Kenyan Time

Patience. I am quickly learning that the people of Migori do not operate on a specific schedule. Surgeries begin when Dr. Agullo is ready, the next surgery begins when the previous one ends, and food is served when food is ready. This requires a lot of something I do not have: patience. Not only do I like to follow a daily schedule, but I prefer to do everything efficiently—I even walk quickly. Here in Kenya, people take the time say hello to everyone they know on the street. They could sit around for hours just drinking tea and chatting with friends. They appreciate the moments spent with one another rather than focusing on what is next on the agenda. This has been a difficult adjustment for us Medics to Africa volunteers, because when we ask a Kenyan how long it might take to get somewhere or what time something will happen, the answer is often inaccurate. In fact, I usually double the answer, and that still might not be the correct time. This does work to my advantage at times, however, as the morning meeting frequently starts 15 minutes after 8:00.

            Another exciting part of Kenya that I am adjusting to is the frequent loss of power. Almost everyday the thunderstorms begin and the power goes out. Judy, the housekeeper, then lights candles and the other girls and I sit in the candlelight talking about whatever comes to mind—anything from weddings to amputations. Luckily, the hospital has a back up generator. Recently, the program director has provided us with sparkling red wine (interesting), beer, and gin as I am the youngest one here. He then proceeds to ask why we aren’t finishing the drinks each night though we don’t often feel like drinking after our long days. In fact, I’m usually feeling sleepy as soon as the sun sets though I force myself to stay awake until 10 so I don’t miss out on any interesting conversations.

            Wednesday morning began abnormally when I woke to an unusual power outage. Just when I thought I would have to go without my morning toast, Helen, the chef, whipped me up some toast on the stove before I could even ask. Rounds in the Children’s Ward began after the usual morning meeting. Much to my surprise, most of the patients who seemed so sickly the day before, had improved tremendously. It was incredible to see the sick kids I once knew walking around the ward and being discharged! However, as we approached Collins, an 11-year-old with pyomyositis causing abscesses in his legs, his condition seemed to be worsening. Each day I had watched the doctors changed Collins’ dressing as his abscesses oozed with puss and he writhed in pain. Today, Dr. Otonga said the infection had spread from his wounds causing fever, edema in his feet, and his breathing to become intermittent. I was told that Collins needed a blood transfusion of O negative blood. After a bit of discussion between the doctors, it was noted that Collins actually needed O positive blood- my blood type. I was told that earlier in the year, someone pretended to be a hospital worker and stole the hospitals funds for blood donors leaving the hospital with no blood for the patients. They desperately had to find someone to donate blood for Collins before his organs started shutting down.

I told the PA student I was with that I had O positive blood but my mom would kill me if I donated in Kenya. Not only would I be exposing myself to disease in a hospital swimming with HIV positive patients, but I’m just not a very good blood donor. I don’t drink enough water so my blood comes out very slow, my veins are difficult to find, and I am known to faint. I absolutely despise getting shots because they hurt! So as I sat eating my lunch to mull over the idea, I weighed these pros and cons. I then remembered my answer to those who asked why I was going to Kenya; I quickly reply, “to save lives.” Though I pretend to be a real doctor sometimes, I cannot actually perform life-saving surgery, as I said in my previous blog. However, I had been presented with the opportunity to actually save the life of a little boy I had seen every day in immense pain. Thinking of it this way, I had to donate blood, no matter how bad it would hurt.

I quickly marched down to the hospital before I could change my mind to find Dr. Otonga at the gates. He told me that Collins had not yet received a transfusion, so I headed to the lab to get screened. I sat down and a man had me fill out the donor questionnaire, which asked questions like “Have you ever done cocaine? No. Are you pregnant? No. Have you ever been sexually abused or exploited? No.” Before he poked me I waved for a little boy to come over and hold my hand as the evil doctor drew my blood. The boy seemed very confused when I didn’t let go of his hand immediately, but started laughing when I made painful faces. I told you guys, needles hurt!! It would take an hour for my blood to be tested and deemed acceptable for donation. This hour seemed to take a lifetime as I went to visit Collins in his worsening condition. Dr. Josiah, who always greets me with a hug and a smile, informed me that Collins liver and spleen were inflamed, which I could feel by pressing on his abdomen. I knew I had made the right choice.

I returned to the lab and Norah, yet another amazingly nice Kenyan, took me to a curtained area where I would give blood. I jumped onto the bed, removed my shoes, and laid down for what I thought would be an excruciating hour. I was right. The vein in my right arm decided to form a clot before the blood bag was half way full, so Norah wiggled the needle around to try and get some more blood out. That was unsuccessful so she stabbed another vein in that arm, which produced literally no blood. At this point, I was gritting my teeth while Norah smiled. She then switched arms and finally found a vein in my left arm as she sang “You are toooooo liiiiitle. Your veins are inviiiiisibleeeee.” After a bit more needle wiggling, we finally had a pint of blood. All I could say was OUCH! I laid on the bed for 20 minutes while Norah wrote down her phone number and invited me to dinner at her house—I was just trying not to faint. When I felt up to it, I wolfed down a Nutrigrain bar and started walking back to the residence. I continued up the hill when I realized that if I was to faint, I would most likely hit my head on a rock and wake up in a strange Kenyan home. I put a little pep in my step and finally ended up on the couch of my beautiful residence. I did it!!

For those of you who are worried about my health, as my mom was, I am happy to inform you that the needles used were very sterile. Furthermore, St. Joseph’s Mission Hospital is dedicated to preventing the spread of HIV/AIDS and therefore, takes the necessary measures to use new needles on every patient. I also have come to the conclusion that God simply would not let me get HIV for saving a child’s life, just like the doctors here don’t get TB though they are exposed to it each day. But, I still pray each day that HIV is not in God’s plan for me, just to be safe!

Collins received my transfusion the following day at noon after the his blood was cross-matched with mine. By Friday, he was sitting up, laughing, and talking to his family showing much improvement. During rounds that day, Dr. Otonga told Collins and his mom that he received my blood during the transfusion, and I could see the gratitude in their eyes. Their surprise accompanied by endless “Thank-You’s” proved that the pain of the needle was nothing compared to the pain Collins had been enduring for weeks.

Thursday afternoon included the new girls’ first trip to the market, which went rather smoothly. On our way home, I was greeted by an old man walking with a cane. He asked if I spoke Swahili, and I said “hapana” (clever, I know). He proceeded to teach me that cuja= come and twende= let’s go. Judy told me that he was actually telling me to come with him to his place. Some locals on the street asked him if they could have one of us girls but he said that we were his girls? Odd. A 16-year-old boy, Elias, from the hospital who had chicken pox and malaria came over unannounced when we returned. I was happy to see his smile and excited to introduce him to my mom over skype. I gave him some neat pencils and he was on his way to school at 5 pm. Helen, who I have decided is a saint, made us pizza for dinner. It was homemade bread and sauce covered in vegetables and cheese. Let me tell you, corn on pizza is scrumptious!

As I woke to the smell of scones warming the room Friday morning, I was excited to begin a new day at the hospital. I only have a few days left in the children’s unit but I am becoming very close to the patients and their families. I am greeted with smiles as I walk into the ward. The morning meeting today included two cases of patients who had died over the night. The first case was a baby born yesterday morning who may have had a congenital. However, the correct tests were not ordered which could have saved the babies life. This is the frustrating part of the hospital here- so many patients could be saved but aren’t because of a lack of communication. The other deceased patient was a 76-year-old man that died from possible liver failure due to alcoholism. The problem at St. Joseph’s is that the cases are discussed each morning because the doctors honestly don’t know what kills most patients. This man had a history of drinking but never had tests ordered on his liver, and therefore, they are unsure of what happened. Autopsies are not performed unless the family requests them so everyone is truly left in the dark regarding the cause of death of most patients. Additionally, over the night, a patient was admitted after he had been shot with an arrow through the nose. The day ended on a high note with 5 discharges in the Children’s Ward. Because there were so many, Dr. Otonga taught me how to do discharge paperwork and let me sign my name as the discharging clinician. Does that make me a doctor? Yep.

         
          On Saturday, we headed to Lake Victoria with a hospital driver, Willis. The lake was massive and a strange combination of green/blue/brown. We took a sketchy motorboat out on the lake to catch some rays and relax. My favorite part of this endeavor was when the Kenyan man taking us on the boat swept me up and carried me across the mud onto the ladder—HOW ROMANTIC! We spent the day on Kenyan time driving around Homa Bay and eating lunch around 3 pm. On our way back, we picked up the most delicious pineapples on Earth—literally I could eat a whole pineapple but my tummy started hurting. I also found a jump rope in the residence to add to Blaire’s Kenyan Workout, which my dad was happy to hear. We are playing in a tournament 2 days after I return, so he is hoping I’m not completely out of shape. The night ended with Sleepless in Seattle, a perfect end to a week full of African adventures.