Tuesday, 28 August 2012

Words Cannot Even Describe-August 24-25th, 2012

Today was our last days of being in Mombasa. We spent the day taking in the whole being in Africa feeling. We had to go out with a bang and have one last meal at Cafe Mocha where we pretty much ate almost every day. On Saturday, we all had to pack our bags and hoped that they weren't going to be over weight. Then came the worse part, saying good-bye. I had such a bittersweet feeling, I was excited to be going home, but then very sad that our trip was over. I never thought that being with a group of people for only 3 short weeks you would get to know them as we all did. To Joel our British friend, I don't even know where to start. Joel taught us everything, if it weren't for him I would have never learned or got the hands on experience that I did. I would have doubted myself and would have never even tried. He even let me practice putting an IV in on him. It was my first time, he had more faith in me than I had in myself, and to my surprise, I got it in on the first try. He also gave us a reason to try out our British accents, to compare differences in name of things, and for him to make fun of our "accents".

I learned more in 3 weeks here than I could have ever imagined. Their culture is much different than ours, which I think was one thing that took the most to get used to. One thing is their emotions toward death and life don't have much difference like they do for us. As I mentioned in a few of my previous blogs I saw 2 stillborn births and after each of the babies were born, the deaths didn't even phase the mothers. I am not completely sure if that was because they are just acustomed to the kinds of hardships because their whole lifes have been hard or because they just don't show their emotion. Another is that when the mothers give birth to their babies, the fathers are not present. They give birth all alone with no epidurals or any pain medications to sooth the pain. They are the toughest women I have ever seen.
I have never been to a place before where the people are so friendly and amused by bluntly speaking whites. Everywhere you walk people are always looking at you, saying "Jambo!" and asking "How are you?" They also tend to be very friendly by whistling or yelling. Also when approaching the orphanages the children were always so eager to grab your hands and take pictures with you. The children always had a bright outlook regardless of what they have been through.
As for the hospitals, I can't even explain how "rundown" I feel it is. They have the minimal amount of supplies and somethings don't even exist like an MRI machine. The patients don't recieve the best quality care that they should and many things are not very sterile. This was another aspect that I couldn't get used to because we are so used to the clean, sterile hospitals here at home.

After a long 30 or so hours on an airplane and in airports, I have made it home. I couldn't believe it that we were back in the US and I cried seeing my parents and boyfriend. This trip was an experience of a lifetime. It made me really realize how much we take for granted living in the US and bottomline how much I take for granted. After taking a cold shower everyday, handwashing clothes, brushing my teeth with bottled water, eating potatoes, rice and pasta everyday and not having clean water, I have realized that the little things we have matter and to not take them for granted because literally somewhere in the world, someone has it worse off.

No words can explain the things I seen and the things I experienced here in Africa. I will treasure these memories for the rest of my life and hope that I can experience something like this again. I never thought that I would have ever made it to somewhere like Africa. I owe a huge thank you to my wonderful, loving, caring and supportive parents for making this dream come true. I would have never got here without them and their support. Thanks to everyone for reading my blog, I hope that it gave you a little perspective on what I saw and learned. I enjoyed sharing it with you! Also to see pictures of the trip please go to my facebook page.

Friday, 24 August 2012

Once last time-August 23rd, 2012

Today I decided to head to minor theater once I arrived at the hospital. Once there, not much was going on but shortly there were many people who needed to be seen. The first patient that we seen was there to get a suprapubic catheter change. A suprapubic catheter is one that is placed through the pelvis into the bladder instead up through the urethra. I have never got the chance to change a catheter so I just stood by and learned how because even after yesterday I didn’t feel very comfortable doing it. On the end of the catheter tube there is a branch, one tube end goes to the catheter bag and the other is capped off. You have to first take a syringe and drain the tube that is capped off. Once there is no more saline coming out, the catheter is able to just be pulled out.  The new catheter is prepared by adding a little lube and inserting it back into the hole. You know that it is far enough in once the tube starts slipping out again. You then take about 10 mL of saline and enter it into the capped end of the catheter. Once that is inserted, the urine bag is added to the other open end of the catheter and the patient is all done. Shortly after the catheter, we had another man come in that needed a catheter change, but this one was a little more complicated because where the catheter entered the pelvis, there were stitches. In order to change it the stitches had to be removed and the same procedure was followed. While this was going on, I and another student helped a man get a dressing changed after he had hit his finger on a fan. The man had a slight fracture on his right index finger, but had a big wound. The wound had to be cleaned and dressed. Once the wound is completely healed, which will take a while, the man will have to go see an orthopedic surgeon and find out what they will do about the fracture.  We then got a man that came in on a gurney who had been in a motorcycle accident. He had broken his femur, got his pinky cut almost off, his lip was cut open and his eye was swollen shut. When he arrived his lip was already sutured and his face was ok, so the doctors had to first start by using Lidocaine to numb the finger and then they started to cut rest of the finger tip off, since it was just hanging on by a little piece of skin. Once they had cut the skin the blood started to squirt (just like in a movie), I literally had to jump back to not be in the line of fire. I missed being squirted by the blood, thankfully. Once the blood was stopped, the doctors had to suture the wound up. They then had to move onto the leg where the bone had poked through the skin. After this excitement, an young boy had come in with a cut on his toe. He had dislocated his toe playing football (known as soccer to us) and he has a small cut underneath. We were just able to clean it and dress it until he was able to see an orthopedic surgeon about a plan on fixing his toe. The last patient we saw in minor was a middle-aged man who had a huge lump between his neck and his shoulder. We used a syringe to see what was inside. Once we put the syringe in and pulled some fluid out, we confirmed that it was puss. The next plan of action was to make an incision and drain out the whole lump. The doctor that was to perform this surgery was called over to casuality. At first, we did not really know what was going on so we just waited. Another one of the students that had been over there came and proceeded to tell us that there was a women who had been attacked in a massacre.
Last night when I had spoke to my parents on Skype, my mom had mentioned that there was a massacre that had happen about 200km away from Mombasa and if we had heard anything about it. I said that we didn’t and that we hadn’t had any patients from their either. Well today right before we were leaving we had heard about the woman who was attacked in the massacre the morning before. Her whole family had been killed and someone had luckily found her. The massacre happened in retaliation from another attack. Two different tribes have been fighting over pasture and swamp land. Women and children were unfortunately the major target, 48 total were killed 31 of them being women and 11 being children. When I first approached the women that had been attacked I didn’t really know what to expect, but I felt like I was hit with a train. Her face and arm were mutilated, with what I believe was a machete or something similar. She had a huge gash in her right cheek, so deep that her teeth had started to come out of the wound and her mouth was leaning to the left. She had a huge gash on her head that was accompanied by a huge lump. I wasn’t able to see what had happened to her arm at first until the doctors had removed the wrap. Once exposed, her arm was cut so deep that her hand been only hanging on slightly. You could see the ends of her arm bones and part of her wrist bones. The doctors had said that she only has about a 20% chance of keeping her hand. Once I had seen it, I met up with a couple other students because it was time for us to leave. I left the hospital today feeling like I did not help enough people and felt terrible. I was really torn up after seeing the woman who had been attacked and knowing that there was a ton more patients that needed to be seen.

Once we left, we decided to grab some lunch and then we headed back to Old Town. We spent about two and half hours shopping and finishing our last minute souvenir shopping. I feel like I spent a lot of money, but in reality it was reasonable. We spent rest of the night hanging out and celebrating being in Kenya for the last time before we have to head home.

Inked!-August 22nd, 2012

Today we arrived at the hospital and I went to minor theater. When we arrived nothing was going on, but we were going to wait it out since it normally didn't start getting busy until around 9 am. A while later our first patient came in who needed a suprapubic catheter change. A suprapubic catheter is one that is placed through the pelvis into the bladder instead up through the urethra. I have never got the chance to change a catheter so I just observed. On the end of the catheter tube there is a branch, one tube end goes to the catheter bag and the other is capped off. You have to first take a syringe and drain the tube that is capped off. Once there is no more saline coming out, the catheter is able to just be pulled out. The new catheter is prepared by adding a little lube and inserting it back into the hole. You know that it is far enough in once the tube starts slipping out again. You then take about 10 mL of saline and enter it into the capped end of the catheter. Once that is inserted, the urine bag is added to the other open end of the catheter and the patient is all done. Our next two patients that came in were a young man and woman who had been in an accident. They weren't terribly hurt, but the woman had skin lesions on her foot, hand, knee and thigh. Another student and I had to clean the wounds and dress them. Once the woman was finished, the man came in and he only had a skin lesion on his knee. We again had to clean and dress the wound. Shortly after they left another patient came in. He was older, but was being escorted by about 6 guards with guns. He was obviously from the prision ward. The man had a quarter sized lump on the left side of his skull. The doctors examined him and confrimed that it was a cyst. They had to use Lidocaine to numb the area. Once it was numb, the doctor made an incision until the cyst was reached. White and yellow pus started coming out and they pushed around the incision to insure all of the pus got out. They then had to clean the wound, suture it up and dress it. The last patient we saw today was a man who had come in after he had been cut by an iron sheet, while roofing. The cut got infected and had eaten away almost the entire surface of the top of his foot and had had another big hole on the side of his ankle. He had to get them both debrided so the old, dead tissue could be removed and to promote the new tissue to heal. Before he was finished up another student and I left to go get a tattoo. A henna tattoo that is. A group of the girls her had talked to one of the doctors we had been working with in minor since we arrived here. She is from India and their religious culture includes having henna tattoos, so the girls had asked her where we could get some and she helped us get in contact with her aunt. We all got one on our hand and on our foot. They turned out really cool and I am happy I decided to get one, since they do only last a couple weeks.

Once we returned back to the compound we relaxed and ate some lunch. Shortly after four of us decided to go to the beach on last time before we left. Once we got there me and another girl decided to ride a camel! It was a lot of fun and worth the experience. We then layed on the beach to get a tan. While laying there a guy had somehow fell on my face. I was shocked and say the least a little mad because my face was now hurting. He repeatedly said sorry and that he was exercising. After he walked away I kind of laughed because I don't know how anyone exercising could not see four people laying there on the beach. But I only walked away with a small bruise and a little cut, so it  didn't turn out as bad as I thought. Once home, we got to relax for the night.

Wednesday, 22 August 2012

Lazy!-August 21st, 2012

Today we returned to the hospital. I didn't make it there until about 9:30am, but I instantly went up to major theater to see what the procedures were today. The first one I was was a little baby who had hydrospadius, which is where the urethra hole on the penis is in the wrong spot. The hole was on the underside and was farther down than normal. The surgeons opened up the head and and to move the urethra into place and stitch the tissue around it back so that it would heal normally. They also did a circumcision, which I am not sure if is normal in Africa or not. When they finished they sutured the incisions back up and dressed the wound. They had to leave a small tube in the urethra to allow urine out without disturbing the wound. After finishing with this surgery not much was going on and it was already 11 am. We decided to make our way to minor theater.

Once we arrived in minor they didn't have much going on either, but I was able to clean a huge wound that a man had got from a road accident. His hand was severely swollen, so I cleaned it and had Omar take a look. He said that we needed to test the feeling in his hand so we took a needle and poked in different places on the hand. He was luckily able to feel everything, but he couldn't move his hand. We had to redress the wound and send him off to a doctor to get his hand looked at since he had loss muscle control. Shortly after he left, another man came in and needed a stitch removed. I got to remove his stitch, which wasn't hard. The wound was all healed up and he only had one stitch left so I cut it out and he didn't even need to be bandaged up. We saw another patient who had two huge wounds on his foot. He had gotten a cut from a iron sheet and it had gotten infected. It was a terrible wound and one of the other students had to clean it and debride it to get rid of all the dead tissue. Right before we left the hospital, there was a woman that had fainted and we had to go help her get to casuality. One of the ladies that was with her informed us that she has been having episodes where she faints, fights and then comes out of it about ten minutes later. She needed to get a CT to see if anything in the brain was causing it, but we had to get her checked out first from fainting. On our way to find a wheelchair for her I came across a gurny that had a body on it covered by a sheet. I knew instantly that the person was dead. It was distrubing, but I had to move on becasue here that was normal.

At about 1230pm we left the hospital and came back to the compound for lunch. We have been relaxing, reading and swimming. Another group decided to go to the beach, but I honestly was too lazy to walk there so I opted to stay here and update my blog. Later in the night we went to the city mall, which was very nice. When we were inside it didn't even feel like we were in Africa. We then ate some dinner and dessert at Cafesserie and went shopping at the Nakumatt.

Tuesday, 21 August 2012

The Beauty of Nature-August 16th-20th, 2012

Today (August 16th) was the day we left to make a long journey to Masai Mara, where we would go on a real African safari! We had to take our vans to the bus stop where they dropped us off and we loaded a coach bus. It was really nice, just like one back home, and it had air conditioning! Once aboard the bus we started driving and let's just say at first we were all a little scared because the road was nicer than we expected, but it wasn't completely level. So this caused the bus to lean quite a bit to each side. Along the way we made several stops to pick people up and to drop others off. We made one stop to get lunch, but with how my stomach has been I didn't chance it by getting anything. We started again and after about an 8-9 hours bus ride we finally made it to Nairobi's bus station. Nairobi is the capital of Kenya. We boarded these other vans and were taken to the "hotel" where we would be staying for the night. I was very impressed with how developed Nairobi was compared to Mombasa, it was like we were in a whole new world being there. Once we got to our "hotel" we were all a little shocked to find that it was like a camp instead. They had separate buildings with many bunk beds in them. They at least had showers with hot water and flushing toilets. We all got to our rooms, settled in and freshened up. By then it was probably around 6:30 pm and we were all starving. We decided to go to this Italian restaurant that was suppose to be really good. At the restaurant they served us a lot of buns and brochette. We all ordered and received our food. I got this tortilini pasta that was stuffed with a cheese and spinach mix topped with a creamy mushroom sauce. There wasn't much to the meal for how expensive it was, but with all the buns and everything we were all stuffed by the time we left. After we got back I wasn't feeling very good so I decided to lay down, rest and read a book.

The next morning (August 17th) we had to be up bright and early at 7 am. Our safari vans got there and we all loaded up. We drove to Masai Mara, which we originally thought was only 2 hours away, little did we know it was a lot longer. We drove for about 4 hours before reaching a place where we ate lunch, the infamous rice and noodles as always. Along the way we also got to see the Great Rift Valley, which was HUGE, but it was beautiful. We boarded the vans again and proceeded to make our way closer to Masai Mara. Soliman, our driver, informed us that the road head was going to be not so pleasant. He was right, we were bouncing up, down, left and right. I lost count on how many times I either hit my head or something else. We had to drive on this road for about 2 hours before we reached our camp. We stayed in these tents that contained 2-4 beds in each and the tent was then connected to a small concrete building that contained a toilet and shower. Once we dropped our stuff off we had a cup of Kenyan tea and we were off to our first look at the safari life. Our camp was very close to the entrance to Masai Mara. We started our safari and right off the bat we seen a ton of animals! We saw zebras, wildebeests, gazelles, vultures, giraffes, elephants, lions and African Buffalo's. After about 2 hours on the safari we returned to the camp and were served a wonderful dinner! I hadn't had that good of food in a long time since being here! We then lounged in our rooms and me and the 2 other girls I stayed with all read books until ten when the electricity goes out. We only get electricity in the morning from 5:30 to 7am and at night from 6:30 to 10pm. It was a bit inconvenient, but it made us go to bed early.

The next morning (August 18th) we woke up and again had an amazing breakfast. We then went on safari all day! It seemed like a long time, but the time went by pretty fast. We saw many of the same animals, but we saw a cheetah, a rino, hippos, crocs, hyenas, wort hogs and ostriches. The only thing we missed was a leopard, but they said those are really hard to find along with the rinos, but we were lucky and saw one. We had a picnic lunch in the grass under some trees and then proceeded on the safari. We saw a lot more animals and then made it back to camp. We all decided that we wanted to see this village not far of the Masai people. We had to pay to go, but the money goes to helping them, so it wasn't that big of a deal. I was shocked to see the village, it was a big circle of mud/ wood houses. The ground was covered by dirt and animal poop. We learned that the women do the cooking, cleaning and building of the houses. The houses last for 9 years and then they have to move because they get infested with termites and the wood starts to give way. The houses are very tiny and they normally have about 7 people that live in it. There is a room for the parents, a "living room", and a children's room. It is also very dark because they only have these small holes in the sides for windows. The men are responsible for keeping the village safe. When a lion enters their circle they have to kill it and the one to kill it keeps the skin and wears it. The men pay for their wife's with cows and they have competitions to see who jumps higher. The one to jump higher pays less cows for their wife. If they can pay for more than one, than they are allowed to have multiple wives, but they have to live in separate houses. We then got to see a welcome dance from the men and women and we all got our chance in joining in. They also make their own fires, so they showed us how and they also tattoo themselves with the stick that they heat up. They opened the invitation to us to get tattoos and a handful of people decided to get one. It was just a little circle burn, but it just wasn't for me, so don't worry mom! We all got to look at all the stuff they wanted to sell and each of us walked away with something. We finally made our way back and had another delicious meal. Again tonight we enjoyed reading, with lights out at ten.

The next morning (August 19th) we woke up extra early at 6 am and were on the road shortly after. The van I was in had to pick up an extra person that we were giving a ride back to Nairobi. It was a little awkward, he didn't talk much. We went on safari for another 3 or so hours and we got to see an African sunrise while on safari! Something not a lot of people get to see so I feel pretty privileged to have the opportunity. We then had to go back to camp, pack our stuff, and make our way on the bumpy road again. Before we got on the road we had to pass some game wardens and Soliman told us that we had to tell them that we were only on safari for one night and we stayed at some other camp. He proceeded to tell us that yesterday when we saw the rino, there were a lot of vans on the grass, which is a big no no and you can get a huge fine if you are caught. Well the game wardens had gotten our licence plates, so we had to lie so they would think it wasn't us. Luckily we weren't asked, but another one of our group vans was. We finally made it back to Nairobi and we stayed at the same place as the last time. We had a reservation at this restaurant called Carnivore, similar to Carnival in Sioux Falls, SD. We had an amazing meal, we started by having little pizza bites and corn cobs. We then had a bowl of soup and some salad. Then came the meat! They had a ton of meat and they served it to you on a samurai sword! I tried pork, chicken, beef, turkey, ostrich, croc, but passed on the ox balls. By the time we were done, I was stuffed, but then found out we got a dessert that was included in the price of the meal. I ended up getting the chocolate chip blondie brownie with a scoop of ice cream. It was so delicious! My stomach felt a lot better today, but it took a little while for it to get used to having meat since I haven't had it in over a week. We returned to our hotel, relaxed in the kitchen/bar and then went to bed.

On August 20th, we had to make our journey back to Mombasa. The bus ride seemed to take forever and we ended up not getting back to the compound until about 6pm. We were all hungry, but were disappointed by they choice in dinner. A group of us decided to head to Cafe Mocha to have dinner and use the Internet. I again had pizza :) We had a relaxing night, which was nice since we had to return back to the hospital tomorrow.

Hold My Hand And Things Will Get Better-August 15th, 2012

Today I got to sleep in! It sounds nuts that I am that excited, but normally only on the weekends do we really get to sleep in. Unfortunately, I haven't been feeling the greatest for a couple days so I didn't really feel like doing a whole lot today except sit hunched over (only position that made my stomach not hurt). I managed to get up and get ready to go to the orphanage, since I made it on time to go today :). The small group of us that were going were all ready to go by 10 am, then Issac, our coordinator, informed us that we wouldn't be going until 11:45 am. I was thinking man I wish I knew that before I woke up before 10. We all decided that we wanted to go get some lunch and that if we left soon then we would make it back before we had to go. At about 10:30 or 10:45am we made our way to the market and decided we were going to eat at the usual, Cafe Mocha. Instead, the cafe was closed so we ate at this Italian resturant called Roberto's. They weren't quite all set up by the time we got there so it took them a while to get us seated, our food ordered, and our meals delivered. Let's just say we were a little late getting back to go to the orphanage. When Issac found us he had said that we would wait about another hour before going. This made us all a little more lazy and we didn't want to go, plus my stomach was still upset. When the time came we all got up and walked to the orphanage since this one wasn't that far from where we are staying. When we got close some of the kids saw us coming and greeted us instantly by grabbing our hands. We arrived at the orphanage and I instantly felt my heart sink. The building was all made of mud and wood and had a tin roof. It was kind of dark in there since they don't have lights. Once we got in and sat down the guardians, teachers, and children all welcomed us. The children did skits, sang and danced. We even got our chance at the dancing and singing fun. There was one boy that was in grade 5 that had did a skit by himself that he compared stuff of his to others, but said look at me I'm just fine. It made me sad, but then I realized that all these children have been through so much, but they continue to have a bright outlook and don't for one second sit and feel sorry for themselves. They know that no matter what they have been through, they will be fine and things will get better. We had a lot of fun playing, singing and dancing with the children and before we knew it, it was time for us to leave. The guardians were very thankful and invited us to come back anytime when we were free. Joel, one of the students here from Britian, is organizing a reconstruction project for the orphange, so that they have a better place to stay. From what I understand, the construction will start next week. We made our journey back and all felt good that we went even though some of us didn't want to or didn't feel well.

For rest of the afternoon and night we didn't do much. We relaxed and had to pack our bags since we were leaving for our safari in the morning. I was really looking forward to going and getting a new experience away from the hospital. I just hoped that I would feel better in the morning.

Practice not with sympathy, but with empathy-August 14th, 2012

Today I intended to go to the orphanage, but I thought the group was leaving at 11 am like they had did the previous day. Instead they were leaving at ten, which I wasnt up in time for. So I got up had some breakfast, lounged around and took a swim. At about 130 pm I joined 3 other students and went to the hospital. They had informed me that we were getting a mentor to follow in the maternity ward. I was a little disappointed since I had been in maternity already for 3 days, but I didnt care because I was getting more experience in the hospital. We started out by seeing a woman who was had been in labor since yesterday, but she wasnt fully dilating so they had to keep giving her a drug to induce labor. The drug was administered every 6 hours for up to 24 hours. They told us that the mother was only 28 weeks along and that they couldn't get a fetal heartbeat, so I instantly knew that I was going to witness another stillborn birth. The doctor said that if they couldnt get her to fully dialate and give birth that they would have to prep her for surgery, but they didnt want to do that since it wasnt really necessary. I also learned that a the mother had a disease called eclampsia. It is a rare disease in which the mother has high blood pressure and rapid weight gain. The cause of it are uncertain, but they believe that it may be due to genes, diet, blood vessels or the nervous system. This can be a problem because it cuts off oxygen to the baby, which I am almost 100% sure why this baby didn't make it. Finally after a while the baby started emerging and they got the head out, but once it got to that part the baby got stuck. The nurses were doing everything they could to get the baby out without harming the mother. After about a 2 minute struggle the baby finally was out and the mother was relieved. They next had to remove the placenta, which also took a while to get out, but finally made it way out and everything was done. We then followed the doctor to another patient that was starting to have contractions, but he informed us that she was HIV positive. In these cases, the doctors can not break the water or do anything to help the pregnancy move along. Instead they have to feel that belly to see how the baby is sitting and to see how far the head is in the pelvis. They are also able to use their fingers to see how far along the baby is. This mother was roughly 34-35 weeks along. If they are not able to have the mother give birth naturally, since they can't help her she will have to do a C-section. They said that they have a good rate of not spreading HIV to the baby from the mother. The mother has to recieve a shot right before birth and the baby recieves on right after birth to help insure the disease is not spread.

After finishing in the maternity ward since not much was going on, we made our way to minor theater. There wasn't much going on, but there was one patient in the room that we seen that had a huge mass on her breast. The woman was a 37 year old and the diagnosis was breast cancer, which they were sure had spread to her lymphnodes. The woman was not really all there, she didn't talk and couldn't really comprehend what was going on. We found out that the woman had been treated for malaria 2 weeks previously and ever since then she started not responding. The doctor said that they would get a biopsy to make sure that it was cancerous and to see what to do from there. I don't have a very good feeling about what will happen since the cancer had spread to the lymphnodes.

You could say today was a pretty somber day. I felt pretty emotionally drained because each of the patients we seen today all had a not so good diagnosis. It did make me feel better that when we were with the mother giving birth to the still born, one of the really nice nurses turned to all of our shocked and sad faces and said, "You need to practice not with sympathy, but with empathy because you are sympathetic, but can also give good care to your patient." I thought that sentence really put it in perspective, since we are not used to seeing this much pain and death that these people see. It is their way of life and it has been hard for me to adapt to it.