an awake male lion walking towards his pack of females and cubs! It was incredible, I kid you not when I say the lion was three feet from our van. The cubs also got smaller and so much cuter and were purring and making adorable noises as they ran towards their mamas. With the sun setting behind the entire scene, it was nothing short of perfect. Shout out to Martin, who we deemed “Young Lion”, for being an awesome driver and helping us see the big five! After a really exciting afternoon, we went back to the lodge again, had a delicious dinner but not so warm shower (we had some water issues) and headed to bed, excited for our sunrise safari.

We left our lodge at 6:45 this morning expecting to see the sunrise, but thanks to the clouds we didn’t have too much luck. The mornings are the time for animals to eat what they killed the night before so we were expecting some excitement but unfortunately there wasn’t too much. In our hour and a half drive we saw one group of lion cubs all alone running around so even though we didn’t see a lot, the cuteness of it was enough to satisfy me for the morning. All of us really wanted to take one home with us since they’re so adorable (it would have been the perfect time since the mom lions weren’t around) but obviously that’s not too logical or likely. We’d never get that cub through customs. 

We ended our trip with another delicious breakfast and packing up for the morning to head off on our 4 hour drive back to Migori. This time we took the backroads through the reserve, so we had an incredible view for the entire drive and got to see some more zebras, giraffes, and elephants as we went. On the other hand, almost the entire drive, probably 3 and a half of the four hours, was on dirt roads so it was insanely bumpy and lots of us ended up smacking against windows and whatnot. During the whole ride, I kept thinking about what time it was at home since today (Monday) is the first day of camp at Sandy Hill and I’m so sad I’m missing it! Thinking that two-week lunch is going on while I’m writing this makes me so camp-sick and I can’t wait to get back, even though I’m definitely not ready to leave Africa yet. If anyone at camp is reading this good luck with your first week!! Hope everything in the med center world is going well too :). After sitting for so long the past few days, we all were pretty sure pressure ulcers were forming, so we were thrilled to finally arrive back in Migori and stretch our legs a little bit. We spent the rest of the day literally laying around, we’re all so exhausted from our weekend that even playing cards seems to require too much energy. I can’t believe my safari is finished already and it has definitely been the highlight of my time here. Even though I felt like I was in Disney World Animal Kingdom the whole time and couldn’t believe it was a real experience, it was one of the most incredible weekends ever. Although I’m sad it’s over, looking forward to starting back at the hospital tomorrow! Check back for updates and look forward to the 73 pictures I post of every animal on facebook – sorry in advance to anyone whose newsfeed I show up on.

Days 13 and 14

Thursday was a very eventful day at the hospital! When we first arrived, one mom was in labor at 5 cm already and there were a few scheduled surgeries as well. First we hung around the labor ward, expecting the mom to quickly progress since it was her fourth child. We chatted with one of the nurses who explained exactly how they handle labor in St. Joseph's Hospital and although I was surprised about some of the tools they use or procedures they perform, generally it was very similar to in the US. One thing I did think was sort of funny was their way of finding a fetal heart rate while the woman is in labor. In America, we have fetal heart rate monitors that are strapped onto the mom's stomach for the duration of labor that alert us in case the baby's heart rate is too irregular. Here, although I think they do have an unused machine, the midwife uses a cone-like tool to press to the laboring mom's stomach, then puts her ear at the other end and she apparently can hear the baby's heart rate! I didn't give it a try, but one of the other girls on the trip did and said you can hear it although it's hard.

We waited around for a while, but by 11 the mom was still not ready so I went to observe a laporotomy. There was a patient in the maternity ward whose ultrasound showed a mass near the uterus, so the doctor decided to do an exploratory surgery to see what he could find. It was really cool to watch, they went in and pulled out the uterus, checking out the uterine tubes and ovaries which were extremely inflamed. The doctor said unfortunately it was likely the girl would be infertile in the future, even though she is only 16. They found the mass wasn't on the uterus at all; instead it was an abdominal mass, which they just drained of pus and then closed her up. It was relatively quick, lasting only an hour, leaving plenty of time, or so I thought, to check up on the laboring mom again. I got there around 12 and was told that she was 10 centimeters dilated, meaning her cervix was ready to have the baby, but the fetus still hadn't descended far enough and she was only having contractions every 15-20 minutes. I left for lunch, figuring I'd try to make it back as soon as possible, but when I came back a half hour later she was still in the same position. A few of us stayed for two more hours, and one poor girl in our group stayed until 7pm, but we found out on Friday the woman hadn't given birth until 10pm! I felt so bad for her being in labor for fifteen hours, but we were also glad we didn't try to stay for the whole time.

After dinner last night, we went for snacks and drinks at a restaurant that is built around a tree about ten minutes away from our house. Everyone in the group had gone there before except me and one of the couples here, so I was excited to finally try out some genuine Kenyan food. At the house we have a lot of chicken, rice, and beans, but nothing that is traditionally Kenyan. At the restaurant, we all got servings of ugali, chipati, and masala chips. Ugali is basically a mound of millet so it doesn't have much of a taste, but I still thought it was good, and chipati is like pita bread, which is always good. Masala chips are fries covered in some kind of spice-filled sauce mixture and they were SO good until my last bite, which contained a dense pack of spice. I literally have never tasted anything so spicy in my life and I could not get it to go away. I was crying for like twenty minutes and seriously thought I was going into anaphylactic shock. Needless to say, I'm gonna be a bit more skeptical before eating masala chips again, even though for most of the time they were really good.

On Friday the hospital was pretty low-key; two other girls and I spent two hours hanging around in maternity waiting for Dr. Agullo, the gynecologist, to come do rounds. Usually rounds start after our morning meetings, which end around 8:30, but by 10:00 Dr. Agullo still hadn't gotten there and he had a surgery to do. We ended up going to the surgery before rounds began, and then spent an hour waiting in the OR. The patient was a 36 year old woman undergoing a hysterectomy because she had cancer and masses covering her uterus. I started feeling not so hot, so I didn't stay for the entire procedure and really only got to see them open her up and start taking out her uterus. It gets really warm here during the day and there is no air conditioning in the ORs, so that combined with a headache was a little too much for me to be comfortable. Nothing else was going on in the hospital today, so I came back home, ate, and went to the market to stock up on snacks and for our safari this weekend! We leave at 6:00 AM tomorrow morning to leave since Maasai Mara is 6 hours away, and then we'll have a nighttime game drive. I have no idea what to expect and I'm hoping we get to see the big five (most dangerous animals) but apparently the reserve is huge (it's an extension of the Serengheti in Tanzania) so we just drive around for hours. Tonight, we're planning a relaxed and early night to prepare - the next blog should be filled with great pictures :)

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!

Days 9 and 10

On Sunday in Migori, our group woke up relatively early for the weekend and went to see a Catholic mass! It was in Swahili, so although I really didn’t understand much it was definitely something I wanted to experience while I was there. According to a lot of the Catholic people here, the general structure of the mass was very similar to in America, they just had a lot more songs and sermons. Even though I really have no basis to compare, I thought their mass was great. The music is so cheery, there are a set of dancers that make their way through the aisle, and everyone in the church danced along. The offerings were also way different from back in America because instead of passing around the bowl for offerings, they kept boxes at the front and everyone who wanted to give stood up and came forward. And I think literally EVERYONE gave something (one person even gave a live chicken). It was amazing to me that even though some of these people are living on less than a dollar a day, they still manage to give to their church. You can tell from being there that faith is obviously very important to everyone here.

 Pictures of the house, as promised! My room - my bed is in the way back

Living room and dining room!

After church, we took a lunch break and then set out to climb what Josh deemed the Rocky Mountains. We all laughed and joked that it would be literally a pile of pebbles but it was actually quite the hike! Even though Migori is far from being a city, where we were was significantly more rural. There were small mud huts spread out throughout the mountains where it didn’t seem like they had much access to basic needs like food or water besides what they can grow. If I had to guess I would say since it’s such a remote area many of the people living there have never seen a white person before because as we hiked, we accumulated quite the crowd! It was mostly kids with some adults and they were surprisingly good at climbing their way around rocks. When I say rocks, I mean massive boulders so our group probably looked pretty pathetic compared to the kiddos. When we got to the top, Josh explained to us that a lot of people spend time praying on these rocks, so it’s really a pretty special area; we could see the remnants of candle wax and writings. 

 

Now I was a little nervous hiking because of course I’m pretty terrified of being up high and standing on ledges. At first I was totally fine because once we got to the top the view was spectacular! You could see for miles in every direction, it was incredible. That’s what’s amazing about Africa, everything is just so rich and untouched, it’s beautiful. I took a lot of time taking in the view, but as soon as we moved to another rock (which to me seemed less sturdy) I started to panic a little. Needless to say, I didn’t spend too much time up there before getting down. We drove back shortly after, then had a relaxed night celebrating the birthday of one of the girls in our house.

So incredible. Wish the pictures did it justice

 The group we acquired!

Peeing my pants in this picture. Can you see the fear in my eyes?

Monday morning we headed back to the hospital, but unfortunately it was pretty quiet. I’m starting to realize there’s really not much help needed so unless I butt my way in it’s going to always be a slow day. We started out in maternity which I enjoyed and hopefully will go back to tomorrow. The doctor there is great; he is willing to teach and engages us which is great for me since I’ve already been through my OB rotation. Unfortunately, part way through our rounds this morning he had to leave for a family emergency so we didn’t get to finish up. Most of the rest of the morning was spent wandering and in the peds ward, which was also pretty slow. I’m hoping to also get a little more involved in peds because even though there isn’t too much to do there, it’s what I want to specialize in so I’m hoping for some good experience! The way they treat here is so different from what we do in America. Tropical illnesses, like malaria and typhoid, are way more present so I feel like sometimes the doctors assume and begin treatment before fully investigating any other possibilities. The information given by the patient just isn’t as explored and questioned here as it is back home. For example, in the pediatric outpatient clinic today, a patient presented with chest pain along with other symptoms. Back home, if someone told me they were having chest pain I would be way more concerned than the doctor here appeared to be. I would have liked to know when the pain started, what it felt like, how frequently it occurred, but the doctor immediately sent in for a lab test for malaria without a second thought. Ultimately most of the patients I’ve seen have recovered and been okay, it’s just a very different way of treating than I expected. Since the hospital has been so slow, we’re hoping to get into the District Hospital, another hospital a short distance away from our house. We work at Saint Joseph’s, which is apparently more expensive and more for the richer population of Migori, while District Hospital takes anyone, meaning it’s much more hectic and has a wider variety of cases. I’ve heard there’s much more autonomy there and although I want to be ethical and not overstep my bounds, I would like to be more hands on with patients here! I know I need to push myself more and now since I feel more adjusted I’m going to try to start doing so.

The afternoon was spent in the house eating and playing monopoly with the other volunteers. We made a market trip (because I’ve been bumming water from other people for two days. Seriously guys I was dying) and when we got back, we were greeted by kiddos jumping on us and holding our hands. They know that white people always live in the house so our yard is always crowded with kids wanting to play. They’re so happy to have company, so we spent the night playing soccer, ring around the rosy, and letting them play with our hair (awful awful idea). It was my favorite part of the day but definitely also the most exhausting.

 Me and Faith, the sassypants of the group :)

Goons, hamming it up for the camera as per usual