Kijabe Hospital

            Even though I’ve only had two days of experience at the hospital so far, I feel like I’ve learned so much. I know that I am in Africa and all, but it amazes me how disorganized, dirty, and lacking in modern day conveniences the hospital is. There are no electronic records and all of the paper records look like they’ve been tossed on the floor and walked over a couple of times. They are tinged with dirt and wrinkly. The patient files get thrown haphazardly into file cabinets, lab results go missing, and there is practically no sense of patient confidentiality. There is always African music playing in the background and strong smells of body odor, sweat, tea, urine, and just sickness in general.

Home for the next few weeks

The air is especially heavy in the women’s ward where I spent Monday morning. Here the women are very sick. In just one hour I saw Pott’s disease, TB meningitis, and a complicated case of HIV+, TB, Karposi’s sarcoma, neurosyphilis, and Varicella zoster. I heard about these during this past year, but maybe now that I’ve seen them in real life I’ll actually remember them! Later that day and for the rest of the day, I joined up with the pediatric team and followed around a 4^th year UTMB student. She has been great! She always answers my questions and makes sure I get to see anything really interesting. While in peds I saw several children with ponseti serial casting for clubbed feet – there’s even a whole ward for children with hydrocephalus. Some of the children are still happy despite their condition. One little boy, paralyzed from the waist down due to spina bifida, grinned every time we came near his bed. Most of the time though, my heart is breaking for these children. I saw one baby just a few weeks old seize for over an hour until it finally got the meds it needed. Another little girl about five years old had just been diagnosed with neuroblastoma with metastases to several locations in her body. I was there while the team broke the news to the mother. Even though the mother did not cry, I could tell she was very upset, and understandably so. I’m not quite sure she understood everything she was being told or how serious the situation was.  Anything the doctor told her had to be translated into Swahili. They told her that chemotherapy was not available at Kijabe so there was no reason for them to stay there. They also explained that they could take the girl to Nairobi, but that they could be refused treatment there since even the best treatment in the world may not save her.

Kijabe Hospital

Today (Tuesday), I began my day with no running water and a spider in my bed!  Once I killed the spider, I headed off to the wards again. We were reviewing a patient’s chart when a resident pulled Neeli and I aside to show us what he described as “the worst bedsore” he’d ever seen. I’m not even sure you can call what we saw a bedsore. Apparently, the man had suffered a gunshot wound and is now on palliative care. This sore was so bad that the head of his femur was actually protruding through his flesh. Not only was this gruesome to see, but I can’t even imagine the pain he must be in. After morning rounds, Neeli and I went to the HIV clinic. This is a clinic within the hospital that runs a program called HIV Relief to provide ART (anti-retroviral treatment) for free as long as they maintain the program by keeping up with their drugs and appointments. Here we just followed around one of the doctors and watched him with the patients. I think the saddest part is that so many babies have to be started on ART because their moms are HIV+ and many of those babies who receive treatment will still contract HIV despite treatment. One other interesting thing I saw today was a baby with myelomeningocele. This basically looks like a large tumor on the baby’s back, but the mass actually contains part of the spinal cord and its coverings in it. It is pretty serious and not something you see too often in the US. After we left the hospital for the day, Neeli and I went for a walk around Kijabe. We walked over to Rift Valley Academy which we decided must be where all the doctors and their families live. It is almost like a city within a city. We wanted to check it out because we had heard there is a gym to exercise at there. Once we got there, though, we decided it was enough of a work out just walking there! It took about 30 minutes and I’m still not acclimated to the elevation yet!    

Neeli and some kids we met on our walk!

Oh and I forgot to mention before – in Kenya, the part of the hospital where surgeries are done is called the Theatre and the ER is referred to as Casualty. I just thought that was kind of funny. Anyway – ‘til tomorrow!