Friday 5 February 2010

rural clinic

yesterday was an exhilarating day. i went with some doctors and medical students to a rural clinic about an hour away on very bumpy roads. many of the patients didn't even speak kiswahili, so their concerns had to be translated into that and then into english. luckily there weren't that many to see and we had all day, so there was no rush. it was great because we talked out every case in depth. the clinic was a little dispensory out in the middle of nowhere, and they only had a few drugs there, so thats all that could be prescribed. most people wouldn't have the means to travel anywhere else for healthcare. so invariably what ends up happening is that the few types of medicine there are just end up getting prescribed for almost everything, mostly just to treat the symptoms rather than the cause of the problem; this is called "jungle medicine" and unfortunately its the best that most africans get. they served us lunch there too which was delicious. then my two med student friends from chicago and i went over to this school that was there and dozens of little kids immediately vacated their classrooms (who knew where the teachers were), and crowded around us cheering and obviously about as excited as kids can get, presumably because we were white and and wearing white doctor coats. so we hung out there for a while.

that night one of the med students was to man the e.r. all night, so i stayed up with him. exhilarating. it was quite busy and all kinds of stuff happened. i learned how to take a complete history and i handled one young man who came into the e.r. from start to end! (it wasn't too serious). i even wrote him a "doctor's note" (he had no idea i wasn't a doctor :) ). we also got called to confirm a death on the ward; i got to peel back the guy's cold, stiff eyelids to see if he was really dead by seeing how his pupils reacted to light. then later we actually watched a lady die :( lots of interesting people seem to arrive in the middle of the night, like a masai woman with the huge necklaces, ear loop thingies and uncovered breasts who casually sauntered in with a baby with a huge growth on its head after walking for who knows how long to get here. and a case of hemorroids that was bad enough to warrant a visit to the emergency room in the middle of the night. i think i'm going to spend more time in the e.r.!

other than that there have been a slew of surgeries relating to an appendage unique to males that i have been watching during the day, some of them a whole lot more invasive than one might ever want to imagine. on saturday i went into nairobi with the doctor i am staying with's son and some of his friends and ate some delectable njera b'wat (if you don't know what i'm talking about you should find your local ethiopian restaurant and patronize it asap!) also, i am doing some research for the doctor regarding infection rates after hydrocephalus shunt insertions. the whole research dealio is a bit tedious to say the least, but hopefully if successful it will stoke my medical school applications a little bit. more importantly, it may also help the organization that provides the surgeries to convince the governments of neighboring countries that they should allow them in because their post-operative infection rates are so low, as currently there are a lot of kids suffering more than they need to in some east african countries because they aren't getting the operations they need.