Hopping Hospital

I have been in Gidel at the Mother of Mercy Hospital for about 3 weeks now. It's probably about time I gave some information about the hospital. There are 4 wards (children, male, female, and maternity) which all together have about 160 beds. There are another 10 beds or so in TB village. The occupancy of the hospital is almost always around 90%. Staff wise there is only one doctor (Dr. Tom), one nurse anesthetist, and only 2 nurses for the entire hospital.  Dr. Tom is the surgeon, internalist, obstetrician, gynecologist, orthopedist, and any other specialist you can think of. There are nursing assistants, but in general everyone is overworked. On non-operating days Dr. Tom and I round on all the patients in the hospital which usually takes 4-5 hours straight...if we're lucky.  The planned operating days are Wednesdays and Fridays with at least 6- 8 cases each day. For most cases I function as both the scrub nurse and the first assisant.
                                 

In addition to all of the inpatient work, there is an OPD (outpatient department). People are bussed in from all over or walk days to sit and wait hours upon hours to see one of the four clinical officers; there are even times they have to wait until the next day.  The clinical officers see about 200 people a day.  After all the inpatients are seen, Dr. Tom and I head to the OPD to assist in seeing patients.  Dr. Tom's perseverance is absolutely astounding.  I'm starting to get the hang of things, but still have a long way to go.  Right now my main focus is learning everything about the operating theater because the person that is currently running it leaves in January to finish high school.

I have already seen a ridiculous amount of pathology here...the largest tumors and abscesses imaginable: goiters the size of honeydew melons and abscesses that drain a liter of pus. We removed an ovarian tumor on an 18 year old girl that looked like she was 9 months pregnant.

    

It is astonishing how many people are able to have surgery and medical treatments with the limited resources

we have. The only diagnostic tool  is an ultrasound machine; the gel is precious and we often use pens to scrap at the last drops.  The only monitoring for patients in the operating theater is a pulse oximeter and taking manual blood pressures. The laboratory tests include CBC, UA, blood sugars, stool cultures, pregnancy, and malaria. Any biopsies taken are sent to Nairobi for evaluation. Dr. Tom's physical examination skills are top notch because that's ultimately the only reliable tool he has. It's all tactile fremitus  here! I know I will learn a lot from him...I already have in a short period of time. 

    

Kenyan Weekend

I spent the last weekend in Kenya before heading off to Sudan. The majority of the time I was just resting & relaxing in the Diocese of El Obeid in Nairobi. The time change (8hrs ahead) began taking a toll. The area around the diocese is beautiful, as is the diocese compound itself. My neighbor was an 86 yr old Italian priest who kept trying to make me eat bread sticks.  He thought I just didn't like the large bread sticks and insisted that maybe the smaller diameter bread sticks would be more appealing to me. Clearly my efforts of explaining glutardation were not fully comprehended. After 3 nights in Nairobi I traveled to Lokichoggio in Northern Kenya. I stayed at a small "camp." Loki was quite different from Nairobi and definitely made me feel like I was getting closer to my remote destination.

I came to the realization in Loki that living in Africa I will need to get over my entomophobia. Back home in the states I have been known to run away from bees and hop onto a chair if I see a cockroach. In Africa, all of the insects seem to be on steroids.  I spent the better half of the afternoon in Loki trying to get a hummingbird size "bee" out of the cabin. In addition to being bombarded by insects, I also had a rodent friend in the middle of the night. I heard some animal crawl into my window and scrape down my curtains around 2:30AM.  I then saw it scamper behind a bureau.  I stayed up the rest of the night under my mosquito net with my flashlight pointed in the direction of every noise it made. To top it off, I decided to make my own animal noises to scare the animal from coming near me.  That should be a nice visual for everyone- me wide awake under a mosquito net with white knuckles, holding a flashlight, imitating the sounds I would expect a larger rodent to make.  I found out the next morning it was an "African rat." I think that living in Africa for a year should be considered the ultimate immersion therapy for all my phobias.

Pictures will come as soon as my last bags arrive with my USB cord!

Departure Day

Today I am leaving for Africa. I'm bringing with me about 50lbs of medical supplies and leaving behind a ton of familiarity. I guess I have the same feelings that anyone would have when they are about to begin a new adventure, but mostly I am excited and eager to get there. I'm leaving five days after one of my best friends just got engaged, knowing that I will most likely miss the wedding. I'm also leaving on the exact day my nephew turns five months old, knowing that I will definitely miss a lot of his firsts. I can't dwell on all the life events of my friends and family that I will be absent from this year, because it's depressing. What I can do is look forward to sharing all these experiences when I return. Who knows what Sudan has in store for me, but I know I will definitely have my own stories to share.  We'll all just have to become better storytellers.