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.
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