I have a new and exciting career in the Theater…which is actually the OR. Since there is no Emergency Department (or Causality as it is known) at St. Camillus Mission Hospital, I have been assigned to the Theater and the Out Patient Department (OPD). The whole hospital has 135 inpatient beds with a Peds ward, surgical ward, maternity ward, and a medical ward. There is an ART (antiretroviral treatment) clinic, a TB clinic, and a MCH (maternal child health) clinic. The OPD is where the patients are triaged by Clinical Officers which are like PA’s or NP’s as well as where wound care and small procedures are done. I have been learning about cockers, sutures, anatomical forceps, anesthesia – yes, the nurses are the anesthesiologists, and the list goes on. I am definitely going with the flow and taking it all in!
Sterility is definitely a relative term: there are ants and other critters crawling around the hospital. There is not strict counting of instruments or gauze during a surgical procedure - but they haven’t left anything in a person, yet. The nurses who do the anesthesia have no formal training (one has a lot of experience – thank goodness). There is one monitor in the hospital which is in theater – the patients are monitored during surgery but there are a limited number of EKG stickers so sometimes they just use the pulse ox and BP. Charting is sometimes optional.
The nurses clean the theater, something they call dump dusting. We scrub the instruments, pack them in a drape, put them in these metal drums, and then put them in the autoclave. We empty the trash and get the laundry. We fold gauze for the whole hospital. The gauze comes in these big rolls, sheets are cut; then we fold them in 3 different ways - ones for OPD, maternity, & theater. I will never look at a 2x2 the same way again - I am going to have Methloquine induced vivid dreams about folding gauze. I definitely have a whole new perspective – I thought life was tough as an ED nurse!
The first case where I scrubbed in was for a 9 year old boy with an appendicitis – my preceptor Becky told me I wasn’t bad for my first time. I was drenched in sweat by the end of it – the sterile gowns are cloth so they can be washed & refused (& put in the autoclave), you wear a big plastic apron under the gown so you don’t get blood on yourself and these white wellies (boots) that can be washed. It’s a sweat fest. But the surgery went well so that is all that matters.
In the OPD, I assist with wound and burn care, remove sutures, and give injections to inpatients and outpatients. It is somewhat similar to an urgent care center but mostly the wounds and burns are much worse. The patients tend to wait before coming to the hospital and use traditional herbs first and western medicine as a last resort. Just yesterday I observed several people at the entrance of the hospital trying to convince a man to get out of the backseat of a car and come inside the hospital to see the doctor. It’s quite a contrast to think of how people at home would call an ambulance for a sprained ankle.
Currently there are 6 babies in the Peds ward with severe burns. Most houses are one or two rooms so there are open flames where babies and children play. Their mother’s bring them to the dressing room in OPD and it’s heart breaking to witness because the babies are not always pre-medicated. I keep suggesting and asking about pain medicine but I am still the new mazungu on the block. I hope and pray that I will have more influence as time passes, and I think I will because everything happens pole pole (slowly in Swahili).
Here are a few interesting differences:
• A nurse is called a sister (I am not sure if a male nurse is called a brother – I don’t think so).
• The nurse manager is called the Matron.
• A unit is a ward.
• There are RTAs (road traffic accident) instead of MVCs (motor vehicle collision) which is more inclusive of donkeys, bicycles and other various modes of transportation.
I also want to wish my sister Alyssa a very happy 31st birthday! And a Happy Halloween to everyone!
Thursday, October 29, 2009
Saturday, October 17, 2009
First Impressions
I have arrived in Africa safe and sound! Sorry for the delay in posting…I am already getting accustomed to “African time” – just add an hour or a week in this case. The safari (journey) from Nairobi to Karungu was an amazing introduction to such a beautiful country and the realities of Kenyan life.
The two other CMMB volunteers (Kayla has a degree in public health and Jimmy just finished his residency in family practice) and I arrived in Kenya on the night of October 3rd. Boniface, the driver from St. Camillus, was there to meet us with a big smile. We spent the night at the Camillian Seminary. The next morning we went to mass at Our Lady Queen Church in the neighborhood of Karen which is named after Karen Blixen, the author of Out of Africa. Karen is an affluent part of the city with beautiful large homes. There was even a mazungu women (white person) out for a morning jog. The mass had beautiful singing and women danced in the aisle, it was a great way to start my first day in Kenya.
Then we set out on the open roads of Kenya which were paved for the first six hours and then became dirt for the remaining two hours. We passed through these little towns which were full of people, goats, cows, and chickens in the street. These “towns” consisted of a few rows of shops selling Coca Cola and cell phone minute cards. Several women had a baby strapped to their back and a bucket of water or a basin balancing on their head. Masai were herding cattle through the country side. A traffic jam consisted of waiting for a herd of cattle to pass while young boys with machetes moved them along. There was the most beautiful landscapes imaginable. We stopped at an overlook of the rift valley which was quite Lion King-esck .
We stopped in Narko for lunch to “take something” which means to eat something. My first taste of Kenyan cuisine was quite yummy, I had chicken and sukuma wiki (a green veggie like kale). Oh, and a light coke, yes, there is DC in Kenya – sweet! Yet most Kenyan homes to not have running water so it is easier to get a coke, if you have the money, versus clean water.
Our next stop was in a town called Kisii where we stopped at a big store, kind of like an African Kmart, where I got a cell phone. My phone number is 0714 795 305, just to let you know, in case you are in the area. But texting is actually prettying inexpensive so email me your cell phone numbers, please! So after our shopping experience it started to torrential down pour. Boniface told us it was very good of us to bring the rain – I thought it was the least we could do.
We arrived in Karungu just after the most beautiful sunset. We met Father Mario (the hospital administrator), some Italian volunteers, and the two American CMMB volunteers. It was quite exciting to meet Lauren, the women behind the blog - it is a must read (www.laurenmeisman.blogspot.com) as well as Christy who is also a nurse. Kayla and I settled into our house in staff quarters which is quite nice (I plan on posting pictures in the near future). I tucked myself in under my mosquito net and thanked God for one of the most amazing days I have spent on this earth.
The two other CMMB volunteers (Kayla has a degree in public health and Jimmy just finished his residency in family practice) and I arrived in Kenya on the night of October 3rd. Boniface, the driver from St. Camillus, was there to meet us with a big smile. We spent the night at the Camillian Seminary. The next morning we went to mass at Our Lady Queen Church in the neighborhood of Karen which is named after Karen Blixen, the author of Out of Africa. Karen is an affluent part of the city with beautiful large homes. There was even a mazungu women (white person) out for a morning jog. The mass had beautiful singing and women danced in the aisle, it was a great way to start my first day in Kenya.
Then we set out on the open roads of Kenya which were paved for the first six hours and then became dirt for the remaining two hours. We passed through these little towns which were full of people, goats, cows, and chickens in the street. These “towns” consisted of a few rows of shops selling Coca Cola and cell phone minute cards. Several women had a baby strapped to their back and a bucket of water or a basin balancing on their head. Masai were herding cattle through the country side. A traffic jam consisted of waiting for a herd of cattle to pass while young boys with machetes moved them along. There was the most beautiful landscapes imaginable. We stopped at an overlook of the rift valley which was quite Lion King-esck .
We stopped in Narko for lunch to “take something” which means to eat something. My first taste of Kenyan cuisine was quite yummy, I had chicken and sukuma wiki (a green veggie like kale). Oh, and a light coke, yes, there is DC in Kenya – sweet! Yet most Kenyan homes to not have running water so it is easier to get a coke, if you have the money, versus clean water.
Our next stop was in a town called Kisii where we stopped at a big store, kind of like an African Kmart, where I got a cell phone. My phone number is 0714 795 305, just to let you know, in case you are in the area. But texting is actually prettying inexpensive so email me your cell phone numbers, please! So after our shopping experience it started to torrential down pour. Boniface told us it was very good of us to bring the rain – I thought it was the least we could do.
We arrived in Karungu just after the most beautiful sunset. We met Father Mario (the hospital administrator), some Italian volunteers, and the two American CMMB volunteers. It was quite exciting to meet Lauren, the women behind the blog - it is a must read (www.laurenmeisman.blogspot.com) as well as Christy who is also a nurse. Kayla and I settled into our house in staff quarters which is quite nice (I plan on posting pictures in the near future). I tucked myself in under my mosquito net and thanked God for one of the most amazing days I have spent on this earth.
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