“Hello! How are you?”

February 2nd, 2010 by INMED


So life since the safari has had its ups and downs.  I’m feeling a little more confident with which tests to order and what treatment to give.  I’ve seen a lot more malaria.  I saw chickenpox on a child, which was pretty cool (even cooler that I made the correct diagnosis before the attending saw the patient).  I gave a presentation about tracheomalacia because it was thought one of the kids from the orphanage had it but upon further study, he really doesn’t fit the picture.  It seems his abnormal breathing is due to something higher up, so they are going to try to have and ENT see him.


On a sad note, one of the kids from the orphanage who came in initially a few weeks ago with severe anemia, abuse, and burns, suddenly died late last week.  We don’t really know what happened.  He seemed to be more interactive the last time I saw him.  Then they brought him in because of vomiting and diarrhea and lethargy, had a platelet count of zero, and then stopped breathing and died.  It was awful.  This poor child of probably around two years of age, probably never had a decent day.  The days that would have been better at the orphanage were burdened with pain from burns and dressing changes. We had another very sick AIDS male who quickly developed confusion and then lethargy and had to be air lifted to Nairobi.  His family is apparently big wigs in the government here.


On a lighter note, an American patient who’s husband works for the oil drilling companies called back to the clinic after I saw her and invited me out for drinks with oil people.  So random, that never happens in South Bend (and I didn’t go out and drink, I was still working at that time).


I went to an HIV clinic starting on Monday.  They have a holistic approach, not only offering medical care and meds, but education, food, community outreach, helping families pay for school fees.  It’s quite a set up.  I will hopefully get to go on home visits on Wednesday.  Also on the way home on Monday I was in a matatu (shared taxi—envision a white minivan equipped to hold 15 people, but usually more) with lots of people and a chicken.  Today I sat in on an annual report for this program.  They do some really neat work and really try to analyze their results for improvement.  Later I sat with the person who starts patients on anti-retroviral drugs.  They have to go through and extensive education process and even today before giving the patients the medications, she made sure they understood what they were for and that they would need to take them reliably.  I wish we had something similar in the States.


Random thoughts about being abroad…sometimes it’s nice being a minority, all the kids (and many adults), run up to me and say something to the effect of hello “mzungu” (white person) (the kids are of course much cuter saying it than the adults).  Memorial prepared me well for this because everyone in the hospital seems to know who we are without me knowing a quarter of them (our pictures are up all over the hospital, often on many nurses clip boards is a copy as well)….The roads in South Bend (or really anywhere in the States) are not bad compared to here.  This major city with a population over a million, probably has more dirt roads than paved and the paved ones have excessive amounts of speed “humps” and large pot holes.


I’m always amazed at people’s generosity and kindness.  This city can be confusing since many of the roads aren’t on the map and there is no such thing as a bus map.  But somehow I manage to get to where I need to be.  Whether it’s a neighbor who’s going the same direction that I am takes me most of the way.  Or it’s a stranger who guides me to the right matatu.  Or a worker at the clinic who brings me tea.  Or a Ugandan doctor who takes time and tries to teach me a thing or two about medicine here.  Or some random person who thanks me for coming here to help, even though I’m receiving more help than giving for sure…I love learning cultural things and wishing I could make everyone do them back home…like tea time (that should definitely be blocked out for in clinic) and when you greet someone here you say “hello, how are you” and actually care about the response.  You have to say this to someone before you ask then a question or they think it’s rude…which I think is great.