First week in the hospital

Time flies. The first week and a half is already behind us. We’ve been in Kenya for two weeks now and we’re enjoying it. We’ve been busy in the hospital now for one week and a half and we’ll both write a short thing about that.

Nick:
The lab looks pretty okay. It’s (of course) not up to Dutch standards, but it’s running, fairly safe and they reuse everything. I am impressed by the ingenuity of the staff to keep everything as simple and cheap as possible. Keeping a window open is not exactly good protocol, but it helps in keeping the room a bit fresh and not to hot. I’ve been asked three times already to help “bleed a donor”, so far I’ve been able to avoid it, but it is compelling. I have bled one donor, but it was a sheep. That doesn’t really count (especially since I was only holding the sheep down :)), does it? It was a funny experience. Trying to catch a sheep (which was tied down by a rope) and tying it’s legs (with the same rope). After the sheep is “subdued”, you sheer some wool away, disinfect the whole area and stick a needle in it. The sheep didn’t make a sound and was not really struggling. I did a good job (according to my colleague). I hope I can do it again.
Meanwhile in the lab I’ve finished updating some protocols and have cleaned up a lingering database (on micro-organisms and their antibiotic sensitivity). Now I’m preparing some continued medical education (CME) lessons. I don’t think I will do real labwork, but I can try and get the microbiology lab working better. Wish me luck :-P

Nynke:
My first week consisted of setting up for my research project and this week I actually started! I had to discuss various issues with Dr. Poenaru: how do I note complications? Who will help me with translating? How do I now which patients were admitted and are going for surgery? There are various record books, but not all up to date the moment I need them, so then you rely on the nurses, but of course they don’t keep track of 80 patients either, so that’s something I’m still trying to figure out. Everything always goes slower than you think it will, so I shouldn’t have been surprised it took about a week to get started. Next to my prospective study on nutritional status of infants up till 18 months and surgery outcome, I’m also doing a retrospective study on the same. This means I look at the medical records of the past few years and try to decode the doctor’s handwriting (it really is terrible; hope I’ll learn from this when I’m a doctor :)). It took me about 1 ½ days to get through 6 charts… So, today I started my first measurements (weight, length, mid upper arm circumference, triceps skinfold). Some babies are real easy, others just start crying and moving. Hard to measure their length then.. I’ll probably learn…

The house and our living here:
For a rural Kenyan setting, we think we’re living pretty luxuriously: hot water doesn’t really run out, but cold water does every now and then; we have a spacious house with living room, kitchen, 2 bathrooms and even internet! Not that it always works, but we had expected to have to go to an internet café or use the hospital internet. Fresh mango’s and pineapples at the marketplace and a lot of nice, helpful people! We had expected to only be able to buy fruits&veggies, but I can even get baking powder ate the Super Duka, which is a “supermarket” (duka=small shop) with 2 aisles, so I can make zucchini bread.. Because of the altitude though, cooking/baking times are different; we just don’t know how yet……