Saturday, October 9, 2010

End of week 1 at Tenwek

When I last posted I was starting to be more utilized by the staff and still defining my role here which is still going on. However in the meantime I have gotten very busy I have seen more death in the last few days than I have seen in a long time, the hardest part was that these were all young patients. It started on Thursday morning when I was called to casualty (there word for emergency) to help them out with a CHF/COPD exacerbation. An elderly lady in severe respiratory distress - I brought here to ICU and placed her on CPAP the first Non invasive ventilation that Tenwek has seen. I worked wonderfully on her which is exciting for me as the next few weeks I will be doing presentations on CPAP/BiPAP and that it worked so well on the 1st patient will make “selling it” easier. At the same time as this lady a 16 year old boy came in very short of breath and hypoxic room air sats of ~50% (normal is 92-100) we discovered that this boy probably had active milliary TB, as he was coughing up blood. He did not improve very much with oxygen so the decision was made to treat him palliatively - he died by noon. As all this was going on  a 8 year old boy coded (heart stopped) and we attempted to get him back but were unsuccessful.  This all happened before 1 in the afternoon and is not abnormal for Tenwek. The rest of the day was better and when I left at the end of the day I gave them my pager number just in case the lady with CPAP needed to go back on. I was paged at 1 in the morning, my CPAP lady was fine but they were having trouble with another patient on the vent and would I come help. The patient has HIV, previous TB, chicken pox in the last week and an ARDS like CXR. He was in our 6 bed ICU with all the beds in one room (infection control would have had a heart attack). I was able to get him stabilized and the ventilator working somewhat.
This was how my work week ended but life at Tenwek continues way from the hospital as well. Friday night supper was pizza at a missionary couples home followed by movie night at the guesthouse. The guesthouse is for short term staff a few weeks to a few months. Today is Saturday, a day off, I think I don’t know what hours I am supposed to be working. I hike up to mutogo (spelling?) a large hill beside Tenwek. This hike was with a few visiting staff and it was great to get out and see the land. We walked by some corn, tea and sugar cane fields as  well as a small village where we stopped at the local church where they were holding a prayer service for the students who are writing a very important exam soon. At the top of the hill lives a family, and the dad is the house helper of the fellow who was leading our hike. The son invited us inside and we had some chai tea. Too sit in a small hut, visit and discuss issues about life at Tenwek as the rain started to come down was amazing. This is something that would never happen in Canada.
Living in Kenya for the next few months is an experience that will change me. I don’t think I will be the same person when I return. I wonder what God has in mind for me here and what he plans for my future. Is the plan to take all I have learned back home or to continue this work here or someone else. I do not know and someday God’s plan will be made known to me but in the meantime I believe I am where he has put me and despite the sadness of death there is good here. But I have to end this post so I can take my laundry off the line it is starting to rain. I will hopefully get some pictures either here or on facebook soon.

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