Sunday, 19 September 2010

from the village to 5* kenyas having a laugh

Ok so today is my last day.

I got no sleep yesterday. My bed was uncomfortable, my mossie nets had holes in it, i was bitten twice on the face and couldn’t really have a warm shower. The Nairobi house was became full of middle aged men and women at about 11pm. They were stopping over before climbing mount Kilimanjaro and frankly i couldn’t be impressed by this venture as they all spoke rather loudly, slammed doors and were just an overall nuisance until about 2am. Funny that though, at least the young climbing teams make a rubbish attempt at being quiet by whispering rather loudly, these adults couldn give a shit and so I reminded them at 5am that there were other people sleeping in the house.

So i was picked up at six and taken to the airport. Took about an hour to go through security due to waiting for an exit visa and having the staff scrutinise my passport as i now have horrible picky hair and eyebrows and my picture pretty much depicts a male post chemo cancer victim.

At boarding i began a convo with the staff, which later paid off as, the flight was overbooked and the same member of staff offered me first refusal on the following deal,

5* hotel (kenyas finest)
Free food
Cinema to myself
Calls and internet
Business class flight tomo

Did i say yes HELL I SAID YES, so here i am in my penthouse suite, double bed, stupidly large bathroom, tv, fridge, etc etc etc.
Ive lived a poor life for two months serious hard times and now I end it off with pure and utter luxery. Someone above is looking down at me and helping me out and for that I am truely fucking grateful.
I spend the beginning of the day sleeping, no mossie net, aircon, soft bed tv on quiet. Woke up and was like, hold on this aint home, this aint the plane, this aint the village either. Lol.
Iv called room service about 6 times, its fucking sweet,

Hello room service
Hi this is ronke in room 714
Hi ronke how can i help you
I would like a glass of wine please
Ok it will be with you shortly
Thank you put it on the room tab
Of course madam your complementary tab will be updated
Ashanti (thankyou)
Karibu (you are welcome)

Fucking sweet man.

So I got up at about three, had a massage and watched sex in the city in a cinema all to my self. This hotel has a swimming pool, ice rink gym spa, business center, etc etc.
I take back everything I said about sex in the city, seeing liza minelli do single ladies was toooo funny. Imagine I laughed out loud and could swear out loud and nobody was in the auditorium. Was a bit scary in there thou kinda kept having flash backs of the scream film where the women gets killed in the cinema! Lol.

Had a pure gluttenous dinner and am now gonna kick back watch tv and hope for a repeat tomo lol. Emma my mate came to the hotel to see me before she goes to mombassa and it was wicked being able to bounce experiences of someone who has been through similar stuff as me

One thing thou, I look like shit, and am dressed like a Kenyan boy, and look like one. Initially nobody gave me respect and I could see the staff talking about me as I approached the reception desk. But I think virgin had briefed them about me being a student dr or just dr and so I have relieved a lot of respect since word has got out. Really shit though, i am not my profession i am a person and i think respect should be shown to people bloody regardless of appearances and employment. I do look like shit thou so who can blame them.
This life aint me though, i feel so out of place, didnt know what knife and forks to use at dinner, couldn’t really keep food on my plate and off my lap, after eating with my hands for so long cutlery is so foreign. Also the richness of the food, man my stomach is doing rolly pollys.
Its been great, I have thoroughly enjoyed this day but although I don’t actually feel lonely and im appreciating all these experiences I have had but man alive a double room with his and hers on everything, pent house and im alone, makes ya think but im not thinking too much. Looking forward to coming home and now I can afford next months rent. YAY!

And dya know whats ironic, im watching ER, the very programme that started my whole medical adventure in the first place.

Saturday, 18 September 2010

last day

Last day

Mates im sad so fucking sad. Went around Nairobi today and it was sunny man, despite the throbbing mossy bite on my fore head, i had a wicked time. Went to Java cafe and had three course meal, wicked coffee. Shizzle the centre of Nairobi is wicked, everyone hanging out together, lots of biracial couples, its fucking brilliant. And i got there alone and got back alone. Travelling is amazing i feel like a sponge everything is something I wanna retain, my brain aint saturated yet, theres a whole world out there man, and I wanna see it not as a tourist but as a professional. I wanna make a change. Not in a Bono way, i mean on ground level, i refuse to send money to well meaning charities I wanna go and help out myself hands on shizzle. If it means being a surgeon and treating the untreatable, and I don’t mean curing shizzle i mean just improving peoples lives. Im excited, im at the start of this new journey, ive discovered what I wanna do and dya know what nothing else really matters ya know (well for now, i guess aint got back to London just yet). Theres this bloody great big world out their and medical skills are transferable, if i had the money and more time these next years i would be abroad, back in a frustrating African hospital, but knowing that everylittle helps.
Was reflecting through my pictures and man, ive had a real rollercoaster of a ride here. I think ive found the kid that im gonna adopt, this fucking sweet girl, er okay maybe i wont be adopting her as she has parents but her and Brian I just wanna steal and bring up here. Man I love these children, every single one of them, even the shits that scream white girl at me. Today in Nairobi, the city centre, the hubbub of wealth, were people look western, drive cars and do coffee, there were these two kids just begging for money and food from everyone and anyone. Really twists up my heart man.
So last week i did a lot with the surgeons, the most grim task of all was cleaning and the burns victims dressings. These men, mostly drunks had as a result of their addictions had managed to burn them selfs, the worst dressing to change was the complete back of these man who had pretty much burnt his skin to the muscle, it was so raw, bleeding, dead skin, puss, fuck it was so fucking grim. The flies were sitting on his wound as i cut of the dead skin. And the smell, the smell, lord. But the job had to be done for about 8 men every morning and afternoon. Its grim work. The men yelp and the sound of peeling bandages is grim. But they were brave and to be honest if my whole back had been burnt to the muscle, and i was in Africa, kill me mate. The infection from unmanaged wounds is PAINFUL and to be honest constant pain day and night without any pain relief Na mate.
There are lot of AIDS patients on the wards and man these men are in the throws of death. I hate to say it but im fascinated by it i cant describe this fascination without sounding a bit odd, but maybe if i put it this way, after delivering countless babies and seeing their first breath or helping resus babies and willing them to breathe, watching a person die is the end of the spectrum and if life is fascinating why cant death be also. We marvell at babies but recoil from the dying. Its all the same to me, process, one entering one leaving, i aint afraid of the dying if anything im more afraid of babies coming out blue and not breathing cos thats potential death without life. Im not sure where this is going but yeah the dying men on the ward are just there, not hidden nothing, a nation use to seeing the dying walk past them as if they are trees part of the Kenyan landscape. HIV such a clever virus hiding in the very cells that are responsible for detecting its presence.
The rest of my time in theatres was spent helping grafting skin, which is gruesome, if ya have a wound that wont heal, a kinda of potato peeler is used to peel a layer of skin from ya inner thigh, this skin is then sew on the area of raw skin that wound heal. Amazing stuff but mad to watch being done man.
I HATE SAYING GOODBYE and leaving the village was emotional, i gave all my household stuff to my neighbour, slept in my bed for the last time, ate my last meal, killed my last cockroach. The bus ride to Nairobi, 8 hours mate then an hour in a traffic jam in a taxi, frustrating especially when ya mind is on home.
Home, ah home, London, the big smoke its gonna be an adaption. Getting a bit emotional writing this so il finish it on the plane. But dono what more there is to say. The blogs below all detail my experiences they are what they are, if i can take anything away from these experience I can say that im not so lost anymore, medicine is my passion and to be honest i gotta focus more, study more and do my best cause only then I can really make a difference.

Friday, 17 September 2010

Things are coming to an END

So much has happened this week, been a bit a lazy with my blog as Ive pretty much been in theatre from about eight in the morning till six in the eve. The Theatres here dont have air con and the mask we have to wear are made from cotton not paper. It gets hot. I dont get home till about half seven, becuase its rainy season, so despite the day time temps being amazingly hot after sun doen it rains really hard for about an hour and its pretty dangerous to travel. So I get home at baout half seven and to be honest all i can do is drag myself to bed and pray for the absence of cockroaches. Anyhow, ive seen and one so much and I really wanna finish this blog with a nice summary of what ive learnt, how ive grown etc, so tomo im gonna spend a good few hours writing up the things ive done and seen this week, with a refelective summary. to be honest it seems like a tall order so bare with me! thank you to those who have read the blog and been patient with my bad spelling and punctuation, extreme attitudes and self praise lol. Im def a changed girl. Im really worried about being able to settle back in London.

15th Sep

15th September

Wooop its taken two bloody months, but i think ive finally been accepted, im no longer ‘Muzongo’ im now ‘Nigerian sister’. Which although annoys me a little cause I don’t really feel Nigerian but i think this is a better label than white black girl. Lol. Except word has gone round that im Nigerian and so very tom dick and harry tries to chat me up with some Nigerian phase that they’ve learnt from some nollywood film.

Today was again spent in theatre. I fainted once this morning, cause the theatres here aren’t air conditioned, and day time temps are reaching thirty. I did have breakfast and was adequately hydrated so I reckon it was the temperature. I assisted in one removal of a thyroid, two hernias and the removal of a keloid. All good in the afternoon I didnt faint and am now allowed to close wounds. Wicked I love asking the scrub nurse for instruments and saying things like ‘can I get a bit more light here’ and ‘can someone mop my brow’. Loser behaviour I know but it makes me feel wicked. And the best part is being lead when im closing a wound. All eyes on me. Love it.

Tomorrow is my last day here in Western Kenya! I am a ready to go home but boy am I gonna miss this place. In the first few weeks I really didnt think I would but today on reflection, life here is sweet. Aside form cockroaches and the lack of foods other than rich carbs , having my mates around, life is good (oh what am I taking about i miss a lot of things about the UK) but essentially, I am saying that I could come back here. Maybe as a Dr higher up in the food chain, so I wouldn’t have to put up with the, oh your a student and so Im not gonna listen to you crap.

14th Sep

14th September

Wooowza today was superb!! So ive realised that I actually don’t hate surgery and that I wanna be a bloody surgeon and so Ive been spending some time with these American Drs at the hospital. Basically they are a team of older, loaded and well connected American physicians, who come to Kenya three times a year for about a month to do a load of operations for free. The Main surgeon usually is alone or with a single assistant when he his operating. I befriended him the day that I was diagnosed with malaria, he got my blood investigated for the parasites and in turn I promised him that I would spend a few days ‘assisting’ him. And so this afternoon we did two operations together.
Firstly, he taught me how to do a couple surgical knots, I forget their names but he made me practise for an hour whilst he had lunch lol. I love how suddenly when im working with an older white gentleman all the other staff suddenly have respect for me. Jokes man. Pff. Anyhow we began by amputating this elderly ladies diabetic foot. Fuck, the smell of dead, gangrenous flesh is worse than birth fluid, ergh. It was grim but i had had to just think this is an amazing opportunity and get on with things. I cut of her third and forth toe and the Dr did her second toe. Man the smell was really really really bad, and man the pus, yuck, but we did it, didnt take long as she had lost a lot of her foot including the little toes already, she had a special vacumm dressing applied to the wound in hope that it would suck out all the infection and leave us with a clean wound to skin graft on Friday.
The next patient had a small hernia, which was dissected out and pushed back with a mesh covering the defect in the abdominal wall, I was allowed to close the skin wound, this made me happy. To behonest, I cant actually believe that I am able now to stand for so long during operations with out fainting, I think that this was the fear that ruled out surgery as a career for me. Bit gutted though as if I had known that I wanted to follow this path, I could have undertaken a surgical elective, but I guess better late than never. Tomo and Thursday (my last official day) Il be in from 9-6 assisting the dr, just me and him, cant bloody wait.

In the morning I was in a ward round with Dr Adongo, who im not gonna lie is getting on my nerves. In Siaya hospital, patients who are on the verge of dying or just dying, are sent for unnecessary test all the time. Today we saw a patient with a CD4 count of 1. Yep that right one and a really high viral load. The man had been on anti virals, but had developed a meningitis and was now comatose. Dr Adongo wanted to do a lumber puncture to isolate the pathogen causing the menigitus. The other medical student and I argued that if he was comatose and had been for some time and frankly with a CD4 count that low and a really high viral load, why don’t we just send him to palliative care and prepare the relatives. The relatives cant afford any more treatment for him, and to behonest we didnt think he was gonna be doing anybetter and LP carries risks for the brain (which hadn’t been imaged). Look I dono everything about medicine but i do know that a lot of the patients in the male ward especially, present when they are literally knocking on the door of death, these men are wasted thin, usually delirius or in a coma, have no money, sometimes no family, are riddled with opportunistic infections from having such low white cells and most have TB. And what do the Drs do? They list everything that is wrong with the patient, and try and treat everything. Not a single thought is cast on perhaps palliative care. Usually the patients die a few days later and the family (if there is any) is laden with an avoidable bill that they cannot pay. Ive really had to bite my tongue (so hard) so as not to get into an argument with the DRs.
One DR today, tried to put in a cannular into a boy with suspected meningitis, he failed three times, then left the patient to answer his phone.

Ive been told that my experience of hospital life is frustrating me because I am at a lower level hospital. The level of hospital is decided by how many services and consultants it has. Nairobi hospitals would be better than village hospitals. Thing is Im cool with that, here the village im doing lots and lots, somthing I couldn’t do in Nairobi as the patients are less willing to be pretty much practised on by students. I maybe should have organised a week so as to compare hospital standards but its not so much the hospital I have a prob with its the behaviours of some of the staff. However, I was told by a few of the other students that they were told that the problem of apathy and patriacy is cultural trait of the tribe of the area, and that they were told that different tribes exhibit different behaviours, and that the repression of women is associated with the tribe of the village in which I live! Interesting, cos I would hate to think that all Kenyan women are treated the way that the women are here!!!

Speaking of women, something I noticed on the male wards was that all the men dying of AIDS related complications had dutiful wifes, supporting them. However, the wifes were negative for HIV. So not only are these women on the whole second rate citizens but they are looking after their cheating husbands. I guess not all the women could be negative but having many wifes, or partners is allowed in the western Kenyan culture, its not fair that the village wive is laden with the responsibility and sadness of looking after her bigamous husband. Heyho.

Oh god sad case today, a women bought in her son, who had been playing with friends at school, fell over, banged his head and has been comatose since. The incident happened two days ago. I really felt for this women, a teacher, her son 18 and nobody was telling her shit. She had no idea what was going on and her son looked helpless in bed, in his uniform, like a child mate. It was only until that ward round that he was referred for a head CT by Dr Adongo, nobody had clerked or seen him since his fall. The look of fear in a worried mother eyes is haunting.

Lastly, I started a fight with this fat ‘i am god’ Kenyan women on the bus home. I was ushered to sit at the front of the bus by the conductor and she refused to most. And so me being the stubborn girl that I am, asked her again, she said , why are you asking me to move up. I said im getting off before you so maybe I can sit closer to the door. She replied, are you shouting at me. I said im not but I will be soon. And then she began a crazy black African women monologue that lasted about half an hour. You stir a mamma and boy they don’t shut up. I moved to the back of the bus cause she threatened to give me the beating of my life. I dared her to try and see how i respond. She was too fat to beat me, otherwise i wouldn’t have said shit, cause ya never too old for a beating from a stranger in Africa. Anyhow for the last ten minutes of her rant she got out pictures of her sons in the uSA and how she couldn’t accept being spoken to like she was nothing with sons in the USA. Man alive, the girl next to me had to tell me not to respond to her , cause she could she that I was getting exasperated with her, my sons are in the USA nonsense. Anyhow, i began the argument, and boy do I like an argument, kinda relieved that she didnt beat me but i would have LOVED TO SEE HER TRY!

13th Sep

13th September

Wow the weekend has been purely cockroach city. We have a problem. Our house has its own longdrop, my neighbour has her own, and the village share two. All are enclosed within wooden sheds and are exactly next to each other. Problem is that, own longdrop and that of my neighbours is kept in clean (as in no human excrement is ever visible on or around the long drop. The two used by the rest of the village are just disgusting, the responsibility of cleaning them is taken by nobody. Many of the children miss the hole and the men piss on the wall etc. This behaviour attracts vermin, and for some reason the cockroaches enter the long drops belonging to the villagers but exit via ours. The critters then make a journey which in critter mileage i reckon is FAR but they end up in our kitchen, make their way across the living room floor and for some reason other than I must be in a fifthy state (which im not) they reside in my room.
Saturday night, we found about 20 in the living room in the space of one hour. The worse scenario of the night (seems as though every nightmare I have regarding these things, comes true) a massive daddy cockroach (or mummy) fell from the ceiling and fell at my feet. I actually felt the wind created by its decent against my face. Pure dramas, we didnt end up sleeping unitl about three and we had to get up as I said that I would take the new med student to church to meet the orphans.

So the next day (Sunday), I had to endure church on two hours sleep. Church is lovely, African church is so animated but, the preaching is like pre historic. And so we left two hours in, after donating some cash to the collection, i couldn’t be dealing with another 6 hours of being told how much of a sinner i was.

Today, patient wise, I saw an albino women with the biggest facial melanoma that I have ever seen. It was at least the span of my hand!
The patient whose ascities I tapped, abdomen burst open and her intestines were exposed to the open air –reported from Dr Adongo.
Another womens c section scar had got infected and the wound had broken down revealing a seeping pusy wound. Which when we arrives was just open to the air.
The neonate i resused was alive and well –yay.
Most of the day was spent in a general outpatients clinic, which was interesting too, patients presented with umbilical hernias (lots of children, must be the way the umbilical cord is cut at birth?), diabetes, prostate cancers, a head injury caused by the wife of a mans brother beating him across the head, a nasty venous leg ulcer and a man with urine incontinence.
All in all a good day.

Tomo, a five hour ward round and hopefully some surgery.

Some more Kenya observations, all the tv adverts have black actors, even those for quite commercial worldwide products like cola and nivea skin cream.

Er I was in an internet cafe again today, and all the stations were taken up by boys on facebook, which i just find so odd.

Lots of the female children and adolescents here have toned arms from all the heavy lifting that they do. It just seems really odd to see these really skinny youngsters with ripped arms.

Oh I remember what I was going to say, i know I come across as a pure man hater but today another English medical student, myself and a Kenyan medical student were shadowing Dr Adongo. The Kenyan medical, male, decided that for the half an hour that we were waiting for Dr Adongo that he would just talk exclusively to the other female Uk medical student and completely ignore myself. Fine. Not really bothered as to be honest he was just talking pure shit, a pre amble to the killer question ‘can I have you number for a contact in England’, or ‘do you have facebook, lets be friends’.
He is being friendly you say. NO HE AINT. All the males here talk to the white skinned people to see what they can get out of them, usually money. Ive seen it far too many times and it GRATES ME.
DR ADongo comes along and leads us to the outpatients area, still, Mr moron medical student hasn’t introduced himself to me or even acknowledged my presence. Lol
We start seeing patients and it turns out that the apathy and pure i can think outside the box, that a lot of the junior Dr have here must begin at medical school. By getting to medical school these boys have achieved a lot and are told that they are very special and are usually wealthy and so with this comes (not always) but usually an attitude of I know everything and an air of importance. This boy ticked all boxes. Throughout the clinic he got on my nerves, not talking to me, interrupting my flow with nonsensical additions of crap. I think what epitomised everything was when I was writing out an ultrasound request for a mans enlarged prostate. The man was called Simon and the investigation was for a part of the body unique to the male species. But mr I am a dick head medical student looked over my request letter and said ‘dont you think that you should put M’ I replied without looking up (yeah I can be a fucking bitch when need be) ‘why, er what do you mean what for’. He replied , ‘M means male, ya know you missed out that he was a male’. Okay me seeing an opportunity to show mr wise guy moron dickhead medical student up, replied ‘so how many women named simons do you know that need ultrasounds for a prostate gland’. He was like yeah but just in case. Ergh, i get that he means that writing male or female is kinda protocol but it was the idiotic , unnecessary way that he had to interrupt everything that I did.
He got his comeuppance anyway as half way during the clinic he got bored and started read a newspaper, and got bollocked. Moron.

A lot of the male staff are like that here, apthetic and really really unable to take advice, criticism or even participate in a patient debate. I love Dr Adongo because he goes completely against the trend.
Seriously though people, many of the men here are like this, does this behaviour trend run through all of Kenyan society? If so this country is fucked. Im left annoyed and disappointed every time I have to deal with any of the male staff here. They openingly flirt with the nurses, stand about in crowds doing nothing, chat shit to white people as if its sport and have no respect for patient dignity. I have no time for any of them. I am so glad that things are different in England, i would probably be one angry women if I were a Kenyan female DR here. Actually i prob wouldn’t be a Kenyan female Dr here. I would have Prob been a nurse or even before then stoned to death for being different.
Man i am so lucky to live in London. So lucky and this realisation gets stronger every bloody day.

11th September

11TH September

Two hours ago I was high, high on Tea!! Had my first cup of tea in about four weeks, it was good but made me feel really merry for about an hour, much to confusion of my housemate, who loves tea and has about 6 cups a day here. My housemate who I bitched about in the last blog has redeemed herself in my books. Not only has ignited a flame of desire in me to be a surgeon, she and I worked as a team on fire on Friday. The great thing about Dr Adongo is that he will show you step by step how to do surgical procedures, even if it is your first time. Yesterday was my flat mates first time assisting in a C-section and she was fabulous, next week itl be my turn but I was so impressed by Drs teaching and her confidence –what she lacks in social skills she really makes up for in theatre confidence. Gonna big myself up too cause the baby came out blue, without a pulse and not breathing, and I under the direction of a midwife bought the baby back to life (okay it still had trouble breathing 10 minutes) but turns out it had an infection from mum. So that was Friday and can I add that I still was heavily fatigued from my brush of death with malaria! –lol.

So newsflash I wanna be a surgeon. NEVER had I ever thought that I would utter those words. General medicine all the way, i thought, perhaps working for an NGO or aid agency. I think that I will still do this but man alive surgery is definitely appealing to me now. Everyone says that Surgery = no life, delayed child rearing in women, lack of sleep, early aging, increased risk of stress related disorders, etc etc, but we only live once right and frankly if I don’t follow this thread through I might live to regret it. I wish that I had this epiphany earlier on in this African adventure though cause I could have participated in more surgery. Umph.

Something occurred to me this morning, 10 years ago, post my GCSE results, we were asked what we wanted to be when we were older, well my answer had been ‘a doctor’ since I was twelve. If all goes well and to plan, I should be a Doctor in nine months –does this mean that I am grown up? Will I at this point be an adult? This scares me a little, no actually I’m quite worried, as being a student means the usual responsibilities of life that ‘working people’ must adhere to have no relevance to me, and in the odd occasion that they do (e.g paying rent) if I fuck it up I can hide under the safety umbrella of being a student. This umbrella closes in nine months and to be honest I don’t think Im ready for the responsibilities of a working life. I mean, im excited and read to be a Dr but along with that i become a professional, not ready mate. There isn’t even a transitional period in which I can prepare myself for the working world, well we get a month off before we start our jobs but still, not sure that that month is going to used for organisation, more intoxication mate. Anyhow, maybe the fact that I am thinking (worrying) about working life, about joining the masses and becoming a useful tax paying member of society is a step towards preparing myself for this inevitability.

Some other things,

Yesterday I saw run over dog in the road. Great thing about Kenyan life is that one gets to see stuff that just isn’t socially acceptable in the UK. I was fascinated, this dog had obviously be run over by a matatu. It was lain dead in the center of the road with it entrails coming out of its mouth. I was disgusted but morbidly fascinated and with some of the village kids we inspected (visually off course) what parts of the entails we could recognise and name. Sick I know but every experience is an opportunity here and I assume that I wont get to see such a display of gruesome again!

9th Sep

9th Sep

‘Come home’ you guys said.
‘Maybe you should come back’ my Clinical advisor said.
‘Maybe call it a day’ Janet said.
‘Malaria! That shit kills’ Simone said

Thank you for all your texts guys but NO WAY AM i COMING HOME, im here till the bitter end, and I can happily report that I am feeling much better. The fever broke early this morning, im still really weak and have the remnants of a headache but I am tonnes better. Malaria, is a great mimic and deceiver. I initially thought that I had a cold but there was something about the headache that made me think otherwise, man alive, the headache, i think it is the worse thing about Malaria (except from it being a killer infection). It paralyses you, ya cant move ya eyes, ya head ya neck for the fear of the intense throb that follows any upper body movement. You feel as though ya eyes are gonna drop out of ya head, like ya brain is actually pushing up against the inside of ya head behind ya eyes. Wow it hurt, and the pain doesn’t subside with painkillers, and I think thats what made me think that something was really wrong. The problem with malaria also is that the pain and pure fatigue come in periodic bursts. So for like two hours ya feel like warmed up poo and then ya better for four hours and then ya ill again. Even on the Meds, but eventually, the feeling of being well is longer than the feeling of utter poo. Except if you leave it untreated the feelings of shittness kinda run into each other and by then its too late to do anything as ya too tired and prob unconscious. I know ive made a bit of a joke about all this but I really did feel like I was dying. Dragging my self to the hospital was exactly that, sweating in the afternoon sun and taking baby step to the hospital, never before have I ever felt the sensation of ‘not being able to walk any further’. Every step I took was exhausting and having to have thirty second rest after ten or so steps must have looked ridiculous to any passers by! But I had to get to the hospital and so I guess sheer willpower and background thoughts of impending death like an invisible pulleys, dragged me along.
Well I don’t think that I should really go in to the hospital until my energy levels are better, as I am only able to do things in really short intense bursts. I managed to clean the house (sweep the floor) in ten minutes then rest. Had a wash in 5 minutes (loving the cold shower now, as its hot here now), then rest did my washing in 30 minutes. Wicked now chilling for the rest of the day.
So I survived a killer disease!!! My body seems to be an excellent host for parasites, first worms now malaria.
Annoyingly, all the villages keep asking me why I haven’t returned to work yet. Ive explained like a million times that once ive finished the medication and feel a bit better that I will. They seem to think that now I have the med il be ok. I mean I am okay but this is my first malaria attack, all these women have had it at least once or twice a year and the more you get it the less severe the course and so for some reason they think itl be perfectly okay for me to stumble my poor body around the hospital because I have the medication. Also annoyingly, one of the women told me that I had to give one of the women money to pay for her malaria treatment. Love these women but today i was done with the being told what to do. I said rather sharply that she must never ask me for money again otherwise I will buy nothing from her ever again. Sounds a bit harsh i know, but these women have enough money to get by and they just cant get it into their heads that I am not here in Kenya on bloody holiday (ok so i had a week off) BUT i feel that Im doing my bit in the hospital, I made a donation to the charity as a part of the elective payments, i buy all my food off these women and tip them I mean i am not handing out my cash willy nilly, and unfortunately for me previous elective students have had spare cash and have just thrown money about willy nilly, but i cant and wont and from today Im gonna have harsh words for women who rather rudely ask me for money.

Im def better cause im ready for a BITCH!. Another medical student is in the house with me, much to my annoyance, as I kinda wanted some time alone for a bit. As its just me and her Im glad she has decided to sleep in the other room just so I can have some space. Ergh its a bit annoying cause all the medical students that have been here have only been here for a few weeks before going onto other areas of Kenya or returning home, and word has got out that ive been here for a while and will I quote ‘look after’ any new arrivals. Aint my job mate. First person who came along, fine. Il show you the ropes. But 4th student down the line. Cant be bothered.. i know I sound like a selfish cow BUT they don’t clean, they don’t wash up, they don’t tidy. I had to learn the ropes myself, I had to get lost on the way home and sort myself out. Ive had to haggle prices down, approach village women , make friends with the neighbours all bloody alone. Ive had to kill cockroaches, swat bees, de mossy my room, hand wash my clothes and work out general living by my bloody self, and these new students have got it into their head that im gonna let them follow me around. Its annoying. Cooking don’t get me started. Im not the biggest fan of cooking, and with limited foodstuffs here ive had to be creative with eggs, tomatoes, bread, rice and not much else. Many of the students here have either an air of, im loaded and am not very domesticated or im scared of my own shadow. Its really annoying. Like one of the girls wouldn’t use the toilet after 5. Another decided that she must clarify everything with me before she did it. Another waited till I got home to see what I cooked for my dinner, then went out and bought the same stuff and cooked the same meal. Another moaned that daddy wasn’t ringing her as much as she would like and this weeks medic has decided that she is also ill (with it seems like-I cant be bothered to work out the bus route myself itis) and wont go into the hospital, despite me actually being genuinely ill, until she can go with me. Yawn city. Look yeah this is bitchy but this is our elective, an opportunity to grow up ya know, let go of our creature comforts and survive and frankly ive been rather annoyed with some of the people ive had to endure during this adventure. OKAY, people are different and take their own times to settle in blah blah blah i get it, but im the one that had the shits, im the one that has sleep with cockroaches, im the one that had strangers knocking on my window in the night and im the one with malaria. NONE of these lot have had to put up with any of that Kaffufle. Okay I wouldn’t change it for shit but either im a miserable bitchy cow (maybe –lol) or backbones aren’t being made anymore.

Okay let me illustrate this a bit more. One boy who stayed here bought enough clothing to last him his entire trip (so he wouldn have to do any washing)?!! BUT NO BLOODY FLIPFLOPS-?
Another girl prepared herself for the monsoon rains with an umbrella-?
Another climbed Mount Kenya but neglected to bring climbing boots-?
Another girl advised me (after the cockroach on my breast incident) that I should chill out and try and put my mind on something else and that way I would sleep better. This is the same girl who wouldn’t drink after 6 so she wouldn’t have to use the toilet in the dark cause of the cockroaches. Luckily, this time away has mellowed me somewhat and I guess being at times surrounded by people who don’t have clue about the real world has taught me how to deal with people who don’t have clue about the real world and so I replied to this girls foolish remark, ‘yeah your right’ but in my head I was thinking; ‘er your a moron cos if this happen to you, you would be on the hotline to daddy asking him to book you on the next flight home’. And annoyingly the next morning she told me that she wouldn have known what to do if it had happened to her. ARGH!

Ok enough of the bitching, Just wanted to end this blog with a case I forget to mention last week. Last week at Dophil Clinic I was presented with a women who complained of headaches and absent periods. Nothing else to note just those two symptoms. We did serial pregnancy test and they came back positive. This women claimed that she hadn’t had a period since march and had her last child last year and wasn’t breast feeding. She had no symptoms of pregnancy and her abdomen was completely flat. She wasn’t on any contraception either. So i examined her abdomen, flat she was not 5 months pregnant. I examined her vaginally, and found a massive lump with could have been on her left ovary.
So here we had a ‘pregnant’ women with an empty womb, no symptoms of pregnancy and a mass that could be felt vaginally. Me being the over excited daft medical student suggested that the pregnancy was growing in her abdomen outside her womb (i had read this in a paper i donno when but this being Africa I like to think that anything is possible. Er yeah I was wrong about that. So I suggested that she had a tumour that was producing the pregnancy hormone. Er, again never heard of this in my life but heyho. Woop I was right, the lady came back later that afternoon, post abdominal ultrasound confirming the presence of a mass on her left Ovary. Not so good for her as she will have to have it removed and to be honest I don’t think she truly understood the magnitude of it all but im sure Dr Phill would have counselled her. These tumours are so so rare, can be bothered to get my book and have a look at the stats but i remember reading that a pregnancy hormone producing brain or ovarian cancer is soo soo rare and I guessed one here in Kenya. Okay so that story isn’t that interesting but I need to give myself these small big ups every now and then.

So tomo, back at the hospital. You just never know what ya gonna be presented with. I hope not a birthing mother, please god no. I cant deal with the smell of birth fluid anymore. Anything but birth fluid. Ergh.

Wednesday, 8 September 2010

This blog is brought to you all the way from my 39 degrees self

8th Sep

So im back in love with village life. Dont think Il be going to Embu for two reasons, a) the Kenyan guy whose house we stay in is having marital problems (jog on with that) b) apparently the weather is really cold (double jog) c) The other medics have told me that Siaya Hospital is better than Embu hospital and Finally the Nairobi in which I would have to stay for a night before travelling to Embu not only has cockroaches and a million (now we know malarious) mossies BUT HAS A RAT INFESTATION. And so im staying here in the village. Ive swapped beds and am now on the top bunk, far from the floor and encased in my mossie net, that at one time I deplored and now I love as once I tuck it in, touch wood, that my bed is impermeable to roaches. PLEASE GOD. I did find another on the floor yesterday though. Dono why they all seem to come to my room. Ergh. Im not really afraid of them anymore just want them GONE.

Its rainy season here in Kenya. Bloody fantastic mate. This means its summer! The sun is up at about half six and doesn’t go down till about seven, half seven, AND IT IS HOT. The flip side is that every three days we have a day of major monsoon weather, the ground becomes really muddy and everything gets dirty but the next day it warms up and the ground is instantly hard again, almost as if the mud didn’t exist. Also, everyday at about six we have monsoon downpours for about two hours. Unlike English weather, Kenyan weather is predictable, and so it is very easy to arrange ya daily activities around the sun and rains.

This is fab for me as im still bloody ill and the side effects from the AL (antimalarial medication) have kicked in, ive got this really really sore chesty cough and am really really weak and tired and blumming hot. Upside, I aint going back to work until the meds are done and so prob not til next week now. So what’s a girl gonna do?

Sunbathe mate

Oh yeah another observation. We don’t realise how fast we speak, when I first arrived here no one could understand what I was saying, even those Kenyans that understood English well couldn’t keep up with the speed of my speech and so Ive had to slow down what I say. Also I use a lot of slang words that also dosnt go down a treat. Finally, Kenyans have a funny way of ordering their words when they speak, for example

We say : how are you today
They say: today, how are you

We say: Are you going to school today
They say: School, you will attend school today

We say: I am 26 years old
They say: I have 26 years

Er i guess it dosnt actually seem weird now that ive written it down, its like they put the subject of the convo first then talk about it. Also the children write in almost biblical language, again a bit difficult to explain but just a few things that I have noticed.

7th sep

7th Sep

Not doing much today. Had a bit off a rough night, felt a bit ill but woke up okay, took my medication and went down to the village in my PJs to get some food. The great thing here in the village is that any clothing is wearable outdoors. Fashion just don’t exist here. My Pjs are out doors attire and nobody batts an eyelid. Didnt brush my teeth comb my hair, wash my face, nothing, just put on my plimsolls and left the house. Wicked. Except, ya know those cute children that I always go on about, the village ones that cal me, black white lady and always run up to me to shake my hands...Well I wont be shaking their hands anymore as I witnessed, three of them doing a poo on the grass outside their house. Not even shy or anything just defecating together whilst a group of men were chatting about their goats a few yards away. These kids must just poo anywhere I thought. Also they use leafs to clean their arses and don’t wash their hands. Same hands that they use to greet me. Oh lord.
Also speaking of goats, I saw the most unusual thing this morning, two dogs, a puppy and a goat sitting next to each other chilling from the sun?
Oh yeah yesterday I forgot to mention that I met this American girl in the hospital, im not being rude or judgemental but the first thing I noticed was her obesity, not cause she was inadequately dressed but cause her pale white self was huffing and puffing down a corridor full of contrastingly deep brown emaciated Kenyans. She is a pre med in the USA. I asked her how she was enjoying her time here, she was like ive only been here a day and im jet lagged. I was like oh im sorry, how bout the hospital you like the place, she replied, AND NO LIE!

-‘Im a real germaphobe not use to hospitals like this’
something about this comment which kinda sums up a certain type of American, the kind from programmes like ‘the hills’ FUCKING CLUELESS AND A WASTER OF SPACE. Mind, this girl didn’t even have alcohol gel on her or a white coat. Germaphobe and a fool. Okay so i was judgemental there heyho.
Oh yeah on the way back home yesterday we were reminded of the perils of Kenyan nighttime. Morris the creepy Kenya guy (who I will talk in more detail about next week) managed to get a taxi to get us home as it was 8pm and Kenyan society shuts down after sunset. Everyone stays home and thats that. Well after leaving hospital, we saw a family bathing in the muddy water at the side of the road! Moriss laughed and called them mad. This is the same man who claims to be known for his compassion, kinda reminded me about what my mate Levi said once, -brand gestures are easy to make, its the small ones that count. Using the example of Morris I take this to mean that its easy for people to throw money around and make a point of doing big things (big things includes anything from emotions to actions) to show how nice they are (Exactly what Morriss does) but when it comes down to the small impulsive behaviours that we all have its here that a persons true self is reflected. Like I told Morriss that one of the village women wasn’t selling her cakes and I was worried that she may be having her baby, as she confided in me that she was having vaginal bleeding. In response to this he says in front of everyone, should I go and give her money. I was like er no she needs to be checked up on, not laden with catch. And so last night, in response to this families poverty instead of throwing money at them he laughed at the fact they were bathing in the dirty muddy water. He is so inconsistent like this. Outwardly nice and one to one a nasty egotistic moron. Man I have so much to say about this man.

Anyways, the charity rang me this afternoon, demanding that I get checked at a Nairobi hospital to make sure I was alright. I rejected this as im back next week and to be honest, all that can be done has been done here. I aint gonna die, ive got the right meds, im drinking, trying to eat, resting (sunbathing) and frankly im wicked. I felt so good for 4 hours that I chilled with the villagers this afternoon, and they now call me by my first name instead of black white girl, which is LOVELY. Im gonna be sad to go. This elective i thought was soley about me improving my medical skills, but not only have I done that (well sort of) ive managed to integrate myself into a well establish community, they are even sad to see me go!! NICE!

Oh yeah pure hilarity, as Kenya was a British colony for this reason I think all Kenyans have English first names. Thats not odd i hear ya say, BUT they pick names from the papers or choose names from famous people usually footballers. Today I met, Wayne Rooney Allen, a year and a half year old Kenyan baby boy. Pure jokes

6th sep

6th Sep

Iv had a brilliant time here in Kenya! This has been an experience and a half. I have done so much –met Obama’s nan, delivered babies, performed circumcisions, felt the breathe of a lion as it lunged at me, had a boat ride on Lake Victoria, been checked out by Kenya women, fed giraffes, petted elephants, sunbathed in the most intense sun, been to a Kenyan church service (never again) breast fed a cockroach, had my guts eaten by worms, actually brought a patient back from the dead, travelled around alone, seriously, I feel Kenyan and an so grateful for this experience, even the bad bits have a place in my experience list. I came here wanting to live like a poor person, and neglect the luxuries of the western world. I think that I have mostly succeeded in my aim. The thing is ya don’t really realise how much youv grown or what ya have been through until you reflect, and now reflecting on the last seven weeks and ive come such a long way. Im not saying that Im gonna come back a majorly changed person, like, i still wanna dance, go out, dress up have fun, but boy am I gonna appreciate life a whole lot more. We just take for granted how priviliaged we are, I think easing back into life will be hard for a few days but essentially ive been in London a whole lot longer than ive been in Kenya but its the appreciation of knowing and experiencing that there is almost a whole continent of people out there who are essentially living in poverty, and not the poverty that we are privy to where people can go places and help can be accessed, but a type of poverty which means if you haven’t got a family, or a shilling to your name well thats it mate. No welfare state. No good Samaritan shelters, or people dropping money into paper cups, or donating unwanted goods to charity. Its a dog eat dog world here in Kenya (and I suppose in many other African countries).
I highlight this point using the example of the lady that I saw last weekend in Kisumu. The apparently mentally disturbed lady who a couple of men offered to beat for me. Well I saw her again on Sunday and it was sad, I was walking to catch the bus, and I noticed a body slumped in a corner. Me being the person who cant help but see whats going on , soon realised that it was our friend the lady from last week. She was in a bad state. Her clothes were just filthy, she was covered in bruises, her gums and lips were bleeding an flies were entering her month and almost feeding of her. She was breathing though and so I nudged her and called out sister sister, wake up. She kinda sighed but didn’t move. This happened about three more times. I was slightly weary about making a scene as I was alone in an unfamiliar part of town, and so just wanted to wake her up enough to leave her a bottle of juice. She wouldn’t move. Passersby were gawping, men laughing. Poor lady. In England shit like that just doesn’t happen, someone will call 999 and he or she would be dealt with. Here, no 999. If ya ill ya make ya own way to the hospital, also if ya do need an ambulance, ya gotta pay up front. Could you imagine mid heart attack, looking for ya purse to get some change. Anyways do you see my point, the lady above will die. Anyone, who allows flies to enter their mouth is at a stage of no return and i saw that, could I have changed anything for her probably not, we change what we can and leave what we can’t and hope for the knowledge to know when to do one or the other. Ah im rambling,

Anyhow, so my experiences took another level today, remember that head ache I complained off two days ago. It reached epic portions last night and this morning. Coupled with a major fever. Im a moron. It didnt occur to me that my fever and headaches was occurring at regular intervals of about 3 hours apart. Guess what, Girls got malaria in Africa.
I’ve just come back from the hospital after managing with very cell in my body working together to get me to the hospital. I had a blood slide taken and it came back positive. The joke is, Ive only been bitten three time here in Kenya and all three were in Nairobi, I know the day, and the time. There is virtually no malaria in Nairobi, but I go against all the odds to get bitten by possibly the only malarious mossy in the whole city. I should have known thou, Ive spend all this time concerned with my poo when I should have figured if im shitting my guts out then duh im not absorbing my pills. Dya know what the bloody joke is , is that i spent 147 pounds on those pills. Malorone, the best my dr says, costly but worth it he says, wont upset your stomach he says. So 147 pounds out of pocket later, not only do I have malaria BUT i hadn’t even absorbed any of the tabs, so it really was money down the gutter (long drop).

Anyways, the headache from malaria is truly something, pure head pain, you feel like ya eyes are gonna pop out of their sockets. Ya feverish, sweating like yav been running the marathon with no training. AND then the fatigue is unbelievable. DO NOT KNOW how I made it to the hospital, although ive got mild uncomplicated malaria and feel like death. Children get this everyday here, poor mites.

So i experienced hospital care in a third world country for a second time in 2 weeks. Lol. Amazing experience. I even allowed one of the medical student to put me on the drip!!. I was initially put on a bed in surgery; pretty sure someone had delivered on it prior to my arrival cos it stunk of labour secretions, a smell that seems to eviscerate all of the female areas in Kenya. Once you have smelt birth fluids, that smell is imprinted in your memory like ya name. I was given a blanket that was wet and had blood stained, that Dr Odongo kindly noted could be years old, but assured me that the blanket was clean. Lol
So i was given star treatment, the nurses fussed over me in Swahili, I nodded and smiled, couldn’t be bothered or had the energy to explain that I didnt understand a word that they were saying. Has my drip was to run for 4 hours I was moved to another ward as the theatres were closing. Guess where I was put in another smelly bed in the early stages of labour ward, in between two women having contractions. Blood joke mate. Then some nurses came and asked me what I wanted to eat, i replied nothing as I was feeling sick, they insisted that they find me some food. Er I recoiled at the word find, after a two months worth of stomach probs, I aint going back to that drama. Ergh its so hard to refuse food here in Kenya without offending someone, but I did as kindly as I could. That nurse never came back to see me. Lol

Im writing this in REAL Time but ul prob only read it next week, anyhow, i have tinnitus one of the side effects of the quinine is ringing in ya ears for a bit. Its shit i am deaf, can’t hear low sounds. Which means I cant hear for insects or COCKRACHES!!!
I asked the medical officer if my hearing would return, he replied, quinine acts on the ears much like gentimycin ( an antibiotic) I was scared gentimycin causes deafness and has to be carefully used. He meant that quinine effects the ears as in the same organ as gentimycin but not in the same way. Er rubbish explaination. Fool.

Right im taking my malrious self to bed im beat.

7th September

Er its 3 am Kenyan time, just woke up and i feel mash up. Dont think I have ever felt this bad before like every cell in my body is fighting for its life. I am ok though. This experience has made me realise how flippant i have been about malaria, every time ive diagnosed it, i have been slightly annoyed that it want something else. This disease is serious, and kills!. Im a fairly fit person and has a mild classification due to it being caught early but I feel shit. People here wait till the last moment before they see a dr, many are undernourished and therefore have anaemia even without malaria, and so must be bloody ill and feel like death when they present at the drs. Its a small miracle that the iron tabs i was taken were absorbed by my body despite my gut illness, as last week my Hb was 16 and boy if it was its usually 10.5 then I could be alot more ill than I am. And dya know what the ironic thing of all is? Its the female mossies that carry malaria. Me, a raging feminist bitten on the back in a non malaious place by a female mossie. Ive only been bitten three times ya know in my whole stay here. Siaya is raging with malarias’ mossies and I get bitten in Nairobi. Lol. Im back in 13 days, dono if anyone wants to lend me their mother, shes gotta be fat (huggable), and a good cook (home made soup) cause im on the hunt there’s only a few times ive pyned to be looked after and now is one of them!!!
The tinnitus has got worse, im virtually deaf! Tinnitus is a rather curious side affect. It isn’t ringing in my ears per se more like a pressure, similar to that ya get when ya about to land or take of in a plane, except this pressure throbs. And so its not like i cant hear anything its more that before sound hits my ear drums it feels as if it needs to go through a wall which in turn dampens the sound before it reaches my ear. So i have to listen harder and i cant hear low frequency sounds at all! Right sleep calls.

Sunday, 5 September 2010

5th Sep

5th Sep

So I ve managed to up load about a weeks worth of blogs. Not really edited as I seem to have a cold??!!! And cant really focus on the text, so please excuse my regression into bad punc and grammer!

Its so hot today, plus my fever, im sweating like a F—ker.

Was worried that Ive become so accustomed tomy surroundings that I am starting to not appreciate the landscape, but Im pleased to report that during the hour long bus ride to Kisumu (alone my I add)I am still taken about by the landscape!!!Could you imagine a massive tech party in the open air here in Kenya. Pure sun, fresh air –NICE! I kinda have ones of my own, with my laptop in a grassy area, not so much fun alone, especially when my neighbor says that is sounds like modern devils music –LOL
They love there RnB hiphop Ragga Bashment Soul here BIG TIME!!! Oh and jesus music. Not sure if House has an untapped market here lol.

Ok so Im about to keel over.

Gonna go treat my self to chicken and chips.

4th SEp

4th September

Knacked, bloody knocked but sooo proud of myself!!! So today is my second day at Siaya district and Ive done so many procedures already!!!!
Helen the Imperial medical student has left so im in the house alone, this is good for me for a bit as, a lot of the other medical students have come here, with no prep at all and to be honest today has been really nice having Dr Odongo to my self. I get a little bit selfish when it comes to doing procedures, for example, hel suggest that one of us do something like erm, put a patient on a drip, and I have to shut my mouth and stand back and subdue my inner eager child, so as to let one of the other students ‘have a go’ ah it takes bloody ages for someone to offer to do anything, and then its another ages as they ‘remember how to do it’. I know i know, im being harse but to be honest some of these students are from Oxbridge and are at schools like imperial and to be honest I kinda expect a bit more drive, its wattles city here!
Anyway, I got Dr Odongo all to my self and I def work better on a one on one basis with the Docs, thank fuck next year we are in small groups. I mean team work is very important in the medical services but, development of skills I think needs to be done on a one to one, could be wrong but I think thats how I work.
Also sharing a room with someone really isn’t my cup of tea. The company is GREAT but some of the medical students are seem to be afraid of their own shadows and were not one bit of help in situations like, clearing cockroaches from the long drop, or mopping or cleaning. Yeah alone time is well over due.
I was reflecting on my way home over my time here in Siaya. Ya know I have fully integrated into Kenyan life. I still don’t really understand Swahili but Kenyan are very expressive and so I usually understand what people are saying in the gross sense of things. For example, Sometimes the Matatu men wanna know how much ive paid for my journey and where am I going, and I answer in English as if I actually knew what they were saying lol. I have a kinda routine –wake up at seven, throw out my container full of wee (I wont use the long drop at night -hell no) wash my face, brush my teeth, get changed, sort out equipment for the hospital, lock up, get my breakfast of small fried dough balls from one of the women vendors in the village, get a bottle of water for the day, top up etc, catch the matatu bus, get to the hospital at half eight , end the day at 4 or 5 at the latest (as everyone wants to get home before dark). Get home, have a wash, eat something, read, reflect on the day, do this blog, if its sunny sit in the sun, then bed a 10 0r eleven. Life is pretty sweet, the routine keeps me focused and looking forward to the variety of the weekend.

So today, my second day at the hospital!! In the morning we resusued four really unwell under five year olds. Never really done one before and so it was a great learning experience for me, sad that these children were so unwell. One baby was just two weeks and was so out of breath the the center of its chest was completely concave and you could actually see the flicker of her heart beating in her chest. Her lips were completely blue, was so sad, she had neonatal sepsis and meningitis. We spent about three hours in paediatrics. The mother of the baby above managed (i dono how as these baby couldn even breath) to coax the baby to breast feed for about a minute. Shortly after the baby had hiccups as it hadn’t been burped. So I had to teach this mother of two children already how to burp her baby. –yikes.
There were so many unwell under fives on this ward, with so many young mothers. Seriously, women just reside to child rearing when they leave school and many of them aren’t really sure how to. Im not having a dig but vaccinations and post natal check ups are free for all women and children in Kenya, they have free books to keep records for of their babies development, but many women present with their babies when there babies are really really sick. Like for example today, we had to resus an 11 month old baby with the weight of 5.5kg, this baby was over half the weight it should have been. It couldn’t hold its head up, sit up, wasn’t mumbling words, or crawling, obv its was ill but it looked like this child hadn’t even learnt to sit up, something it should be doing at 6 months. It was really ill with TB and mother had brought it in cause it had been fitting due to fever. This baby was so unwell, in England, straight to peads intensive care, here, i had to put it on nasal prongs that deliver it oxygen, we couldn’t start any treatment until mum had consulted with dad re treatment cost. Oh dear.
There was another boy that I had to keep checking on cos, mum was no where to be seen, he had been lying in the same position for about 2 hours, he was alive –barely. But with only two of us, Dr Odongo and I had to prioritise our care, can you imagine, no such statement in the Uk.
In the afternoon, I removed fluid from two womens abdomen (astitic tap) out of one women came pus, out of the second we drained blood stained fluid. Lady number one, had sepsis post c section. As no anasestistc was in the hospital, we could only start her on broad spectrum antibiotics, no one was in the lab either so we couldn’t even send of the pus to identify the organism and give her a better chance of surviving. Lady number two most likely had metatisc cancer, I catheterised her and Dr odongo worked her up medically, to be honest her care from now would be supportive and palliative. Her son had that, your from the Uk u can save my mum look about him. I had the oh my god her abdomen is full of so much fluid, is this women even gonna survive the night look about me.
Today went so soooooo fast, so fast I haven’t had time to upload the blogs.

Oh so yesterday, I had the worst diarrhoea that I have ever had since ive been here. Only lasted for about an hour or so but I can pinpoint what it was. At Dophil on thurs, the canteen staff were on leave but someone had cooked my least favourite Kenyan meal which contains a stew made from hundreds of small fish. Hate it. Dr Phill knows that I hate it and so he summoned on of the staff to make me an omelette. The omelette was delicious. Unfortunately, as Helen and my food dective work sussed out, this man was no cook, he was the hospital cleaner, and seeing as Dr phill couldn’t ask anyone else of the ‘higher hospital staff’ he asked this cleaner to buy and fix me an omelette. I had point blankly refused the kaffafle but i still got the omelette.
I don’t think the cleaner washed his hands, the cooking utensils, my plate, anything. Seriously, the only clean thing about that meal were the hands I was eating it with –mine. Yesterday, i expelled that meal as if it was bullet and my arse was a gun.

On my way home yesterday I was informed that one of the village vendors had named delivered her baby and named it after me. I sincerely hope this isn’t a ploy for the women to get money off me cause im living the real Kenyan life now as IM BROKE!! Lol. I wonder if the child is a boy or girl, seeing as she had no idea of the sex and was adamant that it would be named after me regardless. Bet its a boy.

Each day my my opinion of Kenyan women changes depending on the experience I have with them, Ive been proud and admired them, Ive been disappointed in the context of them laughing at me when ive been verbally abused by some ignorant Kenyan man cause i wouldn talk to him, Ive been annoyed when they are rude and ask me for money cause im rich,, but today I feel really sorry for the village women when they present with their desperately ill children, not having a clue whats wrong with them and just doing what they need to do to save this child, often what they feel that they need to do, isn’t what needs to be done.
Today I saw so many burn children. When I say burnt these kids have full thickness burns. The flesh is pink, most of the kids have more burnt body than unburnt body. Many have burnt genital. All due to them being so excited for dinner that they run into the gas burner used for cooking and either catch on fire or have whatever stew has been cooking spill and burn them. The burns are not dressed but mum is taught how to clean the burns with an antiseptic wash twice daily in the hospital. You have not heard a child in apin until you have heard a child having its whole body burns being cleaned with painrelief. These children scream, yell, holler in such an agonising way you just dono how these women do it. As it is all the children are done at the same time, the noise is deafening, and distracting when you are with another patient. You really want to run over and stop the mum from doing this to her child, but it needs to be done and so ya have to do these thing where you disassociate from the suffering kinda like take it place it in a mental box and close the box, and deal the patient taht you are with. This is helpful also when you need to do painful procedures without pain relief, if we worry about the pain the procedure dosnt get done and so Im getting good at looking away the hesitation, the why cant someone else do this feelings and just doing what I gotta do. This dosnt mean empathy is locked away also mind, I guess its just a focusing tool.

Last night I woke up to a cock roach on my breast. Ya think I make this shit up, lol, nope, fat ugly fuker on my right boob. Managed to catch it under a pot though. And tonight, i have cleared my room and sprayed insect killer everywhere, as im alone don’t think I could go through that experience a third time. Where next though, in my mouth –yikes.
Also, I think that I have discovered a new subspecies of animal. In and amongst my stuff, I found an insect that I thought was a fly, but when it moved it bounced up and down like a frog. On closer but cautious inspection, it had frogs legs and a fly upper body. NO lie it was tiny like 2cm or 1 cm but even Helen said it looked like nothing she had seen before. I killed it thou. Would rather have it dead than have a noble prize for discovery frankly.

Lastly On my way home the bus stopped outside a hair shop where a boy about 8 years of age (prob older as all the kids look young here) was braiding a young girls hair. –ey. This boy was doing a fab job but I was a bit like really?!

Anyways, im tireds and the weather has gone from sunny to monsoon downpour, and as we have already had two power cuts in the last hour and im alone, thinking of thoughts of hotel rawanda (don’t ask) im gonna go to bed.

3rd Sep

3rd September

Had a perfectly brilliant day today. I started at Siaya district and got a wicked firsthand experience of a district Hospital in Kenya. Dr Adongo is the Dr who is primarily in charge of things. This hospital is big and unfortunately, he is one of a handful of Consultant Doctors that fun the place. Below him are many Medical officers who are Drs are only a few years out of medical school. Below him are many Clinical officers who are people trained to look after the day to day clinical care in wards. Kinda in between the Doctors and the Nurses. Nurses are a plenty, and other traddional hospital staff can be found but are usually just one in their number.
I was shown around the hospital and was really impressed by some of the services, such as the neonatal ward, the xray centre and the hematology center. I was not however impressed by surgery. I was warned by a consultant anaestatist in the Uk about some African countries inability to maintain and care for equipment. The Surgical area had drugs lying about everywhere, some used, some half empty, no order to equipment (or an order that I was unaware of!).
The day started with a ward round, one that we never finished because we came across a mother who needed an emergency C section and unfortunately, she ripped,by ripped I mean the babys head and the midwifes pulling caused her to tear the skin from the end of her vagina to her anus. –yikes. Dr Odongo sewed her back up the best her could. He seems to be a man of many talents, different from Dr phill in the sense that Dr Phill is some what old school and Dr Odongo is aware of all the new procedures and generally up to date with all things medical and clinical. He dose seem to fit the description of a high functioning autistic person, kinda something rain man about him (but he dose know how to social interact with people and dose have compassion and empathy). Gonna enjoy working with him!!!!!

2nd Septpost Cockroach attack

2nd Sep after the cockroach affair

After reflecting on last nights events, I have concluded that if I aint enjoying something I should change it up. And then on further reflection, especially after having such a nice day in the hospital, I don’t think that I am over Kenya so to speak, mate im just over village life. And so I have decided that tomo I will begin at Siaya district for one week, and then for my last week, I will travel to Embu a town just outside Nairobi, and do a weeks placement in the hospital there. This hospital (i am told) is run by majority female Drs –this I am very excited about; being surrounded by men has taken its toll on my feminist self. Everyday a proposal, every day some middle aged Kenyan man wanting to make me his wife, offering my family various farm yard animals for my hand in marriage. And everyday, its a bloody know. Hey listen im not boosting, Ive only had one fine young thing ask me out, bless him the medical officer that I work closely with really likes me –yikes mate. Aside from him, the flow of eligible bachelors and married who come to the hospital asking ‘to get to know me’ are minging. Im talking about unbrushed teeth-fuck that teeth missing, unwashed bodies –BO that smells pathological, but the thing is these men all dress smartly, clothes ironed, shoes shined, always looking official carrying some brief case stuffed full of papers and flashing wicked up to date blackberries. But the stink, the stink man,im totally immune to body odur now. You think the wiffs that steam from peoples body on packed buses and tubes are bad, man alive you aint smelt the smells her in Kenya. Wowza. And dya know what it aint about not having running water, I DONT HAVE RUNNING WATER, and i forgot to bring deodorant, and for a few weeks neglected shaving my armpit hair, and yes at the end of the day sometimes, i have a slight pong about me, but man at 8am Mr i wanna marry you fucking stinks. Man Im being cruel i guess. Its just so hard at times to work in such a male dominated field, its not that Im not listened to or even that we don’t work together, cause we do. Its just the constant side comments about who im gonna get with, who I like, introductions to smelly yucky men, sexual innuendos about who I spend time with. Argh its boring and Im kinda glad to leave the place despite the fact That im really gonna miss some of the staff big time.

Mr I have TB but the hospital diagnosed it too late died last night.
The boy with the Chiggars is eating and washing his own feed now, and taking his TB meds.
Mr RTAs skull xray came back and guess what, he has a temporal skull fracture and a lovely sub dural, and his GCS was doen form 10 to 8 today, 1 as he dosnt open his eyes. 1 cause dosent talk. And 6 cause he localises pain. He is pretty much comatose thou. Wets himself, dosnt move, dosnt open his eyes, is barely breathing. On th verge mate and guess what we are doing for him, a drip. Today I had the pleasure of cleaning his eg wound and head wound. Cleaning the wounds of guy on the way out, who everybody says will be ok with time. Right.
and also I caught his relatives trying to feed him porridge. This man who is pretty much comatose is being made to swallow!!

The sun had its hat on today. One of the staff who has decided that she is my mother as I look far to young to be doing the thing that I am, took me to a massive market in Lunanda. Speaking of markets, we had very few people turn up to the hospital today. WHY? Because its market day, and apparently Kenyans don’t get ill on market day. Just like Kenyans don’t get ill on Sunday morning cause its church morning.

Anyways, we walked half way and caught a bus the rest of the way to Luanda market. (initially Catherine the HIV dr tried to get me to double up with her on a motorbike. Hell no. This motorbikes, are death on wheels mate. Most of the RTAs in Kenya are caused by them as these men have no licenses, no helmets, no sense of direction or balance and mate when they swerve you die! So i managed to avoid that mode of transport and we arrived at the market on bus. Lord, the market was busy, colourful, vibrant amazing. Exactly how I imagined an African market to be. Food, all kinds of food were everywhere, women sold their wears next to each other . No one argued if you bought from their neighboring vendor. I spoke not a word as I didnt wanna give away my non Luo self. I got 7 potatoes for 20p. 7 tomatoes for 20p. A whole stick of sugar cane for 20p and a massive pineapple for 50p (English equivalent of money). The market was amazing, the sun was hot and Catherine was excited to show me where she bough stuff and introduced me to all her friends. It was a lovely end to the day, and cheered me up no end from the pure nastiness of sleeping with a cockroach.

Actually, the most uplifting aspect of the day was the lovely call I got from my sistah Janet, ended with her blasting my fav grace jones tune down the phone!

So im happy again and gonna proper enjoy my last two weeks.

Ah health update. It is worms, lovely small worms in my gut. In my poo. Killing them fuckers with medication thou. Ha iv had worms. AMAZING!

2nd sep am

2nd Sep 2am

For the second time this during this adventure, I have been awoken from my slumber by my annoyingly acute hearing. I like to think that im tough, im pretty much not afraid of anyone and can rationalize most situations. Cant fight for shit but will make out that I can until the very last moment. Lots has happened here in Kenya, Ive been challenged in every which way that you can imagine and haven’t shed a tear, ive figured that this is Africa ya know. Shit happens and Ive gotta deal with it.
I did wonder when I was gonna break, wanna come home.
Ive broken, i wanna come home.
My arse is itching insanely –all I can picture is a gut infested with worms and I cant get treated until tomo. This hasn’t broken me, cause like I said, this is Africa and if I didnt get some parasite living of me then i haven’t lived the experience.
Remember I told you about the cockroaches that I killed with bleach in our toilet, well one saught its revenge tonight.

About half an hour ago, I awoke suddenly from my sleep. Something wasn’t right. Rustling has awoken me, I couldn’t tell if it was from outside or inside but it sure was rusterling. I listened closer –was my nightime window intruder back i thought, where is my bloody swiss army knife?. No. It was coming from inside. Inside our room. But where. What the hell is rustleing...


Lord above I screamed. I fucking screamed. Knowinging instantly what it was. Thankfully Odongo our Kenyan rep, was awake and came and removed it.


My bed ya know. The one place that is safe for me. Safe from the frustrations and horrors of the hospital. Safe from all bugs, mossies and flies. My throne, my bed. Invaded, invaded by the biggest uglylist cockroach in the world.
Needless to say that im too afraid to go back into bed. Ive check all the surrounding areas and odongo and Helen say that it was just bad luck. Bad fucking lucking luck like the shits ive had frm day one, being groped by some minging Kenyan man, having worms sucking the nutrients from my gut and now sleeping with a cockroach.

Ive had enough. I wanna cry, but I cant. Im not even bloody sad, im just annoyed. Annoyed that I cant eat anything, and now im being eaten. Im tired. I think im homesick again. Don’t really wanna count down the days ( 17 by the way) as this is a fucking amazing experience and I wanna live i to the full. But this bugs are a nightmare.

Ok im gonna go back to bed, i think. Im bloody traumatized though. Gotta give it to the fucker, these bugs are smart, not only did this one survive a bleach bath, it actually came back to seek its revenge. Gotta find the funny side. –RIGHT?


This is not funny. I wanna go home and fuck my arse is ITCHING!!!!!!!!!

1st sep

1st September

Wow ive been here in Kenya over three months (not actually three months but Ive written my blog in July, Aug and Sep now). Had the day off - my stomach was bloody killing me last night. Been trying to work out what is causing me all this jip, and I have concluded that its the water. I only drink bottled water and I am quite facetious about this actually. However, I bath with water that is collected from a well and placed in a big container over our shower and that is what drips out of the shower head when I shower. All other water that I use is boiled and so I reckon that when I shower and the water drips into my mouth that I AM BEING CONTAMINATED!!! So today i laid in bed and finished beloved (finally) man alive that book is absolutely bloody wonderful. Seriously, no wonder Toni Morrison won the noble prize for literature and numerous other awards. I think she may be the only reason that I would ever take a trip the USA. I urge you to read Beloved, and actually her other book ‘Sula’ which I managed to finish in four hours. All her books are pretty heavy and really thickly filled with metaphors, segways from the plot and lots of words that I’ve had to look up –lol but essentially good reads for example this portion of text towards the end of ‘Beloved’ I thought was beautiful; Sixo is a young man describing why he has so much love for the ‘thirty-mile’ woman, named so because that was the distance he had to travel each time just to see her.

He says, ‘She is a friend of my mind. She gathers me, man. The pieces I am, she gather them and give them back to me in all the right order. It’s good, you know, when you got a woman who is friend of your mind’.

From the book ‘Sula’ there is a conversation between the girl the book is named after and her lover, in which they are competitively comparing how much they love each other. Each trying to outdo the other with beautiful metaphors.
I quite like what Sula says, - ‘ I will put my hand deep in your soul, lift it, sift it with my fingers , feel its warm surface and dewy chill below’.

I love her lovers reply, ‘I will water your soil, keep it rich and moist. But how much? How much water to keep the loam moist? And how much loam will I need to keep my water still? And when do the two make mud?’

Sula is a literal triumph for Toni Morrison, the part of the story that really resonated with me was the part in which Sula (the kind of heroine of the book) returns back to her post slavery village, where nothing much has changed and her best friend has moved on, got married, had children and is satisfies with married life and all its mundanities. Sula, is unlike her best friend, she is educated, worldly, much travelled and open to new experiences and most important of all is constantly asking the question – ‘why’. She is rejected by her best friend and the villagers and is branded a witch for her displays of ‘unruliness’ which are actually the behaviours of an educated woman. Toni Morrision eloquently describes Sulas frustration with the ignorant happy-to-live-a-life-that-their-mothers-did-and-their-grandmothers.
It is this frustration that I carry here in Kenya and to some degree in London.
The kids here call me ‘Muzungo’ (which means white person) er because apparently I talk like a white person. I got this same ignorant bullshit when I was younger in London, after finishing my secondary education at a private school, I went to normal regular state school. Here I was ribbed for speaking ‘posh’. As this ribbing did my head in I did lose my well spoken ways sharpish, but on reflection I think, er why did I do that. Anyways how does a white person talk? Or is it that black people aren’t well spoken. Its bullshit and to have the villagers here classify me as a white person despite my appearance looking just like theirs. AND THEN this afternoon on my way to get some fried dough as a snack one of the women vendors in the village, was like ‘why don’t you have children?, you are getting old you must have a husband and children, we will find you a husband’.
Ergh this was all quite charming in the beginning but six weeks on i feel that having to explain that my education comes first because if I did have children now I wouldnt have money to raise them, has become bloody BORING. I had to really bite my tongue and not say what I really thought of Kenyan village men.
Ah slight segway, I gave a lovely girl called Victoria my Kenyan number because she asked for it as she wanted to text me and practise her English. Ok fine i thought. Until today Im getting bloody texts from Kenyan students asking me if I could help them find jobs and placements in London and asking if they could stay with me. FUME. Thankfully the mobiles here have a block number feature, and thats what I have done.
Oh back to the village women, one of the women, showed me her beautiful grandson, who was swaddled in a massive blanket despite the weather being at least 24 degrees. (I know it is winter here and it is cold (24 degrees min) compared to the temperatures that they have in the rainy season (up to late thirties) but the women here wrap their children in so much clothing, that it is no bloody surprise that there is a stigma associated with febrile convulsions, cause every bloody child gets one cause they get so bloody hot!)
Anyways this child was cute, and then its mother came along to say hello, er its mother was 15. 15 mate, mum was proud of her despite this child dropping out of school, having no money and father- long gone into the Kenyan sunset as soon as he slept with her. AND THIS I thought is the life they want for me, instead of studying? EY. I have tried on numerous of occasions to explain that an educated women is a women with choices. The choice of a good husband, the choice of a good job and the choice of her own future. Deaf ears mate, these women don’t listen and don’t have any idea, they are living the life that their mothers did and their mothers before their mothers did. No ambition, or ambition stifled by the harsh reality of life. The excitement of feeling wanted by some Kenyan male whose only ambition is to have his way with as many women as he can. -Without condoms, without the fear, or even knowledge of STIS, HIV being something that, cant happen to him cause he is strong. This excitement is overwhelming for adolescent Kenyan men (and women all over) but nine months later is replaced by sadness as children bring joy, but children need clothes, food, clean water, vaccinations and medication when they are sick most of which a mother n poverty cannot provide.
These very same women, ask me to give them money.
‘Help me feed my baby’, they say.
‘You are rich’ they say.
‘Can I have your clothes’ they say.
Their eyes plead with me to buy the fly ridden food they sell on the roadside, as I walk to work.
Some wont talk to me if I buy food from another women.
Some make jokes with me, hoping that at the end of my laughter I will empty my purse into their hands.

These same women look down on me because I speak like a white person, dress like a boy have no husband or children, but will beg for money from me. It is so confusing.

Anyhow, I do have some village female friends and I really appreciate them. My neighbour lets me play with her children, we chill and talk about life. Today I actually managed to get her 9 month old son to repeat dada.

So the book ‘Sula’ made me think –what is my identity. Who am I. Stuck between two cultures, not feeling a part of either but not really wanting to either. In a world that is becoming ever more multicultural, children being born with families from numerous countries. Life isn’t as simple as black and white people. Black and white culture. Speaking like a black or white person. I cant explain this to the village women, I really want to open their eyes and perhaps initiate change or help them to think about change, but they have resided to living the way life has always been. Complaining but not changing. Im not the first medical student to reside in this village. I know that they would have conversed with other similar black females like me and so I feel that there is no excuse for this perpetuation of ignorance.

The worse feeling is knowing that change is possible, but being unable to propagate it despite really really wanting to.

Oh on a lighter not. My bum hole is well fucking itchy. Like itchy and sore. I think i have worms.

31 aug

31st Aug

You guys must be thinking what the hell? This girls on elective and all we’ve been hearing about are her non medical Kenyan adventures. Well today, I started back at Dophil, I was meant to be at Siaya hospital but Dr Phill has personally requested that I remain with him at his hospital for one last week, as he is on a month long training course from the 6th of Sep. It is quite hard to say no to someone who has saved you from chronic diarrhoea and so I accepted his request and off to Dophil i went. BIG MISTAKE. Today, I major feelings of frustration which almost boiled over into annoyance. Il take you through my day, I hope that you guys can appreciate the pure and utter feelings of ‘whats the bloody point’ that i had today, I’m ashamed to say that today, I nearly just gave with up with the notion that anything I did was helping anyone. I mean what is the bloody point of short term gain, if the long term is neglected, anyways here goes.

So my day started at eight thirty at Dophil for ward round. I hadn’t been in for a week or so, and so I was unfamiliar with the patients. Two stuck out for me today, one was a gentlemen with pulmonary TB but had some focal neurology signs (signs that perhaps the TB has spread to his brain), He was really thin, coughing like no mans business, fever, refusing to eat. Anyhow the Tb had not been confirmed because the hospital had run out of sputum pots. Before any treatment for TB can be commenced here in Kenya the patient has to have a positive sputum test of confirmation chest x-ray. Ok this is fair enough because the treatment for TB can be a minimum of six months worth of tablets. In Kenya many people stop taking the tablets after a few weeks because they feel well. Little do they know that the bacteria persists for many weeks in their blood stream hence the six month long treatment regime. And so as in the UK, Kenya as adopted a buddy scheme which means a friend or family member or good will citizen can retrieve the drugs for the patient (drugs are free) and ensure that the patient takes them. Or the patient has to come to the hospital everyday for the next six months and be observed taking the medication by a trained practitioner. Why so stringent you ask, this is because TB strains can become resistant, and resistant is dangerous when this disease is spread by direct inhalation of infected mucus samples, spread by coughing.
And so because the hospital didnt have sputum pots into which the patient could deposit a sputum sample and it be tested on site and treatment commenced, treatment has been delayed despite us all being aware that the patient had signs and symptoms of a chest infection that was likely to to be TB and has most likely spread. Needless to say the patient was unmasked and coughing infected mucus all over the ward from his bed. Great.
And so the medical officer that I was with was suggesting that the patient be taken for a chest Xray. Chest xrays are a whole lot more expensive than sputum sampling. I argued that not only was the patient confused, and disorientated, he was too ill to walk to the loo let alone to another hospital. They couldn’t pay for a taxi or an ambulance and to be honest, I continued, why the hell should he when it is our fault that his treatment is delayed as we don’t have the supplies. I wanted to go against the rules and just initiate treatment, as it is bloody obvious that this guy had TB. The medical officer still refused to do so (and correctly so) but I was annoyed that another day would pass and this man gets sicker and infect the air some more. Also the medical officer suggested that we test him for HIV antibodies. Er, I was like he aint talking, how can he give consent? And so the officer was like he cant give consent lets do it anyway. I was like in the Uk you have to counsel a patient, get consent, counsel about the results, implications and treatment etc. In the UK we treat all HIV positive people immediately (if they so wish) here in Kenya (not sure if this is WHO or just Kenya rules –i shall check) Patients are only started on anti retroviral when their CD4 (white blood cells) are at the level of 280 or under?? I suggested that if we tested this man and found that his CD4 was above 280 it wouldn’t change our management of him and I felt really uncomfortable ordering an investigation that at this moment wasn’t the pending investigation and without the patients consent. We didnt do the CD4 count in the end I am (antibodies) and Im glad cause frankly if we cant treat a patient because of the resources that we are lacking, then we cant bend the rules for something else, especially in reference to consent and the absence of a next of kin or legal guardian.
Towards the end of the day a sputum pot was found –hurrah . We shall await the results of the test.

The second memorable patient form the ward round was a young boy of twenty who also had TB. He had initially been commenced on treatment last year, but neglected to compete the course and so was back again, sick looking with absoulty horrible feet.
In Mombassa a Kenyan man had told me about an insect called a Chigga. These are very tiny insects, half the size of a grain of rice that like to live in feet. They attach to the soles of feet and slowly eat away until they reach a blood vessel and then suck their human hosts blood. The only suggestion that a person is infected with these parasites is an insatiable itch in the area. Later ulcers and wounds appear as these animals, multiple and erode the soft tissue, causing painful walking. This infestation usually occurs on the feet of non shoe wearers. Many of the villagers walk bare footed here. Some cause they have no shoes, others cause it is more convenient to walk bare footed in the mud after the rains than walk with flip flops. This boys feet were indescrible. Seriously, I had to take a picture as what I saw was perhaps the worse case of infestation that anyone in the hospital had ever seen. The skin on his feet where thickened and ulcerated almost on every surface. It was grim and looked so bloody painful. This boy was ill, very ill, breathing rapidly, very thin and weak. Turns out he was an orphan, he lived alone in a hut, didnt got to school, and had been abandoned by his older brothers who had left him years ago for the bright lights of Nairobi. All alone this boy had contracted TB and Chiggars. He had presented to the hospital the previous day. Was admitted. Howver, he has since been refusing to eat or drink and did not want any medical care. We think that he needed somewhere warm to sleep and perhaps had come to the hospital to die. Twenty years old this boy was and had make the descion to die. Ah i felt the tug of my heart strings again, dosnt take much now though. I gave the boy my breakfast (dry old cake from a stall). I asked the medical officer to tell the boy that he must eat and drink and that we would help him as much as we could. The great thing about being a female, Kenyan looking but ‘muzongo’ speaking student Dr is that people are often fascinated by me. He hasn’t met a female dr before, I gave him food and talked in a language that he couldn’t fathom. Ha, I had his attention and from that moment due to some ill believed faith that I could solve all his problems he began to co-operate with the staff. Wicked. He allowed one of the nursing staff to clean his feet and he took his meds. I made one of the medical officers tell him that if he co-operated that I would bring in some topical cream that I had that the hospital didnt have but would help with his feet. Score. Futher co-opertaion!!!

Some hours later, well after a lunch of beans and maize ( not like the marks and sparks that I know and love). I noticed that a man had been delivered to the hospital in a wheel chair. This eldery man has one massive lump on the side of hid head. A massive gash oh his leg. A bleeding nostril and was urinating all over the waiting area. The man was confused and drifting in and out if consciousness. I summoned DR Phill and we took him to the surgical area. Annoying, I was told to suture his gashed leg. Er, I was like, shouldn’t we assess him first as it transpired that the man that had brought the patient in was a motor cyclist who had driven head on into him. –yikes. No I was told, he will be fine we need to sew up his leg. This man had one fat bump on his temple, and I being the freshly out of fourth year exams medical student who thinks she knows everything was more concerned with the fact that this man may have a serious head injury. No one was interested in my thoughts. And with hindsight, I guess not because they didnt care but because, all of my findings meant nothing, we have not CT, we have no X ray we have an ultrasound. If this man has a serious head injury, pat on the back for me for the diagnosis, but no prizes for guessing that we have a lack of resources to manage it. We have no neck collar, we had no airways adjuncts, no oxygen, no way of managing his vital stats. Nothing. But guess what we did have sutures for me to suture his gashed leg. So I triple gloved up as every now and again the patient would make an involuntary movement, and god forbid i get a needle stick. After every suture I had to rub the guys chest, just to make sure he was still with us and I wasn’t suturing a dead mans leg. So i sewed up his leg (don’t think the sutures will hold, and im pretty sure hel get an infection despite me almost coating the wound in betadine antiseptic). This whole situation although not unfamiliar to me was annoying me, and I actually surprised my self with how bloody annoyed I was becoming. Simple ABC was not being adhered. Bloody basic life support. All that was being cared about was the bloody gash on his leg. This man was pissing everywhere, so I suggested catheterising him. I was told, no point cause hel pull it out. Five minutes later I came to see him, he had vomited blood stained material. Mate, I felt for this guy, I really really really did. But I left it. I walked away. Nothing I could do or suggested was gonna change his management. The nurses all were saying, hel be fine. Hel be fine. I left it.

Later some guy who had had a stroke in 1984 came to see if I could help him and got really irritated with me when I said that he had his there was nothing we could give him medically to get the power backing his left arm and leg. I suggested some gentle rehab exercises(?) to maybe losen up his stiff limbs. He was fumming. Its really hard to explain anything to an angry Kenyan man and soI just let him rant.He ranted and left. I must admit I did utter moron under my breath, but the patients aren’t here aren’t like those in the Uk – they wont listen to any advice when they are angry, even with my patience and willing, they just want a quick fix and nothing and nobody can persuade them to other things.

Lastly, a man bought in his daughter to see me. She had ear swelling, an infection of the soft tissue. BUT HE WAS SO RUDE TO ME. He was def very educated and I totally knew he felt inferior to me and wanted to a male DR. Okay by now I was just frustrated and just told him that if he couldn’t work with me to help his daughter then he can just leave and il see her alone. I told him that politeness and cooperation is all that I ask, I didn’t care if he didn’t like me, cause frankly I didn’t like him but as I wanted the best for his daughter, I would like him to leave. He apologised and cooperated, prob shocked at my up blatant annoyance. One of the medical officers later told me that the man had asked him to apologise on his behalf for his behaviour,moron couldn’t even apologise to me face to face.