Friday I traveled to the CURE outreach clinic with a team consisting of myself, 2 doctors, 2 clincal officers (similar to a physician's assistant from the states), 2 social workers, 2 spiritual directors and a physical therapist. It was a great trip. The drive went by fast, road trips in Uganda are much more entertaining than in the states. There is so much going on outside always, people are everywhere. We drove past all the school children in their matching bright colored uniforms barefoot carrying their books, herds of cows blocking traffic, goats running freely and naked babies dancing. The clinic itself was very productive and time efficient. Everyone got down to business and in a matter of 4 hours approx 50-60 patients were seen. The follow-ups were brief and to the point. I loved it because I rarely have the opportunity to see patient's after they leave the hospital. Some patients looked great, they were walking, talking, developing appropriately. Others came back reporting fevers, headaches, seizures, and referrals were made for them to come back to our hospital the following week. I worked with one of the doctors for a bit, assisting in vital signs and assessments and learning the flow of a typical outpatient appointment. One baby that we saw was a 3 month old with spina bifida who underwent surgical repair of his spinal cord defect at CURE. The baby's inicision had healed well, but the doctor was concerned that he was becoming overweight. Granted he was a chunky monkey, but I wasn't overly concerned due to the fact that he was 3 months old... But the doctor looked to me and asked how we could make this baby lose weight. I was stunned, never in my 2 weeks here has that ever been the concern! The baby was breastfeeding, so I told him that would be a bit hard unless the mother cut his time short while feeding, and she immediately said that he would never allow that. I think his diet planning may have to wait until he's no longer an infant... Another concern was that the parents had not begun catheterizing the infant. I won't go into too much detail about this (probably not the best dinner conversation), but moral of the story is that patients with spina bifida often require assistance for the rest of their lives going to the restroom. The doctor was again a bit upset with the parents because this had not been started, with concern that the kidneys could have been harmed. So the parents were sent into the back room to learn how. I went with them because I was very eager to see how catheterizing was taught in Africa. As we were waiting for the nurse to bring the supplies for the teaching, I asked the father if he knew what catheterizing meant, which he repilied no. I was not terrible surprised because often times patient and family education is not the focus at the hospital, so I was able to spend a few minutes explaining the general principles to the parents, which I loved. Educating families is definitely one of my favorite aspects of nursing. The rest of the clinic went smoothly and I really enjoyed the time I got interacting with patients and the CURE staff.
The weekend was perfect. Saturday my roomates and I travelled to Sipi Falls, about an hour drive from Mbale. So beautiful, I realized when we got there I don't think I've ever seen a proper waterfall in my life. There was a series of 3 waterfalls working their way down one of the hills of Mount Elgon (the mountain range located between Kenya and Uganda). We hiked all day; saw a woman doing laundry at the top of the waterfall wearing a santa claus hat, hid out in a cave on the side of the mountain while it started to rain on us, met a family with 10 children who welcomed us into their home and gave us fresh avocado and passion fruit, and then ate the most magical indian dinner after returning to Mbale. Sunday we ventured to a nearby hotel in Mbale that had a swimming pool! Unfortunately i didn't pack my swim suite, but we spent the afternoon playing cards, reading books and chatting pool side. I was also able to skype with my parents who were on family reunion, so I saw many of my aunts and uncles and cousins and my dog Sam!
Today I got to go to theater! This is what they call the operating room in Africa. And boy was it exciting. I was able to see an ETV, spina bifida repair, removal of a shunt and repair of a lipomeningocele (similar to spina bifida, but there's fatty tissue and skin covering the protruding spinal cord). The ETV was the most fascinating. The baby's ventricles were HUGE!
Here's a little bit of background for those who want to know more: The ventricles are the areas in the brain where the brain fluid hangs out pretty much. below is a picture of a CT scan of a pt with hydrocephalus on the left vs a normal brain on the right. On the left, the dark area in the middle that looks like a butterfly are the ventricles. On the right they're much much smaller, giving the brain room to grow and hang out.
The baby that was operated on today was much worse than the picture above. It's ventricles took up probably 90% of the space within the skull, with the remaining 10% left for space for the brain to be. When they performed the ETV, they brought a camera into the ventricles which allowed the whole room to see the brain from inside, it was awesome! I saw the pituitary gland up close and personal and was able to watch on the camera as they created the ETV.
And now I only have one day left at the hospital before leaving for Kampala to begin our African Safari. I'm in slight denial, it's crazy how attached I've become to this hospital and the people in it in such a short matter of time. But I'm thankful for everyday I have spent here, and hope tomorrow will be as great and blessed as all the others. We cooked chapati, guacamole and I bought snickers to bring to work tomorrow for the last day, can't wait! I can't be too sad because I'm so excited about safari time!!!!
And as for the title name, tonight as I was putting away the dishes, much to my dismay I noticed a jar in the back of the cupboard with 4 huge cockroaches in it. After an embarrassing screaming fit, my roommates and I begun the adventure of attempting to kill the cockroaches (for the fear that they would make it back into the house if we simply released them outside). It was a long battle, but after pouring hydrogen peroxide, bleach, kitchen cleaner powder, beer and spraying bug repellant in the jar, the 4 roaches stayed strong and were still swimming. We finally did them in by pouring some boiling water on them. We later did some research, apparently soap and water is sufficient, we'll remember that next time hopefully. And for the burnt bananas, one of my roommates (the neurosurgeon!) was microwaving a grilled banana we had bought off the street for dessert the previous night and forgot that you can't set a timer on our microwave. So he sat back down and next thing you know the kitchen was full of smoke. We stopped it, and when we opened the microwave and big puff of yellow smoke came pouring out into the kitchen. Luckily there is no smoke alarm, or if there is one it doesn't work so we simply opened all the doors and left the microwave in the side yard.
And for those who read my last post about Peter with the brain tumor, he is stable. Still in the ICU, still not really waking up and now having to be tube fed because he stopped breast feeding over the weekend. Definitely keep him in your prayers, but they are hoping to transfer him to the ward tomorrow.
Picture time!
This is Rose, a patient I met at the outreach clinic. She has spina bifida which was repaired at CURE. She walks on the insides of her feet and requires a cane for support, but doesn't seem to phase her a bit!
The roommates and I at Sipi Falls.
See the santa hat? Not a bad view to have while you're doing laundry.
Some of the children we met at the house with 10 children that we stopped at while in Sipi. My roommates Sarah and Shabani had met the family on their first trip to Sipi a few weeks back, and the mother was so excited to see them again.
In the jar are what remain of roaches with all the substances we tried to use to kill them. We're keeping the jar on the center of the kitchen table as a center piece.
I don't know if I'll be able to blog again while I'm here, but thanks for everyone who read! I really enjoyed being able to share my experince!
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