December 5th, 2019 by Daniel Russo

After completing half a week at Kijabe, we are finally getting into the swing of things. I have been on the inpatient service on the female ward. Our team consists of an attending (which they call consultant), a clinical officer (PA equivalent), a medical intern, a 5^th year medical student (they do 6 years of combined undergrad and med), a nutritionist intern, and me. The first day I was unsure of where my role would be as they have a set method of rounding. First the CO, intern and med student round on their patients, then present the patients on walking rounds to the consultant. Dr. Wandia, my consultant for the first half of the week, encouraged me to observe and add anything of educational value to the students during rounds. Over the course of the week I am now acting in the role of the consultant (with the actual consultant at the wings should we need help). This has been a great opportunity to teach the students and interns as well as to learn from them the local medical nuances and logistics.

Standing behind our house in the lush forest.

Kijabe hospital is very different from the previous hospital and clinic we have worked at in Africa. Resource-wise there is everything from a CT-scanner to blood cultures to Zosyn. In terms of specialties there are general surgery, orthopedics, ENT, palliative care, OBGYN, FM, IM, Peds, dental and platics. There is an ICU with 5 beds as well as 2 HDU’s (step-down units), one in each gender’s ward. The wards themselves are 60 or so beds in 4-5 rooms with retractable curtain dividers. There are also a couple private wards with semi-private or private rooms for an extra fee.

In terms of pathology, over the last 4 days I have seen and helped treat patients with PJP (PCP) Pneumonia, Cryptococcal meningitis, urinary obstruction secondary to advanced cervical cancer, esophageal cancer, typhoid bacteremia, and a patient with a Hb of 3.3 (and relatively asymptomatic).

Everyone has been very welcoming. On Monday we went to Dr. Nguyen’s house for a dessert night designed to help short term visitors like us meet some of the long term missionaries.

True to the season’s name, it has rained every day, with occasional downpours. This has kept the foliage very green. Mist hangs on the top of the nearby mountains. There are Kolb’s monkeys that inhabit the trees (and rooftops) surrounding the hospital. They seem to enjoy jumping from the trees to our guesthouse rooftop, making a loud crashing sound.

Kolb’s monkey, Cercopithecus mitis kolbi

The food  has so far been delicious, especially the hospital cafeteria’s chapatti and samosas. In addition, there’s always a free lunch at the noon lecture, generally consisting of a stew of vegetables +/- meat along with a starch (either rice, ugali (a kind of starchy corn product) or potato). In addition we have been cooking dinner ourselves with lots of fresh veggies from the local market.

Tonight we are sharing call (hopefully not too many admissions) and then on Saturday we are headed to Maasai Mara national park to go on a safari!

Cape Robin Chat, Cossypha caffra