Friday 25 May 2012

So here we are at the end of another working week... It's all passing pretty quickly and I'm sure it'll only keep going faster from now on! Still having a really good time, three American girls arrived at the end of last week, who are staying with us and also working at the hospital, so it's been really nice having a wee group of five of us to explore and have fun.. they're really lovely girls so we've all been having a great time together, and we've got a night out or two planned for this weekend which is really exciting, I can't wait to get out and do some dancing! :)

So this week at the hospital has been really interesting and quite different to last week... I've still been in paediatrics a fair amount but we've also branched out a little more... So towards the start of the week we did some ward rounds on the male and female adult wards, where we saw a lot of problems, most of which were completely different to what we've been seeing on paeds. A surprising load of TB is a bit worrying, especially when there are no indications of any attempts to isolate anyone from anyone else. There was also a lot of cardiac and respiratory disease, a guy in a coma, some thyroid problems, diabetics and some really crazy surgical cases too. We also spent some time in A&E, where we saw some pretty scary stuff... One wee boy had been bitten on his upper lip by a venomous snake, and after his mouth had swollen hugely, it spread over his entire face and started blocking all his airways. It was really scary to see, and all just progressed so quickly. Everyone was really worried because, whilst snake bites usually occur around the ankles and lower legs so that the venom takes a while to move up towards the brain, that this wee boy's bite was on his face meant that likelihood of brain damage if not death was massively increased. In the end he was transferred to a bigger hospital in Mombasa; I haven't been able to find out what happened to him, but none of the staff seemed very optimistic at all.

Another guy made a really dramatic entrance with a massive entourage in tow - he had been in some kind of accident, and had some really severe injuries to both his arms, as well as lots of lacerations over his face and trunk. He was in a massive load of pain, and was an Italian - he was so happy to see us as he thought we were Italians too, and it was really sad when he found out we weren't... In a moment as scary as that it would be so reassuring to see a face from home and someone who speaks your language. It was pretty chaotic when he arrived, and his screams were just the most terrible ones ever - he was in an awful lot of pain. Another interesting one was a twenty-something, fit-looking guy who came in with his 3 friends with acute psychosis... It was quite scary - his eyes were bulging and his mouth was foaming, and he was really struggling; it took all 3 of his friends all their strength to restrain him, it was getting seriously violent but thankfully they managed to pin him to a bed so that a doctor could inject a really powerful sedative just in time to knock him out. Apparently it had never happened to him before, and more or less just started out of the blue, which must have been a shock for his friends at the time. The doctor suspected acute onset cerebral malaria, which would make a lot of sense... after he'd been sedated they sent off lots of blood for testing and hopefully he's doing much better now.

But as well as crazy accidents it's also been a week full of babies!! As well as spending a morning in the mother and child, antenatal and immunisation clinics, we've seen two beautiful healthy babies delivered which was just the most amazing thing ever. There are no routine ultrasounds done in pregnancy here, which seems very strange especially as there is a machine available. Everything is done by poking and prodding, which means that, quite often, there is some complication... most babies here seem to be born with their cord around their neck, which is just such a needless risk in so many cases. Anyway, seeing those little babies born was just incredible. The first baby was 5.1kg which is just ridiculously massive, especially to give birth to naturally. The mother was so calm and strong throughout though, I couldn't believe it! The other mother was much younger, having her first baby, and really really scared. To make matters worse, the labour room was really busy that day and, ridiculous as it sounds, there wasn't a bed for her. She was literally pacing up and down, leaning on the wall, screaming and crying and bent over double, and I seriously feared that I might have to jump to the floor and catch the baby, she was that close to giving birth. At one stage she had all her weight on me as I supported her, and it was just beyond belief that there was no bed to help her to. Finally one became free for her and after that the birth was pretty quick... as soon as it was over she was thanking God that she was still alive, and the smile on her face showed just how relieved she was for it all to be over. I got to be the one to tell her family outside that she and the baby were both fine and healthy, and I went back to visit her the next day on the ward to see how she was getting on... She gave me a massive big cuddle and introduced me properly to her beautiful baby daughter, and the two went home happy and healthy that afternoon. It was really such a lovely thing to be a part of.

Some of the other mothers, however, haven't been so lucky. One woman with a breech presentation waited for hours for an emergency c-section which never happened, so she eventually had a natural birth as she just couldn't wait any longer. We've been scrubbed up in surgery seeing some other emergency c-sections though, which have been really interesting to watch; there have been a few scarier moments when complications arose, but thank goodness the mothers and babies were fine in the end. We also saw surgery this morning on a woman who had a c-section 5 days ago, but whose stitches all burst open so that her small intestine was literally hanging outside of her abdomen. That was also unpleasant to see but the surgeons did a good job of cleaning out the infection before re-stitching through each layer right out to the skin. The bowel had haemorrhaged though, and did not look healthy to us, so I worry about that and imagine that some severe adhesions are a serious risk for that patient. I'll go back to check up on her on Monday.

All in all though, a pretty eventful week!! I'm still really loving it out here, and we've had some really fun times with all the girls! And I'm really excited about the weekend, I feel we've all earned a good rest... Sunday on the beach last week was definitely a good shout, so I think we'll be heading there again, as well as hopefully getting some shopping done at the market tomorrow and try out this Italian restaurant we've spotted by the beach... Although we've had some really yummy stuff out here, one thing we've all been having little pangs for recently is food from home! So that's pretty exciting. And the plan is to go for a bit of a night out afterwards so that will definitely be interesting and a lot of fun!!

I'd best be off now however as I think we're going to head down to the children's home nearby for a bit to play some games and football! Oh my me playing football this will be a sight to be seen indeed... sos!

With lots of love and hugs from Kenya!! :) xxx

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