Tuesday, July 1, 2014
Signing Off
This concludes my Iringa blog posts. Already missing everyone from the Gap Medics house and the hospital, as well as the crazy wonderful African lifestyle. Nakupenda.
Last Day in Iringa
6/27/14
I can't believe it is my last day in Iringa. It's hard to imagine that I have been here a full 4 weeks and will probably never see most of these people I have spent every hour of every day with again.
This morning we did rounds with Dr. Msigwa, discharging many of the patients from minor surgeries. Then we went back ton another ward and Dr. Rahib lectured us on the prostate. Of course he always asks us questions and has us guess the answers, though I rarely knew the answers. For the first time in my life, I am one of the youngest people on the trip and don't really know much about medicine, which puts me at a slight disadvantage because the doctors don't know this.
After the morning shift, I had planned to go to lunch with some friends and finish shopping, but there were 7 C-sections that were going to be happening and it was rumored that Gap Medics students could have the chance to assist. After watching 5, I gave up on the idea of assisting and called it a day at the hospital. Though I didn't get to assist I protect much checked everything else off my list.
For dinner, a group of us stayed at the house and made Mexican food and enjoyed the last night in the house. Definitely a night well spent with everyone.
I can't believe it is my last day in Iringa. It's hard to imagine that I have been here a full 4 weeks and will probably never see most of these people I have spent every hour of every day with again.
This morning we did rounds with Dr. Msigwa, discharging many of the patients from minor surgeries. Then we went back ton another ward and Dr. Rahib lectured us on the prostate. Of course he always asks us questions and has us guess the answers, though I rarely knew the answers. For the first time in my life, I am one of the youngest people on the trip and don't really know much about medicine, which puts me at a slight disadvantage because the doctors don't know this.
After the morning shift, I had planned to go to lunch with some friends and finish shopping, but there were 7 C-sections that were going to be happening and it was rumored that Gap Medics students could have the chance to assist. After watching 5, I gave up on the idea of assisting and called it a day at the hospital. Though I didn't get to assist I protect much checked everything else off my list.
For dinner, a group of us stayed at the house and made Mexican food and enjoyed the last night in the house. Definitely a night well spent with everyone.
Losing Streak with Patients
6/26/14
Another surgery day today! It is much nicer actually being in the surgical department so I can have inside access to all the surgeries and not be turned away if there are too many people. In our morning meeting, Dr. Msigwa (another really good surgeon at the hospital) told us that the woman who had gotten the leg amputation the previous day had died. They didn't know the cause of death yet, though they suspected it may have been sepsis. The surgery had gone well and she was doing well for a while... the woman asked the nurse to get her some soup and by the time she came back the woman was dead. Even though I had only seen her twice, it was really crazy to think she was gone... I had literally just seen her surgery yesterday.
The surgeries started right at 9am and we saw a tonsillectomy, the repairing of a shattered patella, the suturing of the top layer of skin on a man's stomach (he had previously gotten an abdominal surgery and was now stable so they could finish sewing him and up and send him home), a circumcision, and an abdominal hernia surgery. They also brought in the little boy (I'm pretty sure I mentioned him in an earlier post) who had burned his legs and were redressing them. I stayed for part of that procedure and then decided to call it a day as it was late in the afternoon by that point.
I had my last BBQ that night and then we all went to Shooters for the last time. For the past couple days, the power has also been unreliable (it went out during dinner on Wednesday night for 30 min) and it probably went on and off more than 6 times in the 2 hours we were at the bar. "This is Africa", an already very common excuse was used a lot that night.
Another surgery day today! It is much nicer actually being in the surgical department so I can have inside access to all the surgeries and not be turned away if there are too many people. In our morning meeting, Dr. Msigwa (another really good surgeon at the hospital) told us that the woman who had gotten the leg amputation the previous day had died. They didn't know the cause of death yet, though they suspected it may have been sepsis. The surgery had gone well and she was doing well for a while... the woman asked the nurse to get her some soup and by the time she came back the woman was dead. Even though I had only seen her twice, it was really crazy to think she was gone... I had literally just seen her surgery yesterday.
The surgeries started right at 9am and we saw a tonsillectomy, the repairing of a shattered patella, the suturing of the top layer of skin on a man's stomach (he had previously gotten an abdominal surgery and was now stable so they could finish sewing him and up and send him home), a circumcision, and an abdominal hernia surgery. They also brought in the little boy (I'm pretty sure I mentioned him in an earlier post) who had burned his legs and were redressing them. I stayed for part of that procedure and then decided to call it a day as it was late in the afternoon by that point.
I had my last BBQ that night and then we all went to Shooters for the last time. For the past couple days, the power has also been unreliable (it went out during dinner on Wednesday night for 30 min) and it probably went on and off more than 6 times in the 2 hours we were at the bar. "This is Africa", an already very common excuse was used a lot that night.
Bucket List Amputation
6/25/14
Today we just did rounds in the male surgical ward with Dr. Rahib. Most of the cases were post-op abdominal or fracture surgeries. As we saw each of the patients we learned about the different methods for fixing fractures and the importance of immobilizing the joints above and below the break. It was really interesting, but the methods of realigning the bones using weights attached to the casts or screwed into the bones themselves would never be used in the US... or at least I am not aware of this. Dr. Rahib also gave us a lecture on the appendix before we took a break for lunch.
When walking outside through the hospital after coming back from lunch, my friend and I randomly ran into Dr. Ombati, who excitedly told us to get scrubbed in because there was going to be an amputation in the surgery building. We had previously seen this patient on Monday during rounds. The patient was a 28 year old female with type 1 diabetes who had burned the top of her left foot. This burn had become infected and since she was not taking her insulin, the condition had worsened drastically. The week before, Dr. Ombati did a minor surgery to clean the wound, but ended up removing lots of dead tissue and realizing her foot and leg were consumed by gangrene. Today they had to perform and above the knee amputation because the woman had refused the surgery for so long that it had spread from her foot up her leg. After lots of counseling, the doctors had finally persuaded her that she needed to have the surgery in order to live.
The surgery went very smoothly, taking exactly 50 minutes. No description can really do justice to how incredible it was to see someone's leg being cut off... not that it is a good thing, but it was incredible to be standing right next to the surgeons and taking videos of the whole thing... I never imagined that happening for a long time.
Today we just did rounds in the male surgical ward with Dr. Rahib. Most of the cases were post-op abdominal or fracture surgeries. As we saw each of the patients we learned about the different methods for fixing fractures and the importance of immobilizing the joints above and below the break. It was really interesting, but the methods of realigning the bones using weights attached to the casts or screwed into the bones themselves would never be used in the US... or at least I am not aware of this. Dr. Rahib also gave us a lecture on the appendix before we took a break for lunch.
When walking outside through the hospital after coming back from lunch, my friend and I randomly ran into Dr. Ombati, who excitedly told us to get scrubbed in because there was going to be an amputation in the surgery building. We had previously seen this patient on Monday during rounds. The patient was a 28 year old female with type 1 diabetes who had burned the top of her left foot. This burn had become infected and since she was not taking her insulin, the condition had worsened drastically. The week before, Dr. Ombati did a minor surgery to clean the wound, but ended up removing lots of dead tissue and realizing her foot and leg were consumed by gangrene. Today they had to perform and above the knee amputation because the woman had refused the surgery for so long that it had spread from her foot up her leg. After lots of counseling, the doctors had finally persuaded her that she needed to have the surgery in order to live.
The surgery went very smoothly, taking exactly 50 minutes. No description can really do justice to how incredible it was to see someone's leg being cut off... not that it is a good thing, but it was incredible to be standing right next to the surgeons and taking videos of the whole thing... I never imagined that happening for a long time.
Did I Mention I Like Watching Surgeries?
6/24/14
Today was surgery day, and since I am in the surgery department I got to see a lot of procedures, but nothing that stood out or was very interesting. One boy was having his tonsils removed, another man was having his leg reopened from a previous orthopedic surgery and getting it cleaned out to prevent sepsis. A 17 year old boy dislocated his elbow, so he needed it to be popped back in and get a cast, while an older man had previously had his prostate removed, but now his urethra was blocked with puss and the surgeons needed to clear the pathway and insert a catheter. Needless to say, it looked very painful and luckily he was under anesthesia. It's really interesting because in some of the minor procedures such as draining abscesses or removing lipomas and other masses, they only put the patient under local anesthesia and even then it can be quite painful for them. It makes me realize how privileged we are to not only never feel anything during any surgery, but to also be asleep and completely unaware of what is happening... which is not the case in many surgeries here. Though they don't have the medical resources here like back in the states, the kindness of the doctors and the relaxed environment more than makes up for everything.
Today was surgery day, and since I am in the surgery department I got to see a lot of procedures, but nothing that stood out or was very interesting. One boy was having his tonsils removed, another man was having his leg reopened from a previous orthopedic surgery and getting it cleaned out to prevent sepsis. A 17 year old boy dislocated his elbow, so he needed it to be popped back in and get a cast, while an older man had previously had his prostate removed, but now his urethra was blocked with puss and the surgeons needed to clear the pathway and insert a catheter. Needless to say, it looked very painful and luckily he was under anesthesia. It's really interesting because in some of the minor procedures such as draining abscesses or removing lipomas and other masses, they only put the patient under local anesthesia and even then it can be quite painful for them. It makes me realize how privileged we are to not only never feel anything during any surgery, but to also be asleep and completely unaware of what is happening... which is not the case in many surgeries here. Though they don't have the medical resources here like back in the states, the kindness of the doctors and the relaxed environment more than makes up for everything.
First Day in Surgical Placement
6/23/14
It's hard to think that I only have 4 more days in Iringa. My weekdays in the hospital and weekends exploring the city have become natural, and though people shout "mazungu" (white person) at us, I know the culture and I feel like I live here now. Some of the medical customs are really refreshing despite the limited materials and relatively unsanitary conditions. Most children in the hospital have developed a fear for anyone wearing a white coat, associating them with needles and IVs. When a doctor needs to check the child's chest sounds, he puts the stethoscope in his ear and shows the mother where to place it... it's such a smart idea that I've never seen in the states. A bit of a tangent from the rest of the day, but I've been slacking in my recent updates, so I thought I would go back and cover what I missed.
Today was the first day of my last week, and first day in surgery. I have literally been waiting for this placement the entire trip, so I'm excited to see what the rest of the week brings. I was with Dr. Ombati today, who I have met previously from observing many of his surgeries in previous weeks. We were able to see a lot of cool cases and a minor surgery in the ward, which is really unusual on dryas besides Tuesdays and Thursdays. One 5 year old girl had burned 30% of her body from her face to her neck, shoulders, arms, and abdomen. The top layer of skin was still attached in places, which looked like dampened tissue paper. Her eyelids were red and a yellow liquid/oozed from under them. The doctors needed to put in an IV to rehydrate the girl, however, they could not find a vein due to the burns, so that had to do a "cut down"... surgically finding a vein in her ankle and inserting the IV there. This took a while, and instead of moving her to the surgical theater, they did the operation in the ward because the girl was in too fragile a condition to be moved. Of course this is completely unsanitary except for the instruments the doctors used, but they had no other choice.
The rest of the time was spent just doing rounds and brief lectures by Dr. Ombati... he was also the one who performed the cut down, so that was really cool to see. For the rest of the day we played volleyball and I hiked up to the big rock with everyone for the last time.
It's hard to think that I only have 4 more days in Iringa. My weekdays in the hospital and weekends exploring the city have become natural, and though people shout "mazungu" (white person) at us, I know the culture and I feel like I live here now. Some of the medical customs are really refreshing despite the limited materials and relatively unsanitary conditions. Most children in the hospital have developed a fear for anyone wearing a white coat, associating them with needles and IVs. When a doctor needs to check the child's chest sounds, he puts the stethoscope in his ear and shows the mother where to place it... it's such a smart idea that I've never seen in the states. A bit of a tangent from the rest of the day, but I've been slacking in my recent updates, so I thought I would go back and cover what I missed.
Today was the first day of my last week, and first day in surgery. I have literally been waiting for this placement the entire trip, so I'm excited to see what the rest of the week brings. I was with Dr. Ombati today, who I have met previously from observing many of his surgeries in previous weeks. We were able to see a lot of cool cases and a minor surgery in the ward, which is really unusual on dryas besides Tuesdays and Thursdays. One 5 year old girl had burned 30% of her body from her face to her neck, shoulders, arms, and abdomen. The top layer of skin was still attached in places, which looked like dampened tissue paper. Her eyelids were red and a yellow liquid/oozed from under them. The doctors needed to put in an IV to rehydrate the girl, however, they could not find a vein due to the burns, so that had to do a "cut down"... surgically finding a vein in her ankle and inserting the IV there. This took a while, and instead of moving her to the surgical theater, they did the operation in the ward because the girl was in too fragile a condition to be moved. Of course this is completely unsanitary except for the instruments the doctors used, but they had no other choice.
The rest of the time was spent just doing rounds and brief lectures by Dr. Ombati... he was also the one who performed the cut down, so that was really cool to see. For the rest of the day we played volleyball and I hiked up to the big rock with everyone for the last time.
Shopping with Akiba
6/22/14
This morning I woke up super early to go with Akiba (our cook) and two friends to the market to get food. It took us in total about 5 hours to do all the shopping and on average, he spends 2 million Tanzanian shillings a week (~$1300). No words can really describe the chaos of the shopping we did. We went to countless little shops and open air markets getting fruits, vegetables, meat, fish, and processed food. Each is found in a different store, so we went to probably 10 different places and piled the food we bought in front of several of the stores and picked it up in the end. We took a small truck back to the house, filling the back completely with the food and water we bought and squeezing in with it for the drive through town and back to the house.
The rest of the day we relaxed, played a lot of volleyball in the yard, and helped the newbies settle in. All of my roommates left, so I have 3 new ones. Beside that, nothing else really happened... before and after dinner we spent hours playing card games and then all went to bed early in preparation for our new placements tomorrow.
This morning I woke up super early to go with Akiba (our cook) and two friends to the market to get food. It took us in total about 5 hours to do all the shopping and on average, he spends 2 million Tanzanian shillings a week (~$1300). No words can really describe the chaos of the shopping we did. We went to countless little shops and open air markets getting fruits, vegetables, meat, fish, and processed food. Each is found in a different store, so we went to probably 10 different places and piled the food we bought in front of several of the stores and picked it up in the end. We took a small truck back to the house, filling the back completely with the food and water we bought and squeezing in with it for the drive through town and back to the house.
The rest of the day we relaxed, played a lot of volleyball in the yard, and helped the newbies settle in. All of my roommates left, so I have 3 new ones. Beside that, nothing else really happened... before and after dinner we spent hours playing card games and then all went to bed early in preparation for our new placements tomorrow.
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