Thursday, 28 June 2012

Day 24: Departure and Conclusion


I woke up for the last time in Mombasa at around 8am. A few students were packing to leave at around 9am, and most of the rest were getting ready to leave for the hospital. By 9:30am, I was the last one left at the compound.

I took my last cold shower and packed my belongings. Most of my colleagues returned from the hospital around 2pm, so I had time to say my goodbyes and take last-minute pictures with everyone. By 2:30pm, it was time to go, so I loaded my luggage into the van and took the ride to the airport. I flew from Mombasa to Nairobi, to Amsterdam, to Atlanta, and finally, to Jacksonville. After two days of travel, my journey in Kenya was officially finished.

Throwing stars and venus fly traps are prohibited in the Nairobi airport? Oops...

Conclusion

Over the course of the month, I have learned and experienced far more than I can possibly describe with words and pictures. My exposure to a new language, a new culture, a new work environment, and a new ecosystem was overwhelming, but fascinating to explore. Culturally, I have learned about how Kenyans live in day to day life, the kind of food they eat, what kind of hardships they face, and what activities they enjoy. Medically, I have learned the basics of how to suture, change dressings, insert cannulas, change IV fluids, inject lidocaine, take blood pressure, and administer HIV tests. In a matter of weeks, I have made a number of international friendships I intend to keep up with, and we joked that in 10 years we would all meet up again (or was it a joke?). Ultimately, my trip to Kenya was one of the best experiences in my life so far, and it’s one I will never forget.


The Elective Africa group!

Tuesday, 26 June 2012

Day 23: Craniotomy and Excision, Last Full Day

I woke up at 7:30am, when we were supposed to leave for the hospital. Fortunately, the van was running late, so we ended up leaving at 8:30am. When we arrived at the hospital, I first headed up to the Major Theater to make sure I could scrub into the sterile field for a surgery. They said I could scrub into the second surgery, so one of the students agreed to text me when the first surgery was over so I could attend the second. Until then, I planned on going to maternity to see some deliveries.

When I reached the maternity ward at around 10am, I managed to see two deliveries. The first was a blue baby, the second was healthy; both were girls. The doctors/nurses told me I could deliver the next baby, but after three hours, no more births took place. I got the text to return to Major Theater at around 12:45. When I got there, the surgeons decided to take a lunch break, so I ate lunch too (rice, meat, and spinach). Afterwards, we headed to Theater 4, where I would get to scrub into the sterile field for the first time.

Surgery #1
DX: Epicranial mass from metastasis of thyroid tumor
Operation: Craniotomy and excision


The Italian neurosurgeon resident showed me how to scrub in, which consisted of washing my hands and upper forearms, putting on a sterile apron, and putting on sterile surgical gloves. During the surgery, I used the manual vacuum aspirator, kept the wires for the various instruments from getting tangled, and squirted water with a syringe while the drill cut the cranium. I also got to stitch sutures under the skin and use the stapler for sutures on the outer part of the skin. It was interesting seeing a large extradural tumor being removed up close. The whole procedure took about 4 hours, so it ended up being very exhausting.


Me using the vacuum aspirator during neurosurgery!


We got a tuktuk back to the housing compound at a little after 6pm. Another barbecue dinner was prepared for us, since about six of us would be leaving the next day. With burgers, ribs, fish, and other food, it was a great way to celebrate our last night in Mombasa. Since one of the students brought a spare cannula back from the hospital, one of the UK medical school students let me try putting in my first cannula, since I didn't get a chance to at the hospital. After watching numerous cannula insertions at the hospital, I knew the general procedure, and to my surprise, I got it in! It felt good succeeding in what I considered the most difficult thing I would get to do in Mombasa. Eventually the excitement died down and I went to bed, knowing tomorrow I'll need to pack and depart on my 4:40pm flight back to the US.

Me putting a cannula in Sunny!

Monday, 25 June 2012

Day 22: Neurosurgery and Swimming

I slept in until about 9am and then went to the main building to eat breakfast. I wasn't planning on going to the hospital, so I went swimming, but then I was convinced into going with a group from 12:30 to 3:30pm. Although I wasn't there for long, I got to see the end of a cranial hematoma surgery and the beginning of a brain tumor removal. Between the surgeries, I ate some beans, rice, and cabbage the hospital provided for the doctors, nurses, and students.

We left at 3:30pm and hung out until dinner. After dinner, we went swimming again, and I worked on my blog more. My parents and I decided it would be safest to leave Wednesday instead of the originally-planned Sunday departure, so my flight schedule was changed so that I leave Wednesday at 4:40pm. Since tomorrow is my last day, I'm going to try to squeeze as much in as I can while still having time to pack everything; this includes scrubbing into the sterile field of a neurosurgery, watching a baby be delivered, watch a C-section, and start a cannula. I'll be going to the hospital at 7:30am to try and fit as much in as I can in my last full day in Mombasa.

Days 19, 20, and 21: Masai Mara

I woke up around 3:15am, and we left on time around 4am. The airport was only about half an hour away, so we had plenty of time before our flight. On board, I was seated next to a man in a suit who said he is from Mozambique and works for Save the Children. We arrived in Nairobi at around 6:30am, just as the sun was rising.

Downtown Nairobi

Although we were supposed to be picked up at 8am, our transportation arrived early, so we left the airport at 7am. We first went to a small market in Nairobi, where we got water and food/snacks (like Toblerones). Next, when we stopped for gas, we went inside and got chicken and ice cream (the first ice cream since I got to Kenya!).

"Mint Crisp" Ice Cream!

We traveled for about 2 hours and arrived at our lunch destination, which was a small buffet in a small town between Nairobi and the Masai Mara. We ate lunch and continued for another 3 hours; the last 2 hours were on a rock/dirt road which was crazily bumpy (especially at 80 km/hr, or about 50 mph).

At a stop along the way

Wombat! (First Wildlife!)

At around 3:45pm, we arrived at our campsite just outside the Masai Mara reserve. We dropped our belongings off at our tents and went on our first safari trip. In the three or so hours we were there, we saw antelopes/gazelles/impalas, water buffalo, wildebeest, elephants, and lions. At about 7pm, we headed back since dinner was at 7:30pm. The meals were provided at a building where all members of our camp ate together. We met two Australians, two Missourians, and two Danish nursing students.

My Tent

Our tents only had electricity from 6:30pm to 10pm, and since we had to get up early anyway, we went to bed at 9pm. I was awakened at 2:30am by a very strange, hysterical laughing sound... something between a man uncontrollably laughing and a dog barking. It took me a minute to realize it was a pack of hyenas.

Saturday morning we woke at 6:30am and ate breakfast at 7:30am. Afterwards we left for safari. I've combined pictures from all three days below to show the variety of animals we saw; there are many more pictures, but due to limited internet, I've only posted a few.

Elephant

Lion

Impala/Gazelle/Antelope Thing

Water Buffalo

Giraffe

Wildebeest

Zebra

We ate lunch along a river, where we saw mongooses, vervet monkeys, hippopotamuses, and a crocodile. The mongooses and monkeys tried to steal our food until a ranger shot at them with a slingshot. After lunch, we continued to adventure around until about 5:30pm, when we left the Masai Mara and went to the village where the local Masai warrior tribe lives.

Part of the Masai Village

Their village was a small circle of a few huts made of sticks and dried cow manure. The ground was almost entirely manure from the various animals they kept (cows, goats, chickens, dogs). The Masai showed us the inside of their huts, which were very small, with beds made of dried cow skin. They taught us one of their tribal dances and explained how the man who jumped the highest paid the least number of cows for his wife/wives (normally about 20 cows per wife, and each wife needs her own hut). They also told us that the previous night, they had to fight off a group of hyenas that was attacking their animals, which explains why we heard them at 2:30am. We left the village and went back to eat dinner at around 7:30pm.

It was at dinner that we heard startling news: that the US Embassy had issued a terrorist warning for Mombasa, that there was an "imminent threat of a terror attack" from an al Qaeda-linked terrorist group, and that bombs or bomb components had been found in both Nairobi and Mombasa. Since we didn't have internet, we couldn't find out any more information, so we still didn't know exactly was happening. Later we would learn that Kenyan troops had been sent to Somalia in October 2011 to help oust the Islamic militant group al Shabaab, a close ally to al Qaeda. The group threatened retaliation, and various bombs had been intercepted in Nairobi and Mombasa, and some bombs had gone off in Nairobi.

Nonetheless we planned to go to the safari early the next morning, at 6am, so we went to bed around 10pm. The next morning we went on safari for about 2 hours before returning, eating breakfast, packing, and leaving for Nairobi at about 10am. We stopped at the same place for lunch, and continued until we got to a secured area (I don't know what it is called) where we waited for the Elective Africa Nairobi coordinators to talk to us about the safety situation. We also walked around a market to see what it was like (people persistently tried to sell us stuff). Finally, we went to the airport and took our 8pm-9pm flight back to Mombasa.

When we got back around 10pm, we started watching the Euros (England vs. Italy... Italy won). I was on my computer working on my blog, and I decided to check to see the status of the terrorist threats in Mombasa. I was the first person to read the news about the grenades that went off at 9:45pm earlier that night. Since then, students in the group have been indecisive about staying in Mombasa and only leaving to go to the hospital, or leaving early. We went to bed after the Euros, unsure of how bad things were or how bad they will get.

Thursday, 21 June 2012

Day 18: Day Off Before Safari

I slept in until 9am, ate some breakfast, and went swimming. Sunny and I bought a pair of goggles, so I used those to swim laps. We also invented a game composed of tossing a mango and trying to rescue it before it sank all the way to the bottom of the pool (and occasionally racing to get it). After much swimming, I ate lunch, and later dinner. We played some games and hung out for a while before packing for our three day safari at the Masai Mara.

Our flight tomorrow is at 5:30am, so we need to leave at 4am, meaning I'll need to get up sometime between 3am and 3:30am. I won't have my computer with me, so I won't be able to update my blog until we get back Sunday night. Our flight back returns to Mombasa at 9pm, so I'll update it a few hours after that (I'll have a lot to write about and many pictures to post!). After packing, we went to bed early, knowing we would have to wake up and leave well before sunrise.

Wednesday, 20 June 2012

Days 16 and 17: Crazy Night, Morning, and Afternoon Shifts

Since yesterday and today melded together, separated by no more than 4 hours of sleep, I will write about them as a single post. Yesterday morning I slept in until about 8pm. Not much happened before my shift started; I mostly just ate, went swimming, and hung out until it was time to head out. At 8pm, we took the tuktuk to the hospital.

Dinner was spaghetti with beef sauce.

When we arrived, the hospital was the most empty I've ever seen it. Many of the areas, such as the radiology rooms and Minor Theater, were closed and locked. We headed to Casualty, which wasn't nearly as active as I was anticipating. We helped save a woman suffering from an asthma attack (apparently the nurses in Casualty just ignore asthma attacks, because they didn't do anything), and I watched one of the doctors put in cannulas. I was going to get a chance to try putting in a cannula (which was very exciting... I consider the successful insertion of a cannula as my ultimate test for this trip), but we found that the patient already had a cannula on the other side of his elbow, so there was no need for me to put one in his hand. Hopefully I'll get more chances to put a cannula in before I leave.

We also headed up to a general ward to see if anything was happening. We found a baby with cephalohematoma (collection of blood between the skull and the scalp, causing a bulge on the head). Since there wasn't anything we could do in the general ward, we went back to Casualty and followed doctors around for a while. We heard that there was a spina bifida surgery (an intense neural surgery) in the morning at 8:30am, so we decided to plan on watching it.

By 2:30am, we were tired, and there weren't any new interesting cases for us to examine, so we went for a walk around the hospital. We happened to find our van that drives us around and the driver asleep in it. There was also a really cool praying mantis on the van that we stared at for about 5 minutes and poked with a stick. Finally, we headed back to the housing complex. I went to bed at 3am, ready to get up early for the surgery we agreed to see.

Praying mantis on the van! It flew away after a few minutes.

I woke up at 7am, ate breakfast, and got ready to return to the hospital. We left in a tuktuk at 8:30am and arrived at around 9am. As expected the surgeries were running late, mostly due to equipment failures (they couldn't get the Bovie and bipolar coagulation forceps working for a long time). They also changed the schedule, so that the spina bifida surgery came third in line. We decided to stay to watch the first one, then get lunch during the second, and come back for the last. We scrubbed into Major Theater and headed to the fourth theater room.

Surgery #1
DX: Cephalohematoma
Operation: Excision

The neural surgeries we were about to see weren't simple ones. When we walked into Theater 4, we were greeted by a neural surgeon from Spain, and neural surgery resident from Italy (doing his residency in the Czech Republic), and the resident's nurse from the Czech Republic. The team met up in Mombasa a few days ago and are here until Wednesday. It was interesting to learn that neural surgery residency takes 7 years, and the resident in this group was in his 4th year.

They arranged the three surgeries in order from simplest to most complex, with spina bifida being an obvious last. It turned out that the first surgery was the excision of the cephalohematoma of the baby we saw in the general ward last night. Apparently trauma from the birth caused a fracture in the baby's skull. The fracture healed by itself, but the bleeding caused a collection of blood to build up between the periosteum and connective tissue layers. The surgery was somewhat quick (went from 10:30am to 12:30pm) and involved cutting through the connective tissue and draining the blood.

After the first surgery, we left for lunch (at 1pm). We took a tuktuk to a restaurant called Caribou, which is near our housing complex. I got coconut-seasoned fish and a Toblerone milkshake (a great mix of much-needed calcium and more-needed ice cream). We stopped by the housing complex before heading back to the hospital at 2:30pm.

Coconut fish and Toblerone milkshake for lunch.

Surgery #2
DX: Spina Bifida
Operation: Closure

Spina bifida, Latin for "split spine," is a birth defect in which the neural tube does not close properly (instead of forming a closed tube, it is open and allows cerebrospinal fluid to leak out and form a bubble outside the spine). The condition often results in partial paralysis (especially paralysis of the legs), and while surgery does not cure the paralysis, it does close the neural tube and prevent infections that could cause more nerve damage. Spina bifida is very rare in developed countries (it is preventable by consuming adequate folic acid prior to conception), so getting to see this surgery up close is a big deal for us.

The Italian neurosurgery resident (left) and Spanish neurosurgeon (right) closing the spina bifida.

We arrived in Theater 4 just in time for the surgery we had been waiting to see. They had already finished the meningocele excision, had put this new patient (3 year old) to sleep, and were cleaning the area of operation with iodine. They cut the bubble of cerebrospinal fluid protruding from the patient's back and drained out the large amount of fluid that had accumulated. The Spanish surgeon and Italian resident worked together to suture the spinal components closed and clean up any infected tissues. They were almost done by the time we decided we should probably head back and eat dinner. We left the hospital at about 6:15pm.

By the time we got back, I was exhausted. I ate the dinner Dollas had made, which (for the first time) was fish and was arguably the best meal so far (even after having fish for lunch too). It was a long two days, filled with much hospital time and little sleep, so three of the four of us decided to take tomorrow off. We went to bed early, eager to catch up on lost sleep.

Dinner was fish, rice, and spinach.

Monday, 18 June 2012

Day 15: Day Off

I slept in until about 8am and reviewed bone and muscle anatomy for a while since it was my day off from the hospital. Eventually I got up and went to the main building to eat breakfast. Apparently some of the others decided to go to the hospital in the afternoon and night, so there were more of us at the complex than I expected. I made plans to go on tomorrow's night shift (8pm to 6am), so tomorrow I'll have the day off and the night at the hospital.

I didn't do much of anything exciting today. We picked some mangoes from the mango trees using a rake, and ate lunch and dinner. We also bought our plane tickets to the Masai Mara for the safari this weekend; originally we were going to take a bus and stay at a hotel, but we decided flying was faster, easier, and roughly the same price. Interestingly, the tickets were only $60, but the taxes were about $93... not sure how that works, but I got my ticket nonetheless. We hung out for a while before finally going to bed. After working Monday through Sunday, it felt nice having a day off.

Sunday, 17 June 2012

Day 14: Saline and Dressings

I slept in until 9am, the latest I've slept in since I got here. I ate a peanut butter sandwich and got ready for the hospital. Sunny, Joe, and I took a tuktuk to the hospital at around 10:30am.

When we arrived at 11am, the hospital was very empty, with only a few nurses in Casualties and only about two doctors going between Minor Theater and Casualties. We watched a doctor clean necrotic tissue out of a guy's foot, which somehow had lateral fractures across the three medial metatarsals. We mostly followed doctors and nurses around Casualties and Minor Theater for most of the time. My experience for the day included changing a patient's IV saline solution and adding dressings on another patient's right leg injuries. We took a tuktuk back to the complex around 2pm.

After we got back, we ate some lunch and went swimming (with monkeys in the trees around the pool!). We hung out for a while until dinner was ready.

Dinner was beef fried rice and tomato stuff.

After dinner, we played some Uno, reviewed the names and locations of bones, and went to bed.

Saturday, 16 June 2012

Day 13: Catheter, Lidocaine, and Sutures

It's Saturday, but that didn't stop me from waking up at 6am and eating some beef jerky and a peanut butter and jelly sandwich. Three of us (Mimi, Joe, and myself) decided to go to the hospital today and tomorrow and take Monday and Tuesday off. That way, we could avoid the overcrowding from the other students in the program and finally get some more hands-on experience. So at 9:30am, we took a tuktuk to the hospital and headed straight for the Minor Theater.

When we arrived at about 10am, the only doctor present was putting sutures in a torn Achilles tendon. After he finished, we were told to take the patient to orthopedics for a cast (since that is the only ward with casts apparently), but they ended up sending us to Casualties to wait for a cast... but Casualties sent us back to the Minor Theater due to payment problems... so we spent the first hour or so dragging the poor patient around in circles.

We went back to Casualties to see if there were any interesting cases. There happened to be one. On the men's side of the ward, a man lay tied down on a mattress that had been removed from the bed and placed on the ground. The patient was partially sedated and had obvious injuries to the head. The nurse asked us to give the patient a particular glucose solution through his cannula (via IV). While Joe tried to do so, the patient managed to free his arm and ripped out his cannula. One of the doctors came and tried to put another cannula in, but the patient was too unruly. Eventually the nurses and doctor decided it would be best to skip that step and go ahead and put in a catheter and stitch his head injuries, so they sent the three of us to Minor Theater to do just that.

I got the duty of putting in the catheter, under guidance from Mimi (a 2nd year medical student from the UK). It took a while, and the patient smelled like he had never bathed in his life, but eventually we got it working. We then took turns cleaning head wounds with iodine, injecting lidocaine, and stitching. After an hour or two, we had finally addressed each head injury and were ready to take him back to Casualties. The nurses at Casualties asked us to put a cannula in, and Mimi tried, but the patient was difficult to work with so after a while a doctor came and did it for us. Finally, at 3:30pm, we were done and could call the tuktuk to take us back to the housing complex.

We were starving by the time we got back. Fortunately, when we had gone to the alligator farm a week ago, I took a picture of a billboard advertising for pizza delivery, so we ordered a pepperoni/mushroom pizza and a spicy chicken pizza. Not long after we ate the pizzas, Dollas's dinner was ready, so we ate again.

The picture I took of the food delivery billboard a week ago.

Risky backyard waste disposal?

Dinner that Dollas made (tortilla-like thing with beans/potatos/etc.).

We hung out for a little bit and then went to bed early. All the action at the hospital made us pretty tired.

Friday, 15 June 2012

Day 12: Tuktuk Ride and Party

I woke up around 6:45 and left for the hospital at 7:30am, the usual for this week. When we arrived, I headed up to the women's general ward, where I ended up getting herded into a conference meeting about complicated malaria. They talked about 30 to 45 minutes about identifying and treating complicated malaria before finally releasing us. There wasn't much for us to do around the general ward, so we headed to Casualties and Minor. Since those areas were also not busy, we went to the Major Theater to see what surgeries were taking place.

Surgery #1
DX: Left testicle
Operation: Orchidectomy

The patient in Theater 1 was a 6 month old with an undescended left testicle. The surgery was one I never really thought about seeing, but it was interesting watching them make the incisions and pull the testicle into the scrotum. Even still, I'm pretty sure that kind of surgery doesn't appeal to me. When they were stitching the incisions, we headed to Theater 4.

Surgery #2
DX: Right cornea and lens
Operation: Cornea Repair

The four year old patient in Theater 4 had some kind of trauma to the eye. We arrived at the surgery in mid-operation, so the surgeon was already using his binocular microscope. We stayed for a while, but we couldn't tell what was happening very well, so we headed to pediatrics.

One of the Canadian students who has been stationed in pediatrics this week showed us around. The kids seemed happy to see us, since they didn't have any toys or anything to keep them preoccupied while they waited for their bodies to heal. After touring the pediatrics ward, we went to the post-op orthopedic ward, where we saw the guy who jumped off the bridge, fractured his tibia, and later was beaten by security after running around the hospital frantically with a piece of glass he took from the window he shattered. It looked like they were changing the sheets of his bed, and he smiled and waved to us, maybe recognizing us from helping while he was in Casualties.

We found that there really wasn't much left to do in the hospital today, so we opted to take the tuktuk back to the housing complex at noon. Tuktuks are small, three-wheeled vehicles often used as taxis (though they're free for us as long as we're only going back and forth between our complex and the hospital). Since we arrived at the complex early, I decided to go ahead and do laundry before everyone else arrived. It took about an hour, but I was glad to have more clean clothes available.

Tuktuk!

We went swimming and hung out until dinner, which was noodles, rice, and beef sauce. After dinner, some medical students from Kenya and the UK came over for the party. I went to bed a bit early because I was tired, though apparently some people stayed up and continued drinking.

Dinner: rice, noodles, and beef sauce.

Thursday, 14 June 2012

Day 11: Thursday

My alarm woke me at 6:45am, so I ate a peanut butter sandwich and left for the hospital at 7:30am. I went to the women's general ward, where nothing interesting happened for several hours. Mostly the doctors were just going around and talking to the patients in Swahili. The doctor who assigned us topics talked to us briefly about our cases (mine being acute and chronic renal failure), but other than that, nothing of interest happened in the general wards. So we went to Casualties and Minor Theater, where I saw some students put in sutures, but didn't get a chance to put any in myself (I just assisted with stuff). We finally left the hospital at around 1pm.

The cherry yogurt drink I got at the market (highlight of my day).

After we got back and ate lunch, we walked to the market (Nakumatt). I bought some local beer (Tusker) and a cherry yogurt drink to try. A while after we got back, we had dinner (potato/banana mix with vegetable stew), played some Uno, and went to bed. It was a pretty uneventful day.

Wednesday, 13 June 2012

Day 10: Bamburi Orphanage/School

After waking up at 7am, I ate my ham sandwich and got ready for the hospital. My stomach was still a little upset, and two of the others also apparently felt sick. They decided to stay in for the day to get better, but I was feeling better than yesterday, so I still opted to go to the hospital. My group of 6 (usually 8) proceeded to the hospital, leaving the housing complex at 7:30am.

I started in the women's general ward again. Two or three of us followed one of the doctors who was examining the patients. She assigned each of us a particular patient's case, to research the symptoms, causes, characteristics, and treatments for the ailment. Mine was acute and chronic renal failure and the differences between the two. Supposedly tomorrow we're going over our topics.

Monkeys at the hospital today!

After general ward, I went down to Casualties and Minor Theater. One patient got attacked by an alligator, and her leg was completely broken. I followed her up to Major Theater for her osteotomy, but I didn't stay to watch since I didn't have my spare scrubs with me. Back in Minor Theater, I was taught how to take out stitches (though I didn't take any out this time). We left the hospital at around 1pm.

We were back at the housing complex just long enough to eat lunch before being told our volunteering planned for today was cancelled, so we were asked to go to another orphanage. Most of the group were too tired, and I was tired too, but I ended up being one of the 6 or 7 who decided to go. We left around 2:30pm.

This orphanage/school was in a very small village called Bamburi. About 86 kids are taught in a very small hut. When we arrived, they sang for us, and then we played games with them for an hour or so. The games mostly involved making circles and dancing or running around in circles and then stopping. After a while, we gave them some candy and headed back to our housing complex.

The small hut that holds the 86 kids for classes.

Balloons ended in chaos... again.

Me with a few of the kids.

After we got back, we ate dinner (rice, beef stew, and some corn stuff that's fairly common in Kenya), played some games, and went to bed.

Tuesday, 12 June 2012

Day 9: Ceftriaxone Injection, HIV Testing, and Orphanage

Without the rooster here to wake me up at the crack of dawn, I could sleep in until 7am. We left for the hospital around 7:30am. Unfortunately my digestive tract was upset for most of the day, so the hospital trip wasn't the best. But it was still interesting nonetheless.

I spent most of the day in the women's general ward, where I learned how to give an injection through the IV cannula. I gave one injection of ceftriaxone to a patient. Towards the end of the day, I learned how to give HIV tests. The test consisted of pricking the patient's finger, squeezing blood onto an Alere test stick, and adding a drop of chase buffer. Two red lines indicates positive, and one red line indicates negative. I tested one woman, and she came out negative!

After the HIV testing, we went to Minor Theater and saw a patient with breast cancer getting the tumor removed with no anesthetics other than lidocaine (local anesthetic). We left the hospital at the usual 1pm.

After getting back and eating lunch, we went to a different orphanage (Rebby Jr. Academy), which primarily served as a school for orphans. This particular orphanage had fewer kids than the other orphanage, and was much more crammed for space. Like at the previous orphanage, the students at this orphanage sang to us and danced. We brought them toys, candy, and balloons, all of which they enjoyed. We also sang/danced the YMCA song for them, although it ended up a bit of a disaster. But when we gave the balloons to the kids, the whole place went crazy with balloons and orphans flying everywhere and bouncing off everything and everyone. After a last song, they gave us some drinks and left for their homes (or stayed if they live in the orphanage).

The neighborhood right outside the orphanage.

A few of the kids in the orphanage (many more came out after I took this picture).

The toys we gave to the kids (we blew up the balloons for them).

Balloons flying everywhere, like the yellow blob in the middle.

Me with a little person.

We talked to the couple in charge of the orphanage. They told us most of the kids have no parents, and the ones that do have only one (but that parent neglects them). The couple goes around the streets of the slum they live on, looking for stray children who have nowhere to go, and they give the kids some education and one meal (lunch) a day. School for them went from 8am to 5pm due lack of electricity. We asked them what their greatest challenges and greatest needs were, and they told us they desperately needed money to help pay for the teachers, because they can't teach for free (everyone barely has enough to survive) so the kids don't always get all the subjects they need. Of course, they also need money for food, electricity, water, etc.

Soon after we got back from the orphanage, dinner was ready. It was the same style beef stew with tortilla-like things as last Tuesday (the dinner schedule repeats itself weekly). We stayed up for a bit (over an hour while I tried to get the internet working again so I could update my blog) and then went to bed.

Monday, 11 June 2012

Day 8: Tonsillectomy and Laparotomy

Since we have to take two vans to the hospital, some of us go at 7:30am and the rest go at 8:30am. We switched times this week, so this week I go to the hospital at 7:30am instead of 8:30am (which is kind of nice since I get out at 1pm instead of 2pm). This morning, I got up at 7am and left at 8am (the van was half an hour late).

In Major Theater: Brittany (left), me (middle), and Courtney (right)

When we got to the hospital, we headed up to Major Theater again. There wasn't a whole lot happening today... just a tonsillectomy and a laparotomy (to remove a pelvic abscess). After the surgeries, we went downstairs to Casualties to see some of the cases in that ward. The only really interesting case was a woman who had severe edema in her legs. We left the hospital at 1pm.

Spaghetti and meat sauce, rice, and spinach (already eaten).

When we got back, we went to the market to withdraw more money and buy some groceries. I got some more passion fruit juice, some mango juice, some beer and cider, and some snacks. After the market, we went swimming, ate dinner, and watched France vs. England in the Euros (soccer). It wasn't the most exciting day so far, but hopefully tomorrow will be more eventful since we're either going to another orphanage or volunteering, or both.

Sunday, 10 June 2012

Day 7: Fort Jesus, Old Town, and Haller Park

I woke up around 7:30am and got ready for our tour of Old Town. At 9am we left for Fort Jesus, a fort built by the Portuguese in 1593. It larger than Fort St. Augustine, and was in the shape of Jesus.

Information about Fort Jesus.

Fort Jesus!

Me inside a watch tower.

After Fort Jesus, we toured through Old Town, which was right across the street from Fort Jesus. The area was very poor and old-fashioned. The living conditions were amazingly squalid, and it was hard to imagine that people live there their whole lives without experiencing the rest of the world. It really shows how lucky the rest of us are to live in the conditions we live in!

Part of Old Town Mombasa.

Apparently this is a gym in Kenya.

We also went through a bazaar and ate lunch there. It was a great place for inexpensive local souvenirs!

Part of the bazaar in Old Town.

The marketplace at the bazaar.

Mushroom pizza and passion fruit juice for lunch.

Having left Old Town, we took our taxi to Haller Park, Mombasa's largest animal sanctuary. We saw giant tortoises, antelope, and water buffalo, and we got to feed giraffes and monkeys! We also saw the feedings of crocodiles and hippos. It was a fascinating trip, almost a safari by itself! I have lots of pictures, but due to limited bandwidth here, only a couple will be posted below.

Feeding a giraffe!

Feeding a monkey!

Antelope (maybe?)

Hungry Hippo!

Crocodile feeding time!

When we got back to the housing complex around 5pm, we went swimming to wash off the sticky feeling from being sweaty and around animals for so long. Dollas prepared a rice and beef meatball dinner, which was terrific as usual. Some of the people working for the program were going to slaughter the rooster, so we may be having chicken for dinner tomorrow (also means no more 6am wake ups!). I started to do my laundry (which is entirely done by hand here), but two of the security guards came over and showed me how to wash the clothes and volunteered to finish it for me. Despite not getting a chance to play Uno, I decided to go to bed early to catch up on sleep.