Last Day & Night in Nakuru & last day of the mission…wow where has the time gone??? I have worked about as hard as I did in Houston after Hurricane Katrina & I left there thinking there were still so many great needs & I felt the same way at the end of today but IT WAS A REALLY GREAT DAY!!! First of all after we got back late last night Donna told me that since our patients don’t hit the recovery room til about 9 & since we had the night we did that why didn’t I sleep in an extra hour & the “local nurses” who volunteer like shift work 7 am-7 pm could get things set up. I did not argue & felt like I was just given the best gift ever. So I slept in til 7 & then proceeded to take a taxi by myself to the hospital - the fare was $4 & it was quite a ride. The driver stopped at 2 different gas stations & got gas at the 2nd one….no idea why? The taxi drivers gas gages are always on empty I think its because they only put in the amount of fuel based on each ‘job” they get - they don’t have money to “fill up” - another simple thing we take for granted…having money for gas in our cars. The streets were totally bustling with activity…when we leave at 6:30 am & get back between 9 & 10 pm we miss all this activity & it is CRAZY!!!
A few things I have forgotten to write about in my blog…Jannae & I would text back & forth to coordinate patient from Recovery to Post Op they did have one phone in most wards - yep a rotary phone complete with the rotary dialing sound - the 1st time I used it I was instantly catapulted back in time to my childhood home on Memphis Ave in Whittier with our old rotary phone! I even took a picture with it! I think I forgot to blog about 2 patients yesterday…Gladys who was 6 mos old & from a distant Masai Tribe. Her mom & dad had traveled with her 1200 km (over a week) to get to us!!! She was put on the schedule for today & was so stinking cute..I know I took a picture of her with the child life specialist Donna (who I also adored!)
And yesterday I made several trips back & forth to post op & on my 1st trip outside the ward that connected to ours was a mom that I think our plastic surgeons helped & her 2 children..the little girl was about 3 & had beautiful sparkling brown eyes & the most beautiful smile & she waved at me as I walked by with a patient that I was taking in to the post op ward. On my way back to the “recovery room - I use that term lightly” I stopped & talked to her & her mom & found out her name was Faith & I was immediately in love!!! The next trip an hour or so later she was still out there so this time I asked if she would be there in another hour & that time I came back without a patient & with a dress for her - the cute striped one that had a little purse with it…she (& her mom) were so excited & grateful..I took MANY pictures - she was SO DARLING..Kelli & Sarah wanted me to bring An African baby home & if I could’ve I would because there were actually some moms who said this is my 5th or 6th child & I cant care for him/her so please take them…which many of us on the Op Smile International tram might have considered but there is a new law that you have to live in Kenya for 6 mos before you can adopt child. Personally I have always loved toddlers so if I could have I would have snatched Faith in a minute!!! But she had a very loving mother & perhaps that is why she was so happy J I was out of T shirts but I brought her brother some toys & he liked that too! Then today when I was taking some of our last patients to post op she was outside again & ran up to me & gave me a BIG HUG….ohh she made my day! (FYI any patient that can get outside does for the sun & also to get away from the pretty nasty stench that exists in all the wards)
Since it was our last day I brought all my scrubs with me to give to the nurses I was working with, I had also packed some other small gifts for them - they lack simple things we have all the time - bandage scissors are highly valued & I even brought & gave away a few stethoscopes. I even gave my VERY LARGE empty suitcase that brought all my dresses etc in it to John & he was going to use it to cart around baby manikins from place to place when he taught Pediatric Advanced Life support around Kenya J Nothing “extra” would go unused! When I got to the recovery room at 8:30 we hadn’t had our 1st patient yet so all I missed was my morning trip to the Post Op Ward. All the other Kenyan nurses in Recovery room (John & Florence Sr - both with Op Smile & then Florence Jr, Beatrice &Wamboi - 3 from this local hospital) gave me a really cute purse made in Kenya & gave Andreas a safari cap with “The Big 5” on it (the 5 animals you want to see on safari - rhino, lion, elephant, leopard, buffalo). It was so sweet of them J I asked about the mom from last night if she made it & they said they thought so but the staff didn’t want to talk about it & so I let it go & wanted to be respectful of that.
It was a shorter surgery day with the plan we would be done by 2 pm…and we were pretty close to that time frame. Many of the kids who came to be screened later in the week were on todays schedule so we ended with a lot of cleft lips & that seemed to make the entire team happy - a one year old patient w/ a cleft lip even showed up today & the baby hadn’t eaten so we added him on for surgery. Joyce was also scheduled for her burn dressing changes today under Genl anesthesia - the plastic surgeons knew this would be her last “Western medical Treatment opportunity” so I think they wanted to do all they could. They had one of the Kenyan general surgeons assist them so that perhaps he would follow her & help her continue to get care & heal well after we left. She had colored me a zebra that her mom gave me so I attached it to my Op Smile nametag & wore it all day J
I had a few dresses remaining so the students went with one of the hospital nurses & took them to another pediatric ward…it was great to be able to bless over 100 childrens lives with the clothes & toys I brought from the service of so many - I was simply the instrument to share the love of A LOT of really Christ like people in California….
The end of the surgery day came quickly compared to the 8 or 9 pm nights we were used to & even the last surgery on the 1 year old who arrived today was as important as the 1st to that child & family. When we were “all done” we basically dismantled the entire recovery room we had set up - monitors, equipment, meds everything & in about 90 min it was like we were never there (aside from 2 HUGE boxes of extra medical supplies we were leaving them)…. There was this sense that everyone just wanted to linger in the OR or at the hospital a little longer before we went back to the hotel.
I had 2 dresses still in my bag….and I wasn’t sure what to do with them….one of the locals was taking some extra toys back to a far away village so I thought maybe I would give them to him…then as I was walking to the front of the hospital to get to the bus I passed an adult ward & outside was a mom & 2 little girls…I stopped & gave them my last 2 dresses….it was the storybook ending to the 112 dresses….they held the dresses up to themselves & danced around & yes I took pictures!!!
Instead of taking the bus back John my Kenyan recovery room friend said I needed to ride in a “Tuk Tuk” so he got one & we went back to the hotel in this fun 3 wheeled cart. Reminded me of a golf cart w/ only 3 wheels & canvas flaps around it to enclose it - we got back to the hotel about 4:30 & the “Final Party” was at 6.…some of us went across the street to the “open market” to make some final purchases - ever since Monday the market wasn’t open when we left in the morning & was closed when we got back…I found my friend Moses & bough a hat for Doug from him as I had promised….I also got some final gifts for friends & family & found myself less concerned about “bartering” with them & mostly just wanting to give business to ones who were nice…paying an extra 100-200 shillings for something equals about $1-2 American….I am sure that the extra $20 or so I paid after all my shopping will have a bigger impact on their lives than mine at home.
The final party was nice….lots of speeches & thank yous from the Op Smile leadership, local Kenyan leaders in the country & in medicine - even the bus company owner who donated buses & drivers to take us back & forth every day & the people who cooked our lunch each day spoke .it takes SO MANY PEOPLE…yes an African Village worth to coordinate all the local details & needs of an Op Smile Mission The party/dinner ended about 11 but the “younger” team members continued the evening dancing at a local club near the hotel…as for me I needed to pack & even though I gave away so much stuff & offloaded one huge suitcase I filled up my 2 bags to come home. My “roommate” had left the day before so the last 2 nights I had my hotel room to myself & I just appreciated the quiet time to think about these 2 weeks & the truly amazing personal, spiritual, medical, emotional & truly “person to person” or “mom to mom” experiences I had….it has been a LIFE CHANGING EXPERIENCE to have been here on this mission & such a blessing in my life but…I do miss my family & will be ready to start the journey home in the morning.
Saturday, April 16, 2011
Saturday, April 9, 2011
Is it really THURSDAY????
THURSDAY…at least that is what I am told. I really have lost track of the days!!! Because of all the computer issues I have been having I am trying to get this written on a 15 min break I am taking while we have a lul & then at some point when the http://www/... figures out I am here in Nakuru & the internet Gods decide to let me connect I will hit "post" for all I know that may be when I get home!!!
It was a pretty “normal mission day” today & by Wednesday it seemed we were all in our “groove” other than the occasional “emotional case” or some of the day to day funny things that happen Really I almost felt it was running like clockwork here in Nakuru despite the fact we are in a somewhat primitive environment (probably advanced compared to other 3rd world countries). Everyone was doing their job & doing it well & working so great together - seriously not one person with an attitude. The team is awesome - an amazing group of people from all over the world.
The biggest difference in both a good & challenging way is that for the Kenyans the “Hakuna Matata” attitude that is very real…there is no sense of urgency for anything & some of the people have a “minimalist” approach to their work & their breaks are VERY important to them…we start work at 7 & at between about 10:30 & 11:30 everyone gets out of the Recovery Room for tea…no matter what…then there is lunch about 3ish & again about 4-5 everyone goes for tea. And it was a BIG deal because all the Op Smile volunteers were “taking tea” in the Doctors Tea Room near the OR & ICU. As you can imagine it frustrated them greatly that I didn’t want to “go for tea“ aka take a break every 3 hours….instead if it was slow I was poking my head in the OR or asking if anyone needed help…I always went to lunch & some days did take an afternoon break for a diet coke & trail mix and for me that was great cause I enjoyed stating busy and being near the kids. I didnt travel 10,000 miles to "take tea" :) but I also regocnized the importance of "hanging out" with the locals in the tea room & getting to know them better so I did that & also looked for ways to spend time with them whenever I could. I have some great notes all about the people & nursing in Kenya that I will write about another time!
As far as the "Hakuna Matata" life ...when Andeas (our intensivist) wanted to move patients to post op cause we had some “incoming” in the next 20 min & we already full I would be the one to volunteer to take patients to the post op ward - my 100 yd walk just to be able to “take in” everything going on at the hospital & to see my friend Jannae in Post Op. The other nurses wanted the post op nurses to come pick the patients up from us but Post Op was always slammed (that by the way I think is the hardest job of the mission ) so I would go & convince one of them to go with me “for a walk“. So basically all my Kenyan co workers said I worked too hard…but for me it was perfect!!! They do however LOVE the fact that I brought an IPOD & speakers & we have had music in the recovery room for the whole time. In that small room when we have 5-6 patients 2 to a bed most of them crying & the surgeons & anesthesia in there giving us report the noise level does get a bit high though so I turn it off!!! They are also a VERY friendly people & we laugh & joke all the time when we have down time between patients & are setting up for the next ones.
Because of all the extra screening we had done Mon-Wed we ended up cancelling some of the Category 5 adult cases (about 30) and adding on more kids with lips & palates…which is great because that is our primary mission…and we did A LOT of surgeries related to burns..so sad . My friends from KSL left yesterday…I cant wait to watch their piece on our mission and today the 2 high students got to come in the OR & see cases - they were so excited & they have been a fun addition to the team. Karina from San Clemente (who I traveled with) & Century from Norfolk VA.
My FUN patient for today was a 12 year old named Ann…as she came out of anesthesia she kept asking “is my smile beautiful now” and told us she had a good sleep & no pain & kept saying “God Bless You, God Bless the Doctors, I Love You, God Bless You” she was SO SWEET..I gave her a cute dress & took her picture then showed it to her on my viewer on the back of my camera - she made my day!
Also today Florence an ICU nurse at this hospital & one of my co workers said to me yesterday & today that she brought her 3 year old son for screening because of 2 fused fingers after he burnt them (this is very common because I think with the burns they wrap the hand & burned fingers together & then they fuse as they heal). He was a Category 5 but she wondered why he wasn’t put on the schedule because other Cat 5 children like that were scheduled on the end of most days. It FINALLY struck me that I should advocate for her & her son as she would think it not appropriate to ask herself. I explained the situation to Donna our coordinator & she told me to get the chart so I asked Florence what her son’s # was (each child that comes thru is given a # that becomes their medical record #) it was #143 so I went & got the chart & took it to Donna & Dan the Medical Coordinator. I explained Florence was volunteering here all week (took work off without pay) & she has done other Kenyan missions. Even though she & her husband both work they cannot afford even this simple surgery. I told them that either way yes or no I thought she would appreciate knowing they looked again at his chart I let it go from there & about 10 min later Donna came into the Recovery Room & told Florence they were adding her son to the Friday schedule & could she get him here later today for labwork. Florence said of course & then came & gave me a HUGE HUG told me what a difference it would make in his life….such a SIMPLE thing to ask for something for someone who might not ask for themself.
It was a pretty “normal mission day” today & by Wednesday it seemed we were all in our “groove” other than the occasional “emotional case” or some of the day to day funny things that happen Really I almost felt it was running like clockwork here in Nakuru despite the fact we are in a somewhat primitive environment (probably advanced compared to other 3rd world countries). Everyone was doing their job & doing it well & working so great together - seriously not one person with an attitude. The team is awesome - an amazing group of people from all over the world.
The biggest difference in both a good & challenging way is that for the Kenyans the “Hakuna Matata” attitude that is very real…there is no sense of urgency for anything & some of the people have a “minimalist” approach to their work & their breaks are VERY important to them…we start work at 7 & at between about 10:30 & 11:30 everyone gets out of the Recovery Room for tea…no matter what…then there is lunch about 3ish & again about 4-5 everyone goes for tea. And it was a BIG deal because all the Op Smile volunteers were “taking tea” in the Doctors Tea Room near the OR & ICU. As you can imagine it frustrated them greatly that I didn’t want to “go for tea“ aka take a break every 3 hours….instead if it was slow I was poking my head in the OR or asking if anyone needed help…I always went to lunch & some days did take an afternoon break for a diet coke & trail mix and for me that was great cause I enjoyed stating busy and being near the kids. I didnt travel 10,000 miles to "take tea" :) but I also regocnized the importance of "hanging out" with the locals in the tea room & getting to know them better so I did that & also looked for ways to spend time with them whenever I could. I have some great notes all about the people & nursing in Kenya that I will write about another time!
As far as the "Hakuna Matata" life ...when Andeas (our intensivist) wanted to move patients to post op cause we had some “incoming” in the next 20 min & we already full I would be the one to volunteer to take patients to the post op ward - my 100 yd walk just to be able to “take in” everything going on at the hospital & to see my friend Jannae in Post Op. The other nurses wanted the post op nurses to come pick the patients up from us but Post Op was always slammed (that by the way I think is the hardest job of the mission ) so I would go & convince one of them to go with me “for a walk“. So basically all my Kenyan co workers said I worked too hard…but for me it was perfect!!! They do however LOVE the fact that I brought an IPOD & speakers & we have had music in the recovery room for the whole time. In that small room when we have 5-6 patients 2 to a bed most of them crying & the surgeons & anesthesia in there giving us report the noise level does get a bit high though so I turn it off!!! They are also a VERY friendly people & we laugh & joke all the time when we have down time between patients & are setting up for the next ones.
Because of all the extra screening we had done Mon-Wed we ended up cancelling some of the Category 5 adult cases (about 30) and adding on more kids with lips & palates…which is great because that is our primary mission…and we did A LOT of surgeries related to burns..so sad . My friends from KSL left yesterday…I cant wait to watch their piece on our mission and today the 2 high students got to come in the OR & see cases - they were so excited & they have been a fun addition to the team. Karina from San Clemente (who I traveled with) & Century from Norfolk VA.
My FUN patient for today was a 12 year old named Ann…as she came out of anesthesia she kept asking “is my smile beautiful now” and told us she had a good sleep & no pain & kept saying “God Bless You, God Bless the Doctors, I Love You, God Bless You” she was SO SWEET..I gave her a cute dress & took her picture then showed it to her on my viewer on the back of my camera - she made my day!
Also today Florence an ICU nurse at this hospital & one of my co workers said to me yesterday & today that she brought her 3 year old son for screening because of 2 fused fingers after he burnt them (this is very common because I think with the burns they wrap the hand & burned fingers together & then they fuse as they heal). He was a Category 5 but she wondered why he wasn’t put on the schedule because other Cat 5 children like that were scheduled on the end of most days. It FINALLY struck me that I should advocate for her & her son as she would think it not appropriate to ask herself. I explained the situation to Donna our coordinator & she told me to get the chart so I asked Florence what her son’s # was (each child that comes thru is given a # that becomes their medical record #) it was #143 so I went & got the chart & took it to Donna & Dan the Medical Coordinator. I explained Florence was volunteering here all week (took work off without pay) & she has done other Kenyan missions. Even though she & her husband both work they cannot afford even this simple surgery. I told them that either way yes or no I thought she would appreciate knowing they looked again at his chart I let it go from there & about 10 min later Donna came into the Recovery Room & told Florence they were adding her son to the Friday schedule & could she get him here later today for labwork. Florence said of course & then came & gave me a HUGE HUG told me what a difference it would make in his life….such a SIMPLE thing to ask for something for someone who might not ask for themself.
Thursday Part 2....warning this is sad so skip if you want
Never would I have imagined….WARNING….this blog is somewhat a journal of my experiences & while I have not put “everything” in it & have scribbled some notes of things & experiences I will write about later elsewhere for myself this is the easiest way & place for me to “journal” & I need to do this now…what I will write here was VERY SAD SO PLEASE JUST SKIP OVER IT IF YOU LIKE & I DID NOT POST IT ON FACEBOOK as an update.
I was ending what I thought was a very “normal” Thursday…I had written the earlier post for today about 5 pm when we had a 20 min lull & now it was 8:30 I am outting that post ahead of this one). Florence Sr. & I were waiting for our last 2 patients to come out of the OR & John had taken the previous patient to post op. The hospital had “staged” patients for surgery in the hallway all week - usually with no IV, no O2 & no medical person ever anywhere nearby so I noticed a woman on a trolley (gurney) & didn’t think anything of it. Florence went to check on the patients in the OR to see if they were close to being done & I was picking up from a busy day & setting up for tomorrow. When Florence went by the woman she was flailing her arms & not coherent - she called me for help & we wheeled her into our Recovery area put oxygen on her & put her on our monitor she was in pretty significant shock so we called Andreas (our intensivist) he yelled out to the hospital staff “does anyone know what is wrong with this patient” as we started an IV…someone at some point told us she was 36 weeks pregnant & was just brought here from the maternity ward where she had been having seizures (perhaps from Pre-Eclampsia) & was given medicine there (that’s why she was floppy) & now they were going to do an emergency C-Section cause they also thought she had a ruptured uterus??? Obviously “emergency C-Section” is the US is rush them in & get the baby out…here it was wait 30 plus minutes for the doctors to arrive & then start treatment??? We had no way to check on the baby but we gave the mom fluids, Andreas & an Op Smile Anesthesiologist intubated her & then theKenyan doctors came…it was about 10-15 min after we first discovered her….and somewhere in there we lost power & lights for a few minutes.
They wheeled the mom in the OR & Andreas told me & Donna who was there by now to prepare to receive & resuscitate the baby…so we did, got fluids, oxygen, suction, towels, drugs, airway & intubation all set up…about 5 min later they brought in a very limp little girl & also said the cord was around the neck. We immediately tried to resuscitate her according to the best American critical care standards - doing CPR & using all we had set up…we got an IV line in & gave drugs etc etc…we worked on her for about 10 min w/o success. It was so emotionally difficult on so many levels for so many reasons…what would have happened normally in this scenario if we hadn’t intervened? Is this what they always do with their patients? We intervened & still the baby died - if she had any chance we gave her the best one possible, if she was in another country the scene would have played out so differently & I know she would likely have lived. And in the middle of all of this going on our 2 patients came out of the OR & Teresa the plastic surgery resident on the team was so great she walked in & said “Nancy what can I do to help” & I just said recover that patient you just brought me & she said she had no idea what to do but she did great. This really is an amazing team!!!
When we could do nothing more for the baby we wrapped her in a pretty pink blanket (one of the blankets we have been giving each child all week) & the “on duty” Kenyan OR nurse took the baby to “the maternity ward” I didn’t know why they took the baby there & asked Florence & she said that the mother wouldn’t believe her baby had “passed” unless she saw it.
Andreas quickly turned his attention to the mom in the operating room & from his voice I could tell it wasn’t going well…he told me to bring all the IV fluids I had & then asked for a few drugs as well. The situation in there stabilized somewhat & we left with her still in the operating room…we all walked quietly to the bus that had gone to the hotel & then come back for us & was waiting there. I got on the elevator & just couldn’t hold back the tears…I went to Jannaes room cause I just felt like I had to tell or debrief with someone & she was so supportive….never in my mind could I have imagined a situation like this…but we did all we could - I know that for sure…still at the end of a LONG day it was difficult to process…I have so many questions for the Kenyan nurses I will be asking tomorrow
I was ending what I thought was a very “normal” Thursday…I had written the earlier post for today about 5 pm when we had a 20 min lull & now it was 8:30 I am outting that post ahead of this one). Florence Sr. & I were waiting for our last 2 patients to come out of the OR & John had taken the previous patient to post op. The hospital had “staged” patients for surgery in the hallway all week - usually with no IV, no O2 & no medical person ever anywhere nearby so I noticed a woman on a trolley (gurney) & didn’t think anything of it. Florence went to check on the patients in the OR to see if they were close to being done & I was picking up from a busy day & setting up for tomorrow. When Florence went by the woman she was flailing her arms & not coherent - she called me for help & we wheeled her into our Recovery area put oxygen on her & put her on our monitor she was in pretty significant shock so we called Andreas (our intensivist) he yelled out to the hospital staff “does anyone know what is wrong with this patient” as we started an IV…someone at some point told us she was 36 weeks pregnant & was just brought here from the maternity ward where she had been having seizures (perhaps from Pre-Eclampsia) & was given medicine there (that’s why she was floppy) & now they were going to do an emergency C-Section cause they also thought she had a ruptured uterus??? Obviously “emergency C-Section” is the US is rush them in & get the baby out…here it was wait 30 plus minutes for the doctors to arrive & then start treatment??? We had no way to check on the baby but we gave the mom fluids, Andreas & an Op Smile Anesthesiologist intubated her & then theKenyan doctors came…it was about 10-15 min after we first discovered her….and somewhere in there we lost power & lights for a few minutes.
They wheeled the mom in the OR & Andreas told me & Donna who was there by now to prepare to receive & resuscitate the baby…so we did, got fluids, oxygen, suction, towels, drugs, airway & intubation all set up…about 5 min later they brought in a very limp little girl & also said the cord was around the neck. We immediately tried to resuscitate her according to the best American critical care standards - doing CPR & using all we had set up…we got an IV line in & gave drugs etc etc…we worked on her for about 10 min w/o success. It was so emotionally difficult on so many levels for so many reasons…what would have happened normally in this scenario if we hadn’t intervened? Is this what they always do with their patients? We intervened & still the baby died - if she had any chance we gave her the best one possible, if she was in another country the scene would have played out so differently & I know she would likely have lived. And in the middle of all of this going on our 2 patients came out of the OR & Teresa the plastic surgery resident on the team was so great she walked in & said “Nancy what can I do to help” & I just said recover that patient you just brought me & she said she had no idea what to do but she did great. This really is an amazing team!!!
When we could do nothing more for the baby we wrapped her in a pretty pink blanket (one of the blankets we have been giving each child all week) & the “on duty” Kenyan OR nurse took the baby to “the maternity ward” I didn’t know why they took the baby there & asked Florence & she said that the mother wouldn’t believe her baby had “passed” unless she saw it.
Andreas quickly turned his attention to the mom in the operating room & from his voice I could tell it wasn’t going well…he told me to bring all the IV fluids I had & then asked for a few drugs as well. The situation in there stabilized somewhat & we left with her still in the operating room…we all walked quietly to the bus that had gone to the hotel & then come back for us & was waiting there. I got on the elevator & just couldn’t hold back the tears…I went to Jannaes room cause I just felt like I had to tell or debrief with someone & she was so supportive….never in my mind could I have imagined a situation like this…but we did all we could - I know that for sure…still at the end of a LONG day it was difficult to process…I have so many questions for the Kenyan nurses I will be asking tomorrow
Thursday, April 7, 2011
REVISED!!! Joyce got surgery & I was back from the hospital & at the hotel by 9!
Okay well I started this post last night & then the internet went out (as happens about every 15 min here & only part of it saved so it's morning now & I will post what I have & try to catch up later.
Today was 2 hours shorter than yesterday & I got back to the hotel just before 9 pm which was SO NICE!!! The BIG news of the day was that Joyce the little girl w/ the burns got surgery todays she was the one who I blogged about on Monday??? (I think it was then the days have all blended together!)
I guess the plastic surgeons talked yesterday sometime & decided thay could do some skin grafting for her...I was super excited when I saw them walk her into the OR mid morning - it was a 3 hour OR case and they did grafts to her scalp & both forearms. I took care of her in Recovery & we kept her in recovery for 3 hours just because she needed closer monitoring than they could do in the post op area. They had given her alot of anesthesia in the OR so her pain was well managed & she did really well post op coming out of anesthesia except for some temperature issues - & we even held down her post op pain pain. She definitely has a long road & likely many more surgeries ahead of her but it is nice to think that we got her started on the road to recovery. I have to believe that she got a better start w/ the Op Smile surgeons & team than she would have with the local doctors.
Medical care her is WAY different than in the US....first of all they have little to no supplies or equipment available - we have to lock up all our supplies every night so that the hospital staff don't "borrow" them. Monday I made the mistake of not putting away the gloves that were in the boxes we taped to the ends of the bed & Tues morning when we came in there were no gloves in the boxes....and this morning the alcohol wipes were gone??? It makes no sense cause Op Smile will leave at this local "hospital" most all of our extra consumable supplies (except some of the drugs) but I guess there are some desperate needs. Also here in Kenya if you have someone in the hospital then you basically take care of them...bring them all their food & wash their clothes, so there are wash buckets & clotheslines outside all the "wards" & the hospital provides the "medical care" & juice or tea. Also this morning when we were setting up the Recovery Room they were doing a C-Section in the one OR room that the hospital is using (we are using the other 3 rooms & have 2 OR tables going in 2 of the larger rooms for a total of 5 tables) but they are all kinda connected. Most of the C-Sections are done in another OR (or Theatre as they call it here) so I am not sure why this one was here..perhaps a tender mercy for this mom. Anyway in the OR room they were doing the C-Section Delivery in the baby was delivered "blue & limp". According to one of the Op SMILE OR nurses the Kenyan delivery team all just sort of shook their heads. She yelled to us in the recovery room & we went in & with some stimulation & a little suction & blow by oxygen the baby perked up in a few minutes - It was a BOY!!! What we did was just "the basics" in the US & here it was almost advanced care. All day I wondered if they would have just let that little boy die???
I didn't get to the post op ward until later in the day - so I missed seeing alot of yesterdays patients since the cleft lip patients go home after one day & the cleft palate patients go home after 2 days. I did get to see a darling little girl we had the other day who had to stay an extra day because of some respiratory problems. We nicknamed her "Miss Kenya" in the recovery room! When I have them in the recovery room they are drowsy & out of it or crying...by the next day you can see their sweet personalities. I counted all the girl patients on the OR schedule for the next 2 days & went thru all the dresses I have left & then realized I will probably have about 30 extra. The 2 high school students who are with us are going to an orphanage today so I gave the extra dresses to them & a bunch of bubbles to give out...they say they will take pictures. The needs here are so vast & I feel like I don't even have a full comprehension of it...especailly those who live in remote villages.
One part of this post that didnt get saved was that at leat a dozen people usually older men have asked me if I have been to the small village not far from here in Nakuru where President Obama was born...another dozen mostly women have told me that he comes from "their tribe" there are abut 42 tribes in Kenya I am told & now this one has gained stature, & still others have asked how I like having their "Native Son" as my President. They definitely have Obama Fever here he's on T Shirts, Posters & there is even Obama Bubble gum with pictures of him & his family on the packages. I'm just saying that I know the US Govt did their part to investigate where he was born & decided it was Hawaii but they might want to just come to Kenya and chat with a few people here...
Today was 2 hours shorter than yesterday & I got back to the hotel just before 9 pm which was SO NICE!!! The BIG news of the day was that Joyce the little girl w/ the burns got surgery todays she was the one who I blogged about on Monday??? (I think it was then the days have all blended together!)
I guess the plastic surgeons talked yesterday sometime & decided thay could do some skin grafting for her...I was super excited when I saw them walk her into the OR mid morning - it was a 3 hour OR case and they did grafts to her scalp & both forearms. I took care of her in Recovery & we kept her in recovery for 3 hours just because she needed closer monitoring than they could do in the post op area. They had given her alot of anesthesia in the OR so her pain was well managed & she did really well post op coming out of anesthesia except for some temperature issues - & we even held down her post op pain pain. She definitely has a long road & likely many more surgeries ahead of her but it is nice to think that we got her started on the road to recovery. I have to believe that she got a better start w/ the Op Smile surgeons & team than she would have with the local doctors.
Medical care her is WAY different than in the US....first of all they have little to no supplies or equipment available - we have to lock up all our supplies every night so that the hospital staff don't "borrow" them. Monday I made the mistake of not putting away the gloves that were in the boxes we taped to the ends of the bed & Tues morning when we came in there were no gloves in the boxes....and this morning the alcohol wipes were gone??? It makes no sense cause Op Smile will leave at this local "hospital" most all of our extra consumable supplies (except some of the drugs) but I guess there are some desperate needs. Also here in Kenya if you have someone in the hospital then you basically take care of them...bring them all their food & wash their clothes, so there are wash buckets & clotheslines outside all the "wards" & the hospital provides the "medical care" & juice or tea. Also this morning when we were setting up the Recovery Room they were doing a C-Section in the one OR room that the hospital is using (we are using the other 3 rooms & have 2 OR tables going in 2 of the larger rooms for a total of 5 tables) but they are all kinda connected. Most of the C-Sections are done in another OR (or Theatre as they call it here) so I am not sure why this one was here..perhaps a tender mercy for this mom. Anyway in the OR room they were doing the C-Section Delivery in the baby was delivered "blue & limp". According to one of the Op SMILE OR nurses the Kenyan delivery team all just sort of shook their heads. She yelled to us in the recovery room & we went in & with some stimulation & a little suction & blow by oxygen the baby perked up in a few minutes - It was a BOY!!! What we did was just "the basics" in the US & here it was almost advanced care. All day I wondered if they would have just let that little boy die???
I didn't get to the post op ward until later in the day - so I missed seeing alot of yesterdays patients since the cleft lip patients go home after one day & the cleft palate patients go home after 2 days. I did get to see a darling little girl we had the other day who had to stay an extra day because of some respiratory problems. We nicknamed her "Miss Kenya" in the recovery room! When I have them in the recovery room they are drowsy & out of it or crying...by the next day you can see their sweet personalities. I counted all the girl patients on the OR schedule for the next 2 days & went thru all the dresses I have left & then realized I will probably have about 30 extra. The 2 high school students who are with us are going to an orphanage today so I gave the extra dresses to them & a bunch of bubbles to give out...they say they will take pictures. The needs here are so vast & I feel like I don't even have a full comprehension of it...especailly those who live in remote villages.
One part of this post that didnt get saved was that at leat a dozen people usually older men have asked me if I have been to the small village not far from here in Nakuru where President Obama was born...another dozen mostly women have told me that he comes from "their tribe" there are abut 42 tribes in Kenya I am told & now this one has gained stature, & still others have asked how I like having their "Native Son" as my President. They definitely have Obama Fever here he's on T Shirts, Posters & there is even Obama Bubble gum with pictures of him & his family on the packages. I'm just saying that I know the US Govt did their part to investigate where he was born & decided it was Hawaii but they might want to just come to Kenya and chat with a few people here...
Tuesday, April 5, 2011
An even longer day....seriously exhausted & hitting a wall...
Ok I am not sure when I have been more physically or emotionally exhausted...I know there have been times like this for me before but the passage of time has graciously erased the memories...
It has been about an 18 hour day from wake up til now when I just got back to the hotel. I decided to quickly do a SHORT blog entry before I shower then I will eat a granola bar & trail mix & go to bed!
The day starts at 5:30, breakfast is at 6, there's a team meeting at 6:30 & we leave for the hospital at 7 & the 1st five surgeries start at 8. Being in the Recovery Room we don't get our 1st patients til about 9 so this morning I went to the Post Op ward to see some of my little patients from yesterday & that was SO FUN & SO REWARDING. When I have them they are "coming out of the black hole" of anesthesia & while their faces look "fixed" they are drowsy...this morning they were awake & smiling & happy & wonderful! Even little Joyce was there in that area with fresh bandages over all her burns, in a little dress & while I dont think there was a smile yet her eyes looked just a little brighter :)
By 9:30 things were hopping in recovery & unlike yesterday when we got lots of patients in & then had a lull today was just a steady stream of patients with occasional chaos for one reason or another but multi-tasking is something I can do even in another country!
One of the highlights today was when Salome came to recovery after her surgery (the 14 year old I blogged about on Saturday). we have 3 beds & rotate the patients to each bed & she came to mine :) She looked great with her cleft lip fixed! I found out that someone helped her mom get busfare to Nakuru from Nairobi so she was there with her daughter...we had her mom come into recovery once I had her settled (as we do with all the kids whenever possible) and as soon as her mom came in she teared up & then bowed her head & started praying aloud in Swahili. All of us in the room also bowed our heads as she prayed & there was such an amazing spirit in the room. Florence (a Kenyan nurse I am working with in recovery) translated the prayer & said that mom thanked her Lord for this miracle & all those who have helped "her girl" an asked for blessing for everyone involved & prayed the Salome would take this good gift & go on to make a difference in the world and pass the kindness on to others...it was definitley the best part of the day. A KSL news crew (the Salt Lake City affiliate of NBC) has been here with us all week (they leave tomrrow) & Brooke Walker the reporter is darling & has been so fun to get to know. They picked 3 stories for an Op Smile series they will be airing in April & Salome's story is one of them...so I may have gotten some camera time in recovery & then they did interview me...so friends in Utah may see me on the news or maybe not - I will keep you posted when it airs they also said the local NBC affiliate in the LA area was interested in picking up the story so who knows...none of that really matters but I do want to see Brookes series about this mission & Op Smile.
Because of all the "add on's" the day went on much later than expected & honestly I do think I have hit a wall...I am feeling SO GRATEFUL to be here & be haing these experiences but I am a little homesick & miss my family (altho I did talk to all of them today), I have been gone for 8 days living in a very different environment, I am not getting alot of sleep & am working hard & long days...I am not sure when the "getting more rest" will be a possibility so I just keep moving forward as does all the team.
My last tender experience happened late tonight...we have been doing some adult patients but with the influx of new kids yesterday the adults have been delayed until the end of each day. Tonight we had a 20 year old girl who was getting surgery for some old burn scars on her face & neck (burns are a huge issue here because they cook indoors over an open flame with oils...there are so many people & children with burns I have been amazed!) Anyway she was to have this done & then be able to go home. I recovered her & then walked her to Post Op to gather her things & in pretty good english she told me she was married & had 2 young children. When we go to the post op area because of the add on surgeries it was over crowded & they had some babies sharing beds. As I told the night nurse she could go home the young woman said she lived 12 km away & had walked her but now at 9 pm it was unsafe for her to walk home so she would need to spend the night. I had to go back to recovery but as I walked back there I thought "really she has to share a bed in a hospital & not be home with her kids & husband?" So since I had taken a cab back to the hotel last night & it was 300 shillings (about $4) I asked the Kenyan coordinator Diana...can't we just call a cab for her I will pay??? Diana said that others might want the same thing etc but I felt like I just needed to push the issue & advocate for this young mom. I asked Diana how much she thought a cab would be for 12 km & she said maybe 500 shilling ( $6) I said let me do it please so we went back down there & I found her doubled up in a bed with another teenage patient. Diana talked to her in Swahili & then took her to a more private area where other patients wouldnt hear the offer & she said yes she really wanted to go home & all she needed was 200 shillings ($2.50)...I already had given Diana 500 shillings so she gave her 200 & the girl thanked me profusely & I just said "go home to your children" & just that got me choked up. It was a very simple thing..anyone would've done I am sure; I was just the one put in the position to meet her & then help her...there was no reason for her to stay & I am glad she got to go home...it ended my very long day on such a positive note :) How many times do I misplace a few dollars or waste it on something or buy a large diet coke & I never think twice about it & here in Nakuru $2.50 made a difference.
There were some other intersting parts of my day...like the ventilator tubing I saw hanging out to dry on a clothesline or the fact that I never imagined myself walking 50 yards from teh recovery room on slightly pave but very bumpy & on some placed dirt paths to get a patient to the post op area at 9 at night in the pitch dark using my flashlight to guide me! (not logistically the best but it is one of the nicest buildings here), that I would be so excited to have the a "Tuna Lunch Kit" & right now that taking a shower & getting to bed is almost as good as Christmas! so goodnight!
It has been about an 18 hour day from wake up til now when I just got back to the hotel. I decided to quickly do a SHORT blog entry before I shower then I will eat a granola bar & trail mix & go to bed!
The day starts at 5:30, breakfast is at 6, there's a team meeting at 6:30 & we leave for the hospital at 7 & the 1st five surgeries start at 8. Being in the Recovery Room we don't get our 1st patients til about 9 so this morning I went to the Post Op ward to see some of my little patients from yesterday & that was SO FUN & SO REWARDING. When I have them they are "coming out of the black hole" of anesthesia & while their faces look "fixed" they are drowsy...this morning they were awake & smiling & happy & wonderful! Even little Joyce was there in that area with fresh bandages over all her burns, in a little dress & while I dont think there was a smile yet her eyes looked just a little brighter :)
By 9:30 things were hopping in recovery & unlike yesterday when we got lots of patients in & then had a lull today was just a steady stream of patients with occasional chaos for one reason or another but multi-tasking is something I can do even in another country!
One of the highlights today was when Salome came to recovery after her surgery (the 14 year old I blogged about on Saturday). we have 3 beds & rotate the patients to each bed & she came to mine :) She looked great with her cleft lip fixed! I found out that someone helped her mom get busfare to Nakuru from Nairobi so she was there with her daughter...we had her mom come into recovery once I had her settled (as we do with all the kids whenever possible) and as soon as her mom came in she teared up & then bowed her head & started praying aloud in Swahili. All of us in the room also bowed our heads as she prayed & there was such an amazing spirit in the room. Florence (a Kenyan nurse I am working with in recovery) translated the prayer & said that mom thanked her Lord for this miracle & all those who have helped "her girl" an asked for blessing for everyone involved & prayed the Salome would take this good gift & go on to make a difference in the world and pass the kindness on to others...it was definitley the best part of the day. A KSL news crew (the Salt Lake City affiliate of NBC) has been here with us all week (they leave tomrrow) & Brooke Walker the reporter is darling & has been so fun to get to know. They picked 3 stories for an Op Smile series they will be airing in April & Salome's story is one of them...so I may have gotten some camera time in recovery & then they did interview me...so friends in Utah may see me on the news or maybe not - I will keep you posted when it airs they also said the local NBC affiliate in the LA area was interested in picking up the story so who knows...none of that really matters but I do want to see Brookes series about this mission & Op Smile.
Because of all the "add on's" the day went on much later than expected & honestly I do think I have hit a wall...I am feeling SO GRATEFUL to be here & be haing these experiences but I am a little homesick & miss my family (altho I did talk to all of them today), I have been gone for 8 days living in a very different environment, I am not getting alot of sleep & am working hard & long days...I am not sure when the "getting more rest" will be a possibility so I just keep moving forward as does all the team.
My last tender experience happened late tonight...we have been doing some adult patients but with the influx of new kids yesterday the adults have been delayed until the end of each day. Tonight we had a 20 year old girl who was getting surgery for some old burn scars on her face & neck (burns are a huge issue here because they cook indoors over an open flame with oils...there are so many people & children with burns I have been amazed!) Anyway she was to have this done & then be able to go home. I recovered her & then walked her to Post Op to gather her things & in pretty good english she told me she was married & had 2 young children. When we go to the post op area because of the add on surgeries it was over crowded & they had some babies sharing beds. As I told the night nurse she could go home the young woman said she lived 12 km away & had walked her but now at 9 pm it was unsafe for her to walk home so she would need to spend the night. I had to go back to recovery but as I walked back there I thought "really she has to share a bed in a hospital & not be home with her kids & husband?" So since I had taken a cab back to the hotel last night & it was 300 shillings (about $4) I asked the Kenyan coordinator Diana...can't we just call a cab for her I will pay??? Diana said that others might want the same thing etc but I felt like I just needed to push the issue & advocate for this young mom. I asked Diana how much she thought a cab would be for 12 km & she said maybe 500 shilling ( $6) I said let me do it please so we went back down there & I found her doubled up in a bed with another teenage patient. Diana talked to her in Swahili & then took her to a more private area where other patients wouldnt hear the offer & she said yes she really wanted to go home & all she needed was 200 shillings ($2.50)...I already had given Diana 500 shillings so she gave her 200 & the girl thanked me profusely & I just said "go home to your children" & just that got me choked up. It was a very simple thing..anyone would've done I am sure; I was just the one put in the position to meet her & then help her...there was no reason for her to stay & I am glad she got to go home...it ended my very long day on such a positive note :) How many times do I misplace a few dollars or waste it on something or buy a large diet coke & I never think twice about it & here in Nakuru $2.50 made a difference.
There were some other intersting parts of my day...like the ventilator tubing I saw hanging out to dry on a clothesline or the fact that I never imagined myself walking 50 yards from teh recovery room on slightly pave but very bumpy & on some placed dirt paths to get a patient to the post op area at 9 at night in the pitch dark using my flashlight to guide me! (not logistically the best but it is one of the nicest buildings here), that I would be so excited to have the a "Tuna Lunch Kit" & right now that taking a shower & getting to bed is almost as good as Christmas! so goodnight!
Monday, April 4, 2011
LONG DAY #1 & a little girl who broke my heart
Well it's almost midnite here & I am pretty sure I am the only Op Smile Volunteer still awake & I am definitley the ony one in the hotel lobby (only place I can get internet) ohh aside from the hotel guard who yes does carry a weapon. I have given up on the idea of ever posting pictures before I get back...there is just no time to upload from the camera but I am taking lots of them.
It was a long first day...we had our wake up call at 5:30 a.m. which will be our wake up time every day so yes that is about 5 hours from now...
Today was our 1st day of surgeries & getting all the areas organized, pre op, surgery, recovery room (me), & post op. We also had about 50 more people show up to be screened even though it wasn't supposed to be a screening day so that was a challenge but somehow it got done...I wasn't anywhere near there but I heard it was busy & there are now several surgeries that were added to the schedule & we will likely have long days Tues/Wed/Thurs. It went well in recovery we had time to get organized before the 1st round of patients came to us but then all of a sudden we were swamped in our tiny little space as 5 patients came back in about a 30 min time span... we had 2 to a bed & moved them thru as quickly & safely as we could. Then we'd get a brief lull once we sent them all out to the Post Op area & then the rush would happen again. That went on 5 different times as each OR table was scheduled for 5 patients today & then they did a few add ons.
The little girl who broke my heart wasn't even one of our surgery patients...first thing in the morning one of the volunteers came to me to ask for a dress for a little girl who was in the pediatric ward where our patients were waitng to go to surgery - she said it was SO SAD & I really needed to see her & how happy the dress made her. She is 8 years old & her name is Joyce....she & her family were among many displaced in 2007 after all the unrest that occurred after the elections (I know nothing about this myself but John who is Kenyan & in the Recovery Room with me explained it to me a little) Anyway her family has lived in a tent since then...yes for 4 years!!! 3 weeks ago the nylon ten caught on fire she & her younger sister were inside & tried to get out but the tent essentially melted & burned on them & her sister died. They came to this general hospital we are working at & she has been her the whole time as she didn't qualify to go to the burn center an hour away...I can't quite imagine why because her burns were so extensive...her entire scalp, back & shoulders & arms were badly burnt & the wounds looked fresh & painful & her eyes had both a look of terror & pain in them. They brought her to the an area outside the Recovery Room so the Op Smile Plastic surgeons could look at her. We made a solution to cleanse her wounds, got her some appropriate pain medicine & the Docs made a plan that the ward nurses could follow....I have been a PICU nurse for over 25 years & seen alot of pretty horrific things (not burns because we don't do those at CHOC) and this really rattled me. I ended up giving her 3 dresses & some flip flops & books etc. Her mom asked our Chief Mission Plastic surgeon if she could get skin grafts but he said not this week while we are here - her wounds needed more time to heal & then she asked if Joyce could ever grow hair again & when he said it was very doubtful the mom just looked so sad & defeated & walked away to spare her daughter from seeing her moms own sadness. It took me awhile to shake that brief 15 min experience (it was between rushes of patients) so getting busy & back to work helped.
I dont want this blog to be full of sad stories...but there are many AND there are some GREAT ones too...lots of kids got new SMILES today & looked so darling after surgery & those moms had tears of joy when we showed them their kids....every child who lef the the recovery room left with a dress or T-shirt & usually a toy or flip flops or something & that was fun...the 5 Kenyan volunters I am woking with in Recovery were so good to be sure "their patients" had something from my bags before they left us & one time one of them picked a darling dress out for her patient & then we were all a little embarassed when we realized it was a boy!!! - quick change to a T-Shirt & no problem.
About a hundred other things happened today & I really need to write more just to I remember but right now I have to get to bed wake up time is coming quickly...
It was a long first day...we had our wake up call at 5:30 a.m. which will be our wake up time every day so yes that is about 5 hours from now...
Today was our 1st day of surgeries & getting all the areas organized, pre op, surgery, recovery room (me), & post op. We also had about 50 more people show up to be screened even though it wasn't supposed to be a screening day so that was a challenge but somehow it got done...I wasn't anywhere near there but I heard it was busy & there are now several surgeries that were added to the schedule & we will likely have long days Tues/Wed/Thurs. It went well in recovery we had time to get organized before the 1st round of patients came to us but then all of a sudden we were swamped in our tiny little space as 5 patients came back in about a 30 min time span... we had 2 to a bed & moved them thru as quickly & safely as we could. Then we'd get a brief lull once we sent them all out to the Post Op area & then the rush would happen again. That went on 5 different times as each OR table was scheduled for 5 patients today & then they did a few add ons.
The little girl who broke my heart wasn't even one of our surgery patients...first thing in the morning one of the volunteers came to me to ask for a dress for a little girl who was in the pediatric ward where our patients were waitng to go to surgery - she said it was SO SAD & I really needed to see her & how happy the dress made her. She is 8 years old & her name is Joyce....she & her family were among many displaced in 2007 after all the unrest that occurred after the elections (I know nothing about this myself but John who is Kenyan & in the Recovery Room with me explained it to me a little) Anyway her family has lived in a tent since then...yes for 4 years!!! 3 weeks ago the nylon ten caught on fire she & her younger sister were inside & tried to get out but the tent essentially melted & burned on them & her sister died. They came to this general hospital we are working at & she has been her the whole time as she didn't qualify to go to the burn center an hour away...I can't quite imagine why because her burns were so extensive...her entire scalp, back & shoulders & arms were badly burnt & the wounds looked fresh & painful & her eyes had both a look of terror & pain in them. They brought her to the an area outside the Recovery Room so the Op Smile Plastic surgeons could look at her. We made a solution to cleanse her wounds, got her some appropriate pain medicine & the Docs made a plan that the ward nurses could follow....I have been a PICU nurse for over 25 years & seen alot of pretty horrific things (not burns because we don't do those at CHOC) and this really rattled me. I ended up giving her 3 dresses & some flip flops & books etc. Her mom asked our Chief Mission Plastic surgeon if she could get skin grafts but he said not this week while we are here - her wounds needed more time to heal & then she asked if Joyce could ever grow hair again & when he said it was very doubtful the mom just looked so sad & defeated & walked away to spare her daughter from seeing her moms own sadness. It took me awhile to shake that brief 15 min experience (it was between rushes of patients) so getting busy & back to work helped.
I dont want this blog to be full of sad stories...but there are many AND there are some GREAT ones too...lots of kids got new SMILES today & looked so darling after surgery & those moms had tears of joy when we showed them their kids....every child who lef the the recovery room left with a dress or T-shirt & usually a toy or flip flops or something & that was fun...the 5 Kenyan volunters I am woking with in Recovery were so good to be sure "their patients" had something from my bags before they left us & one time one of them picked a darling dress out for her patient & then we were all a little embarassed when we realized it was a boy!!! - quick change to a T-Shirt & no problem.
About a hundred other things happened today & I really need to write more just to I remember but right now I have to get to bed wake up time is coming quickly...
Sunday, April 3, 2011
On a lighter note..a day of team bonding!
So today was our day for "team bonding" to unite all the Kenyan Op Smile Volunteers (about 75% of the team) with the International Volunteers (25% of the team). Except for the fact that the "bonding day" started a little early with a 5 am wake up call (which is someone from the hotel knocking on your door until you respond...no phones in the rooms)...it was great :). We went to the Lake Nakuru National Park...Schoolbuses & drivers had been donated for our transportation (that was interesting!) and we had to pay $75 to get in (more than Disneyland!)...but it was worth it especially since I am not staying after to go on a Safari. We drove all thru the park on non paved roads & saw SOOOO many animals....before we went in we (meaning the non Kenyans) were so excited when we saw the monkeys at 6 a.m. little did we know that by the end of the day Zebras would barely get our attention because we saw so many of them. We were able to get out of the bus & up close - except for near the lion...and we saw....baboons, water buffalo, gazelles, white rhinos, giraffes, lions, monkeys, flamingos (what the lake is famous for but alot had migrated), hyrex (an african varmant), a variety of lizards (Sarah you would've hated that!), ostrich, water bucks, hyenas, zebras, pelicans, impalas, elands, warthogs & probably a few things I am forgetting. Yes it pretty much made me want to start singing all the Lion King songs!!! We were there for 8 hours & I took a TON of pictures. Then went to the "Rift Valley Sports Club" (African Version of a Country Club) for lunch - interestingly enough it was just a nicer version of the hospital lunches - must be standard fare...cabbage salad, rice, cooked spinach or collard (looks like cooked grass to me), beef in a sauce (really good) & they had chicken too. The Kenyan team members did some singing & dancing for us - I did a video of them - they were great! We finished at 3 & then at 4 the eight Latter Day Saint members of the team had a brief church service & then I took a much needed nap before our team mtg.
A few other "Fun Facts"...at dinner one night the "Amazing Race Spain" teams w/ their camera crew came in the the same restaurant (3 teams of 2) & one rule is they couldnt buy dinner after 7 pm so the Op Smile team bought them dinner...I am sleeping under a mosquito net every night although I have yet to see or be biten by a mosquito (but other have so no complaining & I am still taking my malaria medicine), the "Pantry" of food I brought has been a lifesaver as I can only eat so much African Hospital food for lunch & my friends on the mission are calling my room Wal-Nancy (like Walmart) becasue I seem to have everything everyone needs so I am feeding many!, it was odd to be at the African outdoor market & hear Justin Beiber blaring from the speakers, they feed us a wonderful breakfast each morning - a chef that makes omlettes & fruit & lots of African food I have tried but not added to my morning routine, I bought a Kenyan cell phone (a Nokia actualy) a SIM card and 300 minutes & texting to the USA for $35...best money I have spent here so I have talked to all my family & that makes me much more focused on doing the work that needs to be done here w/o worrying about home!
And let me tell you about the "Diet Coke Miracle"...finally yesterday I was able to walk to a grocery store a few blocks away (being out on the streets here in & of itself is an experience). I was tired of getting bottle "Coke Light" at the hotel & other team members told me to go there & get the plastic bottles so I could take one each day to the hospital to have when I "hit a wall" mid afternoon. It was a nice store & I immediately went to the soda aisle & NO COKE LIGHT (except in bottles)...imagine my distress!!! I stopped a store clerk & asked about it & he said they were out of stock...the rest of the Op Smile team had gotten their first & bought it all!!! arghhh was I really going to have to buy & lug bottles? I decided to ask another clerk when it might get restocked...he took me to their "office" looked on the computer for inventory & then took me to another office & another computer & said there should be 1 case in the wholesale section of the store. I followed him dowstairs to some sort of a basement (yes I was desperate & yes it was safe) & there were cases of all kinds of soda everywhere, he moved about 30 cases around & found me the last case of 20 oz bottles of Coke Light in all of Nakuru I am sure...he said it was packaged to be sold as a case & I said no problem I will take it :) So between the phone & the coke light I am ready to take on the week! It was added to my pantry & I have already shared with other team members!
So tomorrow the chaos starts (so I am told) the 25 surgeries for tomorrow checked into the hospital tonight at 5 & will get bathed & prepped for surgery & we will head over there to set up at 6 am w/ the 1st surgeries at 8...there are 5 surgical tables & our tiny recovery room w/ 3 "beds" so the patient flow should be interesting, also the post op ward is about a 10 min walk outside from the recovery room. I am sure it will all work out after all Op Smile has been doing this for almost 30 years!!! & over 160,000 smiles. I will let you know how it goes but I gotta get to bed - big day ahead of me! Love to everyone & check in on my family its week 2 & things might be getting scary there!
P.S. Probably can't upload pics tonight sorry!
A few other "Fun Facts"...at dinner one night the "Amazing Race Spain" teams w/ their camera crew came in the the same restaurant (3 teams of 2) & one rule is they couldnt buy dinner after 7 pm so the Op Smile team bought them dinner...I am sleeping under a mosquito net every night although I have yet to see or be biten by a mosquito (but other have so no complaining & I am still taking my malaria medicine), the "Pantry" of food I brought has been a lifesaver as I can only eat so much African Hospital food for lunch & my friends on the mission are calling my room Wal-Nancy (like Walmart) becasue I seem to have everything everyone needs so I am feeding many!, it was odd to be at the African outdoor market & hear Justin Beiber blaring from the speakers, they feed us a wonderful breakfast each morning - a chef that makes omlettes & fruit & lots of African food I have tried but not added to my morning routine, I bought a Kenyan cell phone (a Nokia actualy) a SIM card and 300 minutes & texting to the USA for $35...best money I have spent here so I have talked to all my family & that makes me much more focused on doing the work that needs to be done here w/o worrying about home!
And let me tell you about the "Diet Coke Miracle"...finally yesterday I was able to walk to a grocery store a few blocks away (being out on the streets here in & of itself is an experience). I was tired of getting bottle "Coke Light" at the hotel & other team members told me to go there & get the plastic bottles so I could take one each day to the hospital to have when I "hit a wall" mid afternoon. It was a nice store & I immediately went to the soda aisle & NO COKE LIGHT (except in bottles)...imagine my distress!!! I stopped a store clerk & asked about it & he said they were out of stock...the rest of the Op Smile team had gotten their first & bought it all!!! arghhh was I really going to have to buy & lug bottles? I decided to ask another clerk when it might get restocked...he took me to their "office" looked on the computer for inventory & then took me to another office & another computer & said there should be 1 case in the wholesale section of the store. I followed him dowstairs to some sort of a basement (yes I was desperate & yes it was safe) & there were cases of all kinds of soda everywhere, he moved about 30 cases around & found me the last case of 20 oz bottles of Coke Light in all of Nakuru I am sure...he said it was packaged to be sold as a case & I said no problem I will take it :) So between the phone & the coke light I am ready to take on the week! It was added to my pantry & I have already shared with other team members!
So tomorrow the chaos starts (so I am told) the 25 surgeries for tomorrow checked into the hospital tonight at 5 & will get bathed & prepped for surgery & we will head over there to set up at 6 am w/ the 1st surgeries at 8...there are 5 surgical tables & our tiny recovery room w/ 3 "beds" so the patient flow should be interesting, also the post op ward is about a 10 min walk outside from the recovery room. I am sure it will all work out after all Op Smile has been doing this for almost 30 years!!! & over 160,000 smiles. I will let you know how it goes but I gotta get to bed - big day ahead of me! Love to everyone & check in on my family its week 2 & things might be getting scary there!
P.S. Probably can't upload pics tonight sorry!
Saturday, April 2, 2011
Setting up the Recovery Room & 2 Special Girls
What an incredible day….I was all set to be the gatekeeper day #2 when Donna (the mission coordinator) asked me to go with Andreas )the Pediatric Intensivist & her husband) to set up the Recovery room..this is his 1st mission too but Donna has been on several so she gave me her advice & off I went. Since I didn’t know I would do this today I didn’t bring any scrubs so I had to borrow some from the hospital…very interesting since they have very few & wash them by hand & hang them to dry behind the hospital. The “recovery room” was….lets just say less than ideal…a 10x10 room maybe with dirt & trash everywhere, one bug infested bed, a leak in the ceiling & everything was rusted, dirty or otherwise disgusting & there were open windows w/ flies coming in & ants all over the floor…after I took it all in & was in shock I gave myself a “pep talk” I said “I can do this”. I took before & after pictures that I will try to post tomorrow…there should have been 3 recovery room nurses setting up but my 2 Kenyan partners were gone so it was just me - the OR Nurses were busy setting up the OR but they tried to help me when they could & when I needed a translator. Andreas (the doctor) said “set it up however you want” - so I instantly liked him & when he helped me unpack 12 BIG boxes & figured out a way to duct tape boxes of gloves to the end of the 3 beds & I rounded up I loved him!!! I adore the intensivists at CHOC I have worked with for so many years but he was running a close second! 4 hours after I walked into the disaster I had 3 beds all set up - yes I had to keep the buggy mattress but I cleaned the heck out of it & getting a sheet for the 3rd bed didn’t happen so I did a makeshift one..it was all good. I had the students & volunteers use the unpacked cardboard boxes to make my IV arm boards & “no no restraints” - so the kids cant bend their elbows & touch their face). Usually the recovery room nurses do that but since it was just me they were lifesavers. Anrdreas & I went thru all 3 “Crash Boxes” & set them up how we both liked….my roomate Poly made cardboard dividers for my empty small cardboard boxes so I could have all my supplies at each bedside just like awe do at the hospital & I taped all the “emergency supplies” I needed above each bed…organized the one shelf I had with all the other supplies, stored the extra stuff under the beds & at the end I was REALLY HAPPY…I wanted everyone to come tour my “beautiful” recovery room…it is all about perspective & doing the absolute best you can with what you have.
The OR & recovery room are in the same building as the 3 bed ICU….I again was a little shocked as I saw 3 rickety beds there w/ mosquito nets over them & in one bed was a 6 year old girl Penina who motioned to me as I went by…I asked the nurses if I could go to her bedside…she didn’t speak English & I don’t even know what was wrong with her but I held her had & talked to her & smiled & the nurse translated a little then I hurried off & brought her 2 dresses & her eyes it up & I cold not hold back the tears….she is so precious & I told her I would visit her again on Monday.
Then at screening I was just helping as needed it was a slow steady stream but very manageable so I didn’t volunteer to be the gatekeeper!!! I had already had a BUSY day. But one of the patients that came in totally stole my heart…perhaps because she spoke English & spoke quite well…her name is Salome & she is 14 & has a cleft lip…she lives in Nairobi & came with her 27 year old eldest sister who had saved all her money for a month to pay for the busfare to bring herself & her little sister here…their dad was recently unemployed & the mother is a “housemom” (stay at home mom) so they didn’t have money for the parents to both come so her sister brought her. There are 8 kids in the family 6 girls & 2 boys & Salome is the 5th child. All her life she has asked her parents why she was the only child with “this lip” & said all the kids at school had teased her all her life & boys don’t look at her & she just wants to be normal & wants her lip fixed so she can sing better (she sang for us) & wants to sing praises to her Lord. Her sister said the family had always prayed to have a way or the money to help her but they never could. Again…lots of teary-ness the entire time….I cant even imagine the life she has lived & how a 45 min surgery will change her entire life…when we told her she would have surgery on Tues her older sister & she both cried….her sister was going to call to see if she could be off work &to stay here w/ Salome & they were going to stay with friends in the area….the love of this family & especially these sisters was palpable in every sentence….I thought of my own girls & how I think they too would do whatever they could to help each other….this day was one of those when I again KNEW I was meant to be in Africa on this mission perhaps for my own person & spiritual growth as much as for the ways in which I am able to help the team.
There is really nothing else of importance I could possibly say…tomorrow is our “team boning day” & we are going to the Nakuru Natl Park…I am sure it will be fun…although we have to be up at 5 & leave at 6...so I need to go to bed…the amount of emotion in each day along with the real “work” makes me a tired girl! LOVE to all of you! I bought a phone here & can now text & call home - best $35 I spent so if you want the # call my house!
P.S. Sorry this was so LONG!!! I will try to uplaod pics tomorrow bu the iternet here is spotty
The OR & recovery room are in the same building as the 3 bed ICU….I again was a little shocked as I saw 3 rickety beds there w/ mosquito nets over them & in one bed was a 6 year old girl Penina who motioned to me as I went by…I asked the nurses if I could go to her bedside…she didn’t speak English & I don’t even know what was wrong with her but I held her had & talked to her & smiled & the nurse translated a little then I hurried off & brought her 2 dresses & her eyes it up & I cold not hold back the tears….she is so precious & I told her I would visit her again on Monday.
Then at screening I was just helping as needed it was a slow steady stream but very manageable so I didn’t volunteer to be the gatekeeper!!! I had already had a BUSY day. But one of the patients that came in totally stole my heart…perhaps because she spoke English & spoke quite well…her name is Salome & she is 14 & has a cleft lip…she lives in Nairobi & came with her 27 year old eldest sister who had saved all her money for a month to pay for the busfare to bring herself & her little sister here…their dad was recently unemployed & the mother is a “housemom” (stay at home mom) so they didn’t have money for the parents to both come so her sister brought her. There are 8 kids in the family 6 girls & 2 boys & Salome is the 5th child. All her life she has asked her parents why she was the only child with “this lip” & said all the kids at school had teased her all her life & boys don’t look at her & she just wants to be normal & wants her lip fixed so she can sing better (she sang for us) & wants to sing praises to her Lord. Her sister said the family had always prayed to have a way or the money to help her but they never could. Again…lots of teary-ness the entire time….I cant even imagine the life she has lived & how a 45 min surgery will change her entire life…when we told her she would have surgery on Tues her older sister & she both cried….her sister was going to call to see if she could be off work &to stay here w/ Salome & they were going to stay with friends in the area….the love of this family & especially these sisters was palpable in every sentence….I thought of my own girls & how I think they too would do whatever they could to help each other….this day was one of those when I again KNEW I was meant to be in Africa on this mission perhaps for my own person & spiritual growth as much as for the ways in which I am able to help the team.
There is really nothing else of importance I could possibly say…tomorrow is our “team boning day” & we are going to the Nakuru Natl Park…I am sure it will be fun…although we have to be up at 5 & leave at 6...so I need to go to bed…the amount of emotion in each day along with the real “work” makes me a tired girl! LOVE to all of you! I bought a phone here & can now text & call home - best $35 I spent so if you want the # call my house!
P.S. Sorry this was so LONG!!! I will try to uplaod pics tomorrow bu the iternet here is spotty
Friday, April 1, 2011
Screening Day #1
I am honestly not sure I can capture the essence of today in a blog post...I truly cannot put into words all that I experienced but I will try... our wake up call was at 5:30 & we then were supposed to board the bus at 6:30 but...it didnt come so they started sending "key people" in taxis...yesterday they Mission Coordinator asked me to be the "Gatekeeper" & I said "sure" not really knowing what that meant...when they told me I should go in the taxi cause I was the gatekeeper I knew I was in trouble. Basically on the screening day the patients go 1st to Medical records, then to Patient Imaging to get pictures taken, then to the pre & post op nurses, then to the plastic surgeons, next the anesthesiologists, then the pediatrician, to the dentist/oral surgeon, speech pathologist & then ME!!! My job was to check & see that everyone else saw the patient & filled out ALL the paperwork then note what priority they are & thru the translator send them for labs if we for sure will do surgery (the priority 1,2,3) & tell the 4's & 5's to come back Sunday to check the schedule & see if they are on it... & the NC's (not a candidate for our mission for a variety of reasons) tell them that too...broke my heart...then send some off to get labs & they came back to me then I passed their chart off to the "local hospital" medical records, then to Op Smile Electronic Medical records then back to me & I did this for 148 patients, It was a VERY busy day - I had to use my ICU Nurse & mom multitasking abilities all at the same time in concert with a translator & sometimes 2 translators. I didnt even take a break for anything :) and I LOVED every minute of it :) except for the few times I had too many patients backed up & lost my helpers!
So that was the scenario...I had taken a few dresses & shirts to give away but was so busy I couldn't even do that so I told Zippee & she would identify those most in need & bring them to me & we got them stuff - I gave away about 15 dresses today & 5 or 6 shirts. We are going to have a better system tomorrow plus I will be able to give dresses etc on all the surgery days as all the kids pass thru the recovery room I am not at all worried that every item will find a good home. I did get some pics today (or actually Zippee did w/ my camera!) Tomorrow is another screening day & since it didn't rain today they expect perhaps even more people. We will also be setting up the recovery room & "John" the Kenyan RN who is my lead in the recovery room just found me here in the lobby on my computer to tell me that he has to go back to his home area so he can work tomorrow & the other Kenyan nurse who is with us doesn't come until Sunday so I will be setting up the Recovery room with the help of the OR nurses late tomorrow after I finish another day of being the "Gatekeeper". He did say we can go double check things on Sunday - good plan! I appreciate the vote of confidence but clearly no one got the memo that this is my 1st Op Smile mission w/ the responsibility they are giving me :)
Now....on to the important stuff before this post gets so long no one reads it.... I was amazed that we actually had alot of adults come to be "screened" with a variety of problems...they all were priority 5 & as I understand it if we have any "extra time" we will do them the last day...clearly no one told them "Nurse Nancy ususally doesn't do big people" Guess I will have to make an exception here in Africa! Screening in the morning was slower that normal (# wise) they said likely because of the rain but we started about 8ish & by 10 it was getting steady & more kids were coming thru...they are SO PRECIOUS (& actually a few of them were named Precious, Happiness,etc). I was so busy "doing my job" that I had to remind myself to pause from the "busyness" & stop & talk to the moms or kids & hug or hold the little ones or tell them how beautiful they are. Many times I felt myself get teary when I realized that we are here changing lives. The end of the day was especially amazing...a busload (about 20) of tribal Kenyans arrived after travelling from 850 kilometers away...they had walked for 4 days then were on a bus for 2 days & arrived late in the afternoon....all of them adults & children with such tremendous needs & not just medical....first they had little to eat the 5 days of their travel & most were barefoot or clothed in tattered garments - kids & adults...we gave dresses to all the girls there :) They were so grateful...I think most all of us who are parents would do whatever we could for our children but at home those things we do & sacrifices we make seemed so small compared to what these parents had done. Just the hope of getting help....compelled them to walk & get a bus to go 850 km & 5 days for help. They will stay at the "hospital" now until we start surgery on Monday & they will be the 1st cases so we can see them recover before they return to their village....if that was all I experienced here my time would be so well spen BUT...I still have 9 days...I am the one blessed to be here & blessed to serve...truly tht scripture that compelled me to go to Houston after Katrina rings true here....inasmuch as ye have done it to the least of these....ye have done it unto me....
Sending my love to all fo you from far away in miles but not in spirit or heart....
So that was the scenario...I had taken a few dresses & shirts to give away but was so busy I couldn't even do that so I told Zippee & she would identify those most in need & bring them to me & we got them stuff - I gave away about 15 dresses today & 5 or 6 shirts. We are going to have a better system tomorrow plus I will be able to give dresses etc on all the surgery days as all the kids pass thru the recovery room I am not at all worried that every item will find a good home. I did get some pics today (or actually Zippee did w/ my camera!) Tomorrow is another screening day & since it didn't rain today they expect perhaps even more people. We will also be setting up the recovery room & "John" the Kenyan RN who is my lead in the recovery room just found me here in the lobby on my computer to tell me that he has to go back to his home area so he can work tomorrow & the other Kenyan nurse who is with us doesn't come until Sunday so I will be setting up the Recovery room with the help of the OR nurses late tomorrow after I finish another day of being the "Gatekeeper". He did say we can go double check things on Sunday - good plan! I appreciate the vote of confidence but clearly no one got the memo that this is my 1st Op Smile mission w/ the responsibility they are giving me :)
Now....on to the important stuff before this post gets so long no one reads it.... I was amazed that we actually had alot of adults come to be "screened" with a variety of problems...they all were priority 5 & as I understand it if we have any "extra time" we will do them the last day...clearly no one told them "Nurse Nancy ususally doesn't do big people" Guess I will have to make an exception here in Africa! Screening in the morning was slower that normal (# wise) they said likely because of the rain but we started about 8ish & by 10 it was getting steady & more kids were coming thru...they are SO PRECIOUS (& actually a few of them were named Precious, Happiness,etc). I was so busy "doing my job" that I had to remind myself to pause from the "busyness" & stop & talk to the moms or kids & hug or hold the little ones or tell them how beautiful they are. Many times I felt myself get teary when I realized that we are here changing lives. The end of the day was especially amazing...a busload (about 20) of tribal Kenyans arrived after travelling from 850 kilometers away...they had walked for 4 days then were on a bus for 2 days & arrived late in the afternoon....all of them adults & children with such tremendous needs & not just medical....first they had little to eat the 5 days of their travel & most were barefoot or clothed in tattered garments - kids & adults...we gave dresses to all the girls there :) They were so grateful...I think most all of us who are parents would do whatever we could for our children but at home those things we do & sacrifices we make seemed so small compared to what these parents had done. Just the hope of getting help....compelled them to walk & get a bus to go 850 km & 5 days for help. They will stay at the "hospital" now until we start surgery on Monday & they will be the 1st cases so we can see them recover before they return to their village....if that was all I experienced here my time would be so well spen BUT...I still have 9 days...I am the one blessed to be here & blessed to serve...truly tht scripture that compelled me to go to Houston after Katrina rings true here....inasmuch as ye have done it to the least of these....ye have done it unto me....
Sending my love to all fo you from far away in miles but not in spirit or heart....
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