A final note

I just want to clarify that this blog is an outsiders perspective on the Kenyan health care system as compared to our health care system in America. None of what I have written was meant to offend anyone or to say that our ways are superior (the kenyan doctors are certainly some of the most talented I have seen) but to show how unequal wealth and knowledge distribution is in our world. I have had an unparalleled opportunity to gain this insight and am so appreciative of everyone who has helped me along the journey. Thanks for reading! See you in the states!  

Last day at the hospital

Today was my last day at the hospital, it came so quickly. I ended the journey where I started, by first participating in peds rounds. I learned about symptoms and how they can be connected to different diseases, mainly focusing on convulsions, fever, headache, cough, and vomiting. All symptoms that can be associated with malaria, epilepsy, meningitis, and other diseases. After rounds I went to the surgical theater where I saw a cesarean section and an abbcess removal. Both went very well, a healthy baby was born, and the little boy with the abbcess was treated. This was a great last day and an incredible three weeks. I am so thankful to have had this opportunity to participate in this type of program and I definitely learned a great deal about medicine and about Kenyan culture which is exactly what I was hoping for.

hospital cont...

The past few days at the hospital have been relatively slow in terms of exciting new cases. I have gone on rounds in peds, seen patients with tuberculosis, malaria, pneumonia, and malnutrition. On a different note though, an Italian doctor is visiting and I was able to watch him do a double hernia repair on a 2 week old baby boy. It was great to watch it because he was sure to explain everything he was doing and did so in clear english. His hospital in italy is part of a program that establishes connections in lower income areas and at the Malindi hospital they have built a new ICU and ER which are both gorgeous. Unfortunately, they aren't opening until after I leave, but the technology and resources that were donated will most certainly make a huge difference. For the majority of today I helped him to organize the new buildings, putting together beds, organizing wires, installing heart monitors etc. I am glad that I got to help out with this because I know that it will make a difference in the future of the hospital and in the lives of the patients treated there.

Back to the hospital

Today was a very interesting day in the surgery ward. I was able to observe the removal of the dead tissue on a three year olds neck cause by necrotizing fecsiitis, a bacteria that eats away at dead skin and is a doctors nightmare. It can spread in a mere amount of hours and destroy limbs and bodies and is virtually unheard of in the states. Definitely an incredible opportunity to be able to see it from feet away. I GOT TO SCRUB IN in the next surgery, a  hydrostatic hernectomy! This consisted of my wearing three layers of long sleeve and pants scrubs, boots, a mask, a hair net, and two pairs of gloves. I stood on one side of the patient, the head surgeon on the other, and was able to use tweezers to hold the incision open for the doctor, wipe the excess fluid with gauze, and utilize tools that helped to set aside the blood vessels from the abscess. Under the OR light, in an OR with out air conditioning, and the many layers, the heat definitely got to me. Embarrassingly enough, on my first time scrubbing in, I had to scrub out before the surgery was over or I would have fainted. I was so happy though that I got to do some hands on things and the fact that I am only pre med and got to participate in a surgery was incredible. Quite the experience.

Safari

My safari trip began with a ten hour bus drive on an un-airconditioned, crowded bus (truly going rustic) to Nairobi where we spent the night before continuing on the rest of our journey. Nairobi is a much larger city than any I have been to here so far, but it still was under developed. People were just as forward about asking for money on the streets as they are in the villages and taxi drivers competed for attention and costumers. We didn't venture too far from the hotel, which we paid ten dollars a night for, and got a pretty decent meal a block away and went to buy treats for the ride at the kenyan super market, Naku Mat. On the way home though, when we stopped in Nairobi again, we were able to check out the local market which was huge and had some really cool trinkets and delicacies. The second leg of the trip, from Nairobi to Masa Mara was eight hours, another long trip on bumpy, dusty roads. Once we finally arrived, we drove through the Massai village, which we later got to explore, in order to arrive at our accommodations: a series of canvas tents with two beds each in them, attached to bathrooms, with running water and electricity from 7pm-11pm. Theres also an outdoor restaurant here where we ate breakfast and dinner, overall exceeding my expectations. We arrived just in time to go on a sun set game drive and saw the first animals of the weekends. Right away we were able to spot zebras and antelopes and even lions and jaguars. On the way in we even saw a series of elephants walking together. A successful two hour drive. The next morning we woke up at the crack of dawn and spent the entire day in the park. We saw more of the above, but also got a chance to see giraffes, hipos, a variety of birds, wildabeasts, and more. I felt as if the animals had been placed there for our viewing rather than in their natural habitat. There were several times when the animals grazed the van. On the way back to the hostel, we stopped in the massai village and were taken on a tour and shown the typical male dance. Their culture is very interesting: they believe in polygamy and one must buy their wives with cows, and their work ethic is unparalleled but what struck me was that this whole tour and insight into their culture was a small scam. We each paid 10 USD to enter which is fine because their village definitely needed the help, but as we were exiting, we were attacked by numerous villagers selling jewelry and other things. They put the bracelets and necklaces on you as you exited and when you tried to take them off to give them back if you didnt want to buy them they refused to take them back. We basically were all forced into buying at least one thing, them clearly taking advantage.
The next morning we were out on the park in time for sun rise which was beautiful. We saw more of the same animals, and after about an hour or so headed back so that we could leave early enough to make it to nairobi by night fall.
The safari was definitely an incredible experience, one of a kind, but I am glad to be back in Malindi and back at the hospital.

Week 2 Day 2

Today I spent the majority of the day in the OR. I first was able to observe a tonsilectomy and adenoid removal on a nine year old girl. She walked herself into the OR, was picked up and placed on the operating table after she shook all of our hands, began to bawl, and was then sedated. It was a hard surgery to see because the ENT was using a scope and head lamp, but he explained to us the anatomy of the mouth and throat. I then saw a cesarean section which was one of the most traumatizing experiences I have encountered here. As the mother was cut open, green and brown fluid oozed out of her opening, a bad sign, which prompted the doctor to shove his hands into her uterus to pull out the child. The baby was a pale grey, not crying, had a smushed head, limp legs, and feet bent backwards. This site alone was terrifying but the fact that they took their time attempting to resuscitate the baby was even more mind boggling. The doctor carried the baby into another OR, which was currently being used for the ENT surgery, placed the baby on a blanket on top of a metal table and placed a hand oxygen pump around its mouth. The nurse would shake poke and prod the baby but it still did not respond. Then they used suction to clear his airways which final managed to muster faint sounds. They had saved the baby, but the legs still looked immobile and the head was still crushed and I imagine the baby's vitals and future would not be top notch.
To continue the trauma, as I walked into the womans ward, doctors were wrapping one of the patients  in sheets, like a mummy. She had been brought in ten minutes earlier due to a motorcycle accident. She was now dead. They placed a metal box over the stretcher and wheeled her outside to the hospital cemetery, her family following close behind. They were very unemotional, I saw only one out of 8 of the family members crying., the rest were silent.
Death is obviously a part of health care that comes frequently enough but I am sure that it will always be as unsettling as before.
Tomorrow we leave for safari, we are going to nairobi and then to masa mara and will return monday night. I am so happy that I will have a chance to see this and I will share everything with you all when I return!

week 2

Today nothing too special was going on at the hospital so I spent the day rotating around clinics trying to get a taste of things I hadn't seen before. I started in OBS/Gyne, but the consultant never showed up to do rounds. I then headed to optometry where I was able to observe cataracts, lumps caused by diabetes, ulcers, and inflammation in the eye. One patient came in who had been chopping wood and got a splinter in her eye. Her eye was red and swollen and it looked so painful. After that, I stopped by the surgery theater and got to observe a prostatectomy on a cancer patient which was very interesting. A slow day at the hospital, but I learned some things nonetheless.