Thursday, May 30, 2013

Work in the basement

So it is high time I get a blog post up. I have been debating about what to write those of you wanting stories from the hospital it’s the same as last time. My ventilators don’t always work, patients are very sick, and I am enjoying being part of the team here.
Today I have been having a new adventure. Tenwek being a mission hospital gets many things donated. These things all end up on the shelves in Central Supply, much of the donated equipment is used and put to good use however among every container of donated supplies is the junk. Things are donated because they are no longer needed by the place that donated them. Maybe it was a mistaken purchase so its fine for us to use or it is something completely random that would never be used – ever. When I was here two years ago I spent some time in Central Supply familiarizing myself with the items on the “respiratory shelves” which is a lot of equipment from little connectors to 40 feet of oxygen tubing.  Amoung these shelves I also find the obscure like hoods – no clue what these hoods are for – I think maybe the OR. Although now that I am writing this I should double check and see if they’re oxyhoods. Anyway I was asked today to assist the staff in going through these shelves. It is tedious dusty work but I am enjoying it. We emptied one whole shelf today. I found some treasures: in-line suction catheters and incentive spirometers, and sent some things to the trash: water traps are useless when your humidification is HME. I also have matched up some supplies to other areas of the hospital such as double lumen endo tubes to the thoracic surgeon, he did not know we had them – we have 38.
I will probably end up spending a week down there taking breaks to see my patients and respond to pages. Today breaks involved doing CPR, chest physiotherapy and some ventilator checks, as well as a few e-mails to Europe as someone there has some equipment he wants to donate and wants to be sure its appropriate, I am so thankful he asks.
I will end with a few pics of my work. 
I head to work around 7am and caught this beautiful sunrise out my front door.

We have been having trouble with the power to our CT scan, so we now have all these batteries to  hopefully fix it.

This is currently behind the hospital, not sure why?

Today I emptied the shelf on the left tomorrow the right, then the next one. 

Friday, May 17, 2013

Home at Tenwek

So I should be preparing my lecture for next week, or figuring out how the new (to me) spirometer works or reviewing my Swahili. But I think you all deserve an update on what I am up to so I will write this instead, and work on the rest later.  I work the best under pressure.

I finished language school with my final oral exam on May 9 and the next day headed to Tenwek. I got here just in time for new missionary orientation. This was a time spent with missionaries who have been in Kenya from anywhere from 8 months to a few days. This was a good start to my life at Tenwek, although it did delay the unpacking a bit. I gave myself Monday off to get settled in and meet my house help, a wonderful lady who will be coming 2 days a week to help me out with cooking, cleaning, shopping and laundry. Her help is an excellent bridge into the culture around me as well as frees me up to spend more time in ministry – whether working at the hospital or the surrounding community.

I am staying in the home of a long term missionary who is currently on furlough. She has generously let me use her furniture and kitchen stuff. It is great to move into a furnished home all I had to do was unpack the bags and hang pictures on the wall.

I made it to Tenwek just in time for a graduation ceremony of one of the Family Practice residents I worked a lot with in my last term at Tenwek. Dr M. is a wonderful doctor and I am sad to see him go. We had a fun graduation evening. I skipped out of some of the speeches to play with his 2 young boys who thought this Muzungu (white person) who attempted to talk Swahili was interesting.
Sugar high=Smiles
Good-bye Dr M, we will miss you. 

I headed to work Tuesday morning. Introduced and reintroduced myself to many of the staff here many names and forgot many of them – a challenge of working everywhere in the hospital is I work with almost everyone and it makes for a lot of names to remember or more often forget.
All set for my first day at work

My days have been busy the first day I attended 3 different codes, assisted with 2 intubations and functioned as a ventilator as we waited to get a bed in ICU. I am quickly refamiliarizing myself with our equipment and the challenges we face here;  I have already had to bag patients because of malfunctioning oxygen system, my pockets are overflowing with all sorts of necessities from Peep valves to hand sanitizer, and  I have been called out of bed at midnight to help out with our ventilator that has its idiosyncrasies. I have been busy working from 7:00 or 7:30am until  5:30 or 6:00pm, long days however I am loving it. It is great to help out the career missionaries and shoulder some of the load of working here. I also love sharing knowledge with the staff as we learn from each other.

I have appreciated my time spent learning Swahili. I have been having chai with the nurses and being able to be a part of, or at least understand, some of the conversation going on around me has been great. The staff has also been very encouraging speaking to me in Swahili and saying it again when I ask and telling me what word is what. I have been able to do basic respiratory assessments in Swahili  it’s not always right but I am learning and when the patient laughs at my Swahili mistakes it’s a good form of chest physiotherapy.

Well I should end there, and get some lectures written. I ask for your prayers in the continued months as the novelty of working here will wear off and become routine I will need strength both physical as the days are long and emotional as I see a lot of death each week. I need to continually remind myself that healing the physical body is a good goal but the spiritual body is even more important. 

Tuesday, May 7, 2013

Last few days of School

I have completed my last few days of language school. May 10thI will be moving again, for the last time for a while, to Tenwek. My classmate finished last week  so that left just me in my class for the last week and a half. I  stopped working through the textbook and instead I had the teachers teach me medical things. Medicine in Kenya is done in English(the staff all communicate in English regarding medical matters) but the patients may only speak Swahili and their tribal language, or just their tribal language– in which case my learning will not be helpful but this is still time well spent.

To illustrate the importance of the time I have spent learning Swahili over the last three months here is a true story from last week. It was a holiday in Kenya and I took the opportunity to head into Limuru to pickup a few things. I went by matatu (after walking a mile to the main road). I got in a matatu where not much communication is needed, after you are seated you get a tap on the shoulder and/or a look that is your cue to pass up your fare and say where you are going. No need to speak Swahili there. After I had paid there was some confusion between the tout (guy who collects the fare, not the driver) and a passenger over the fare. This fellow ended getting off thematatu early saying in English “how would I know I don’t speak Swahili”. Now this fellow blended into the population much better than I did, and when he got off there were a few murmurs of “he should speak the national language”. At this point I turned to my seat mate and said “Nasema Kiswahili” (I speak Swahili).This spread some smiles around the matatu, and it reminded me that communication is only one of the goals of language it is also to be a part of the culture, to show respect and to be able to be one of the crowd.

So since last weeks holiday, I returned to school and continued to make my lovely mistakes. The other day I mistakenly said “when my brothers and I were cows” Instead of when my brothers and I had cows – introduced much laughter to our lunch break. I am sure that was not my last mistake and I will daily make more.

I ask that you pray for me in these final days of formal language study – that I will continue to learn and that I will know how to best focus my class time. These past 2 weeks have been fun. During the mornings I create my lesson plan – we joke that I have a clinic, and it’s not far from the truth. I am explaining, in Swahili, how to manage asthma and we are doing “spirometries”. One of my teachers desires to be an actor and he is loving putting his skills to use when I tell him – Ok you are coming to the clinic because you are short of breath. I have  learned the words to use during chest physiotherapy – interesting as the best word we have is "beat the patient", hopefully I don’t scare them away.

My next post will be from Tenwek my home for the next 2 years - the time has finally come.