Maseno Hospital

Last week I was working and shadowing the doctors and nurses at Maseno hospital, an African hospital run by the anglican church. I didn't take many pictures of the patients although I saw so many things that I wanted to take pictures of - in some cases I quickly sketched what I saw.

In particular, the event that stuck out the most was helping to hold a baby before it suddenly and unexpectedly died. We were trying to give the baby some asthma medication through a nebulizer but it kept fighting vigorously, at one point even ripping the mask off its face. All of a sudden the baby stopped moving and I thought it had gone to sleep as it had done similarly earlier in the morning after being nebulized. As I was walking out of the ward, one of nurses ran up to me and told me that the baby had died. I hurried back to the room where the mother, still holding the baby, asked me if her child would be ok. I still couldn't believe that the baby was dead and told her that I didn't know and that she should ask the professor. 

This was the first time I had seen a patient die, let alone one that I had been holding. Even when I volunteered at NY Presbyterian for a summer, I saw patients who were probably going to die, but never actually a death or even near death on the operating table. I was struck by how no one actually tried to revive the baby  after the nurses realized that something was wrong. In the US, the hospital staff would have been going crazy with defribillators, wheeling the baby out of the inpatient wards to emergency, maybe even performing a tracheotomy to secure access to the airway. Actually, it would probably never even have gotten to that point in the US because of the monitoring equipment showing the baby's vital signs at every moment

Eventually the nurses and I congregated together in a different room and the head nurse asked me to deliver the news - I have no idea why she asked me to do it (I think she just didn't want to do it herself) but I refused. The head nurse said ok and went to the room where the mother was, hugged the mother tightly, and told her the news - actually, the nurse never had to say anything because the mother fell down to her knees in tears as soon as the nurse put her arms around the mother.

Sketch of the baby made a few hours before it suddenly died

The next day, I saw a C-section. Incredibly, there was absolutely no monitoring equipment used during the entire operation. The anesthesiologist actually left the room at one point for about 15 minutes with no one watching to make sure she was properly anesthetized. The operation ended up going fine, with the birth of a healthy baby and the mother surviving, but I thought of all of the things that could have gone wrong (however unlikely) and it made me appreciate all the precautions that we're expected to take as physicians to reduce or prevent those unlikely complications and emergencies.

C-section performed in Africa. Notice that there is no monitoring equipment at all around the mother.

Nurse double-checking the medicines

Picture of Prof. Hardison, the mzungu doctor at work

The visiting nurses and the clinical officers listen intently

One of the patients, most likely has a juvenile form of hepatitis. One of the nurses put a sticker on his forehead!

this man was admitted to the hospital after his family found him lying in a coma after drinking illegal homemade alcohol which likely contained jet fuel. He ended up passing away after a few days, never waking up from his coma

This old man had jiggers all over his hands and feet. (jiggers are bugs that burrow inside your skin and lay eggs) It got to the point that he could not walk because the pain was so unbearable

We also helped deliver babies in Africa - an experience every pre-med hopes to include on their application

 

Cute little babies less than a few hours old - note that there is NO information on the babies to identify it to its mother

Volunteers busily working at the free health clinic

Just a small sample of the overwhelming number of people who showed up

While most of the patients who came were seen by a doctor or nurse, many of these women and children had to be turned away due to a lack of time and resources

Overall, I learned a lot, even though I was only at the hospital for a week. I learned how doctors are forced to think and diagnose problems, oftentimes with great uncertainty due to the absence of reliable tests that we take for granted in the US. I saw how many of the problems could have been prevented, but due to a variety of reasons - often the expense of seeing doctors regularly or a lack of education - patients mostly came to the hospital once the problem had escalated significantly (actually this is a big problem in the US also). I saw a lot of diseases, especially opportunistic infections, in its latest stages that I likely would not have seen in the US because they would have been stopped before getting to that point.

Most of all, I think I saw how little I know about medicine at all. This makes sense since I haven't even started school yet but it was a terrible feeling to know that I had the potential to help but not the knowledge. I found myself wishing that I could transport a 35+ year old version of myself, confident and finished with my training, to help the hospital. The experience actually made me excited to start school in August so that I could learn to heal others, whereas before, I had really been focusing on and dreading all the studying I would have to do for the next several years. I can't send an older version of myself back in time but what I can do is to try to fulfill whatever potential I do have so that the 35+ yr old version will be the best that it can be.