My last day in Peds was a great one. An English doctor who had been volunteering at the hospital for more than ten years came in for rounds. Not only was he extremely intelligent, but he totally change the ambience of the ward, making the interns and doctors more alert, responsive, and involved. We redid the rounds of all of the same patients with the same cases and the doctor changed some of the treatments, rediagnosed some, and discharged others who, with the very high possibility of cross infection, were much safer going home. He was so knowledgeable about everything, including Kenyan culture (he was fluent in Swahili) which made it much more interesting.
In Kenya, a common practice in villages is an uvulectomy, for the uvula is thought to be the root of many diseases. In many of these cases, a string will simply be tied around it and then it will be yanked, pulling the uvula out. Of course none of this is done sterilely, so infection is extremely common.
Another issue is that in Kenya, the patient is unable to leave the ward unless they are able to pay their bill. So, even after they are cured and healthy, they continue to sit in circulating germs and infection, likely to get sick again. The patient pays for the bed per night, and with that receives free drugs and food. After the patient is healed, they no longer have to pay for the bed, so they are being fed (an extra cost to the hospital) just because they have no means to pay for their stay.
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