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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