This is Scott, it has been awhile since I last posted so I thought I would give a quick update on some of the things that we have been up to over the several days.
Last weekend, I had the opportunity to join a few other visiting missionaries for a morning hike up to Motigo Mountain. The hike passes over a nearby waterfall, and through the countryside of a mountain. On the way up we passed by small family homes, and were joined by close to a dozen Kenyan children who hiked all the way up the mountain. Ed, a visiting gastroenterologist, brought peppermint candy to give to the kids, but even after it was gone, they continued to follow us, ask questions, press on our white skin, etc. It was a bit of a hazy day, but the 360 degree view from the top was beautiful. The mountains and hillsides are full of tea, corn, and various other vegetable plots, as well as cows, donkeys, etc. Here are a few pics from the hike:
While I was hiking, Whitney was helping proctor the surgery residents’ yearly exam. Afterwards, they invited us to attend a pig/goat roast celebration on Sunday. One of the first year residents, Seno, grew up on a pig/goat farm, and had the animals slaughtered on the day of the roast. He butchered the animals, and spent hours attending to the grill in preparation for the feast. The food was absolutely amazing! It reminded me of a Southern style barbecue with the pork and the presence of coleslaw, but with a Kenyan twist as we also had spice-coated potatoes, fresh salsa, beets, and of course, ugali, which is the Kenyan staple dish. Ugali is made of cornmeal, and is rather bland and flavorless, but it picks up the flavors of whatever it is served with. Prior to the meal, we played foosball, basketball, volleyball, and even Twister with some of the residents. Afterwards, we played all kinds of crazy games. The residents were a lot of fun, and they made us feel right at home. Here are a few pics from the fun night:
Regarding, the hospital, I am slowly becoming more comfortable taking care of the diseases commonly seen here. The heart disease, diabetes, and cancers commonly seen in the states, are replaced here by AIDS, meningitis, and TB among others. My second call night was yesterday, and was more hectic than the first. We had one patient who had a severe PCP pneumonia (infection seen in advanced HIV) and her oxygen levels were slowly dropping throughout the night. By 3am, her O2 levels were at 50% (normal is >90%) despite us giving her 100% oxygen by a face mask. In this situation, the only way to try to oxygenate her, is to intubate her and place her on a breathing machine. The only problem is, I had not intubated anyone since my third year medical school anesthesia rotation, since at Duke, intubations are done by pulmonologists and respiratory therapists. Usually when you intubate someone, you first aggressively use a bag to blow extra oxygen in their lungs until it reaches 100%, since you have to sedate them and they stop breathing while you are placing the tube. An additional problem was the fact that despite bagging her for 45 minutes, we still couldn’t get her oxygen levels over 80%. This is a very bad sign. Finally, we had to go for it. I asked God to help me place the tube where it needed to go, and was nervous, but trusted he would help! Fortunately I was able to get the tube in, but she ultimately passed away several hours later as her lungs still would not allow her to receive oxygen.
That night we had a few more cases of meningitis, pneumonia, and an unfortunate young girl who was brought by her mother from another hospital. She had been at that hospital for 3-4 weeks, and has been having 20-30 seizures per day, and has been more or less comatose since then. She was actively seizing on arrival, and continued during the night. I had her on nearly every anti-seizure medication we have, along with multiple antibiotics, and it still was not preventing her seizures. In the morning, I consulted with a few of the long term physicians to ask their opinion but we were all stumped. We all went to the bedside, and did the only thing left that we could think of…we asked God for wisdom as well as healing. I am happy to report, she has not seized for >48 hours. She is still not responsive, so please keep her in your prayers!