Monday 20 August 2012

Day 8: Lions, Tigers, & Centipedes – Oh My!

My wakeup call: 7:00 am my alarm went off.  7:01 am I lifted up my mosquito net. 7:02 I screamed bloody murder due to the CENTIPEDE under my foot. 7:03 a security guard came to “escort” it out of our room. I knew it was bound to be a great day after that start…

Surprisingly, today actually did turn out to be a great day at the hospital! I followed around a resident here named Omar, and he taught me a lot! The morning started off a little rocky because the minor theatre ran out of sterile gauze. NO gauze in the entire department. That caused minor to shut down for the day because that is where all the suturing, catheter changes and dressing changes are done – all of which require sterile gauze. There was a line of patients waiting to be seen, so we began asking other departments if they had extra for the time being. They told us “no” of course, and said we needed to “just accept” the fact no gauze would be available until the following day. The lack of supplies (which they can’t help) and the lack of empathy towards patients make some days almost unbearable. Many patients will wait at the hospital all night just to ensure they will be seen the next day – but many times we end up turning them away anyway.

That was a bummer for me, as well as the patients, but from there I went over to the casualty department which was swarming with people as usual. That’s where the “fun” began, but I use that word lightly! I was in seventh heaven getting histories on the patients and diagnosing them with Omar, but I’m sure that would be the farthest thing from fun for some others!

The first patient we saw was screaming nonsense words and phrases, growling, and moving uncontrollably – typical behaviors of a psychosis patient. One could quickly assume she was mentally unstable and send her to the psych ward, but further blood testing revealed she had Cerebral Malaria. This infection is known to cause psychotic behaviors as one of its symptoms. Luckily we were able to start treatments in time, and she will make a full recovery.

As usual there were numerous patients that were involved in traffic accidents due to the chaotic streets. The victims all had fairly minor wounds – a few stitches and a few X-rays – but the worst was an open oblique fracture of the tibia. The X-rays were unbelievable – even I could tell that leg was definitely broken! The other major complaint was women coming in with severe abdominal pains. Most were caused by a PID and the others were caused by something they termed “incomplete abortions.” From my understanding, it is when the mother has a miscarriage but fails to shed the placenta. The treatment is equivalent to that of a D&C in the states.

The most interesting case by far was a woman who came in with blisters covering her entire body, mouth, and eyes. Her skin was beginning to slough off in places, her mouth was bloody and swollen with sores, and her eyes were swollen shut to the point she couldn’t even see. The diagnosis was Stevens-Johnson Syndrome. It is usually caused by a reaction to a drug or may also be caused by other infections, such as: Influenza, HIV, Typhoid, Diphtheria, or Hepatitis – many of which are prevalent in the Mombasa area. Without treatment, this syndrome may cause blindness or even death. Luckily, once again, this woman came in just in time for proper treatment and she is also expected to make a full, yet long and painful recovery.

Those are just a few of the cases we dealt with, but overall it was an exciting and educational day. I’m so thankful for the opportunity I have at this hospital and it really makes me anxious to start my career in medicine. Hopefully someday I’ll be able to come back here – with more knowledge – and assist those who aren’t getting the help they need and deserve.

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