First day...

(JOURNAL DATE 3/15/2010)

...at the hospital and I didn't sleep well. More than a little anxious for the day. Landed at 10 PM last night and off to work at 6 AM today. Met one of the keepers of the guest house, Leah, and she made me an egg to go with some sort of cornflake cereal - which I proceeded to eat with cream instead of milk. Awesome.

The hospital is a REALLY BUSY place. The patients show up at 5 AM and start getting numbers. Patients come all day and go through a triage system, which sends them to the appropriate doctor, nurse or provider. It's basically the busiest ER I've ever seen. The acute care and surgical clinics see no less than 300 patients per day. The hospital is situated on the outskirts of Nairobi (to the SW) in the suburb of Langata and adjacent to one of the largest "shantytowns" or "slums" in the world called Kibera (google it, it is impressive).



Got a tour of the hospital and met most of the staff. There are 300 beds divided up into maternity, pediatrics, womens and mens wards. The hospital has the bare bones needed to provide decent care to an impoverished population: a basic lab, basic pharmacy, x-ray and ultrasound. The wards have 1 nurse for 25-40 patients - guess our nurses have little to complain about. They are not only understaffed, but they have no ability to regulate fluid rates, ins and outs, and maintain dosing schedules. This was most obvious on the pediatric wards, where IV medication rates were impossible to regulate. So much for weight based dosing. The operating room (to be called the theater from now on) consists of three "major" rooms, outpatient surgery room and a "scope" room. I got started in the theater right away. Minimal urology today, just a meatal stenosis and hypospadias revision. Spent most of the day doing ortho, general surgery and cesarean sections. This hospital does 900 deliveries per month and 300 are via C. section. I assisted 2, then was observed doing 2 and then did 2 c.sections on my own. Jet lag was terrible and I had to scrub out and go take a nap at 3 pm. It was embarrassing but going halfway around the world takes an adjustment. Not to mention, an overwhelming sense of being out of place.

The day certainly has made an impression on me. I'm in absolute awe that these people have any hope at all, that they find any reason to carry on, and that they have not been completed corrupted by the horrid conditions in which they live. The slum of Kibera is one of the most awful places I've seen. I'm just overwhelmed today...I'm having trouble understanding how God expects me to reach these people from my "ivory tower"... I can feel the prayers of those at home and will continue to do my own...