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Thursday, January 13, 2011

Beans, bugs, hail, pink scrubs, and long needles, hope

Beans:  Ah, you know you're back in Africa when you buy a cup of dried beans at the market, bring them home, pour them out, and find out that about a quarter of the cup consists of sticks, dirt, and live bugs.  Sigh.  This requires spreading the beans out on a tray, picking out the worst debris, scooping them up as the bugs run away, then rinsing (i.e. drowning the little insects) repeatedly.  Then soaking overnight, then boiling for a few hours.  All for a bowl of chili tonight.   

Weather:  Yesterday, I ran out mid-afternoon as it started to lightly rain, because my neighbor's clothes were on the line.  But she saw me and said, leave them, the sun was going to return.  Today we had a staff meeting at 7:30 a.m., and it's pretty impossible to get the clothes washed and hung before 7:30  .. so it was about noon by the time I got back and threw them outside before our Swahili lesson.  Once again, it started to rain, and I ran outside, then remembered the lesson from yesterday.  I confidently left them hanging.  And hanging.  Through a total-afternoon down-pour, drenching.  Whoops.  Up the hill at RVA there was HAIL.  LOTS.  Yesterday a roofing sheet blew off the 3-story apartment complex under construction next door and landed in our yard.  Crazy.

Dress:  For a reason I have yet to understand, all the parents of pediatric patients are issued pink hospital scrubs which they wear instead of their own clothing on the ward.  So every bed has a pink-garbed mother (or occasionally a twin father) sitting in it, holding a child.  Hygiene?  A perk?  

Medicine:  Simply put, almost every patient we have on the Paediatric service at Kijabe would already be dead in Bundibugyo.  An 11-month old with TB pericarditis just transferred down from the ICU, and the doctor I'm following decides the effusion should be tapped.  There is a Chinese missionary radiologist handy who agrees to meet us in the ultrasound room.  He confirms the presence of the abnormal fluid around the beating heart, and then goes to search for a needle longer than the estimated 3 cm depth from skin to sac.  A little lidocaine (the radiologist), a little firm holding down (me, the mom is understandably shaken and unable, though she gives verbal consent as wanting whatever it takes for her child to be better), two tries, and then there is an abundance of light golden translucent fluid flowing out. Next bed is an 11 year old with pulmonary hypertension, echo-proven tricuspid valve endocarditis, hypoxia and fevers.  A few asthmatics, a diabetic, a sickler, a malnourished former preemie with rickets (really, classic xray and consistent labs, who would have thought on the equator, but it seems to be common because of the calcium-binding sorghum and millet in the typical porridge here), a baby with AIDS.  Two consults on infants with neurosurgical problems, open spinal cords and encephaloceles.  And not one case of run-of-the-mill malaria.  It's a different world.

Hope:  I went to my third meeting of the day in the late afternoon, and decided to try a few Swahili phrases from the day's lesson.  Which made everyone happy.  Even me.  It's a start.  


Heidi said...

an ICU? echo's? radiologists? longer needles? a "we" that includes other doctors? This might sound funny, but I'm so excited for you! (and praying :)

Anonymous said...

Dear Jennifer,

I read your most recent message which mentions the calcium-binding ability of the sorghum and millet used in porridge. Is this due to the pectin-like polysaccharides present in the grain, and could a pectinase of some variety be used to cleave those moities and reduce this nutritional issue.

You might ask your father-in-law about this.

Be regards,

Neal Franks

KevinandJD said...

Hey, hey!

We used to call that the extra rinse cycle in Fort Portal... Hang in there. Thinking of you often.

Sarah said...

I think it makes the kids feel more comfortable since they are in the scrubs too. When my son was in the hospital for an extended period of time, my husband bought some scrubs from this site called and they had matching ones to wear at night before my son fell asleep. =)