On Thursday while I was waiting for Osbourne I went to the New born unit (NBU) and told them I was waiting for the doctor. I dress in a lab coat and everything so I look like a doctor so the sister was like ok while you are waiting go and see patients. I was like I am sorry I can't I am a premed student. The sister didn't quite u dear stand and so I waited and then left to call and found out I was in the wrong area. It was just funny that I got asked to go see patients while in the States that would never happen.
The ward is a big hallway almost with 6-7 rooms on each side. Each room just has a bed and little dresser side table. The beds though have no sheets it is just a plastic mattress cover which are never clean and have spots. The women come in all with their own sarongs to lay on but the sanitary conditions are very bad. The tops of the rooms are all open and there are just a 8 ft wall between each room and no curtain or doors. I have come to learn that privacy is not really a practice here. There will be a physical exam going on and 5 people will just walk in and out of the room. It's very different with their mentality and I guess they have to be used to things like that.
Thursday was very interesting in learning how they examin pregnant woman and access her and the babies' health. They do everything manually. I learned how to determine the gestation stage by pressing and finding the fundal height with your fingers. They "rule" they use is I finger is equally to 2 cm which is equal to 2 weeks. So they naval or umbilical region is considered 20 weeks plus or minus 2 and then how many fingers above is how many you add. I got to determine and check with the clinical officer ( which is our equivalent to a a physician assistant) and determined a woman was 22 weeks.
Malaria is very common down here and of course it causes problems in pregnancy. So in order to treat it they insert a cannula and put Quinonine on a drip for 4 hours then another one for 4 more hours. It's a very long process. I watched the inserti g of a cannula twice and then got to tape the cannula and insert the IV. The woman had to leave for a urine sample so I got to take it out and put it back but it blocked and the drip would not work. So in order to check I got a syringe and water to flush. I did this to also check that the cannula was still in the vein and not in the tissues. I then inserted the IV again and set the drip speed.
After the ward rounds Osbourne taught me how to do history taking and accessing the patient from his medical book. I got to see how they access each patient and how they check routinely for jaundice, pallor, edema, cyanosis, capillary refill, dehydration, and lymph nodes. In the next coming weeks he will teach me how to listen and check the respiratory system with stethoscope and cardiovascular and other systems it is very exciting. I also will learn how to do a VE or vaginal exam to check dilation of the cervix and use the Bishops score.
I got a small cold Friday morning so after hospital took a nice nap before the farewell BBQ for one of the English interns Kris. It was cool because a lot of the doctors came to our compound and we got to talk and teach about our culture. Saturday was a really calm day. We actually taught two of the teachers from the school to swim this morning and one of our interns. They made so much progress. It was so amazing. Even on our day off we get to do fun things and teach and be with the people and learn more about Kenya and the way of life here. It's both a medical and cultural experience.
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