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.