Sorry for not updating the blog in awhile- I have not had internet access.
Quick update. Last weekend I went to Masvingo with Major, Jordan, Rick and Sue. We had a great time and got to visit the Great Zimbabwe. It was beautiful and amazing how everything was made out of stone.
Yesterday Jordan and I were at the airport to pick my mom up, she arrived safely after a very long journey. We then drove back to Chidamoyo and this morning I gave my mom the tour of the hospital and the surrounding area. It was so great to have her meet everyone that I have been working here with. I thought I was going to make it out of here without seeing a snake but today on my last day there was one at the school. We yelled nyoka (snake in Shona) and 2 girls ran over and started throwing rocks at it and hit it with a stick. Then the boys caught wind of it and ran over and killed it with the stick. They don't mess around with snakes here because with the poisonous ones it can be life or death.
Later today Major is driving us back to Harare and we will hopefully (because things don't always work here) be flying to Vic Falls and then going on a Safari. Next week we will be going to Cape Town, South Africa which should also be fun.
I am excited to travel around the country more although I am sad to be leaving everyone here. I don't think I will be able to update my blog again, so see everyone back in the U.S. in a couple of weeks!!
Tuesday, August 7, 2012
Tuesday, July 31, 2012
A little bit of everything
Well I have now spent my last weekend at Chidamoyo (I will be travelling the next few). I babysat Dr. and Mrs. Kajesi's puppy over the weekend and it was quite a job. Full time, unfortunately that little thing couldn't be left alone for even 2 seconds without barking. The rest of my time was spent watching the Olympics. Go team USA!
Monday was a very busy day and I was so tired by the end I fell asleep at 8:15. My day started off early in the morning in theatre. A baby girl had an abscess on her neck and needed an incision and drainage (IND). Noe told Dr. Kajesi that I was going to do it- I hadn't asked for this but I was excited. This was going to be my second one. Last time however I did it in the outpatient department under local anesthesia and this time it was in the operating room and we put the baby to sleep. I felt pretty confident with what I was doing- after double checking I was well away from the jugular vein. Last time though I did the IND with Dr. Kabonzi. Turns out they want it done slightly differently... but the adjustments were simple and working together we got all of the pus out by expressing the abscess.
After the baby was done a man walked in (yes lots of them that can just walk into the theatre and lay down on the bed). He had some pretty deep cuts on the back of his hand and his palm and he needed stitches to close them. He got the wounds from an RTA (Road Traffic Accident) which at 95% of the time at Chidamoyo means scotchcart accident. Dr. Kajesi showed me an interrupted suture and then had me do some. I have been watching them suture a lot of people but steady hands are harder than I thought! The needle we used was very thick and wasn't a cutting needle so it was a bit tough on the back of the hand. I did the palm with a smaller needle and it was easier. Dr. Kajesi ended up finishing the sutures because in the middle we were told that they were beginning the funeral.
The funeral was for one of the drivers that works at Chidamoyo's son. He had died on Friday and they were bringing the body here so they were expecting the funeral to begin any time. Actually from what I have learned the funeral can be days, people arrive as soon as they hear, everyone from the town seems to go (there were 200-300 people there). We arrived as people were giving speeches. When we got there everyone was seated on the ground (just sitting in the dirt). The women were on one side and the men on the other. It was really hot (so much for it being winter) and the sun was right in my eyes making it hard to focus on anything. Everyone talked in Shona for about an hour (who knows how long it had already been going on). Then everyone stood up and started singing and people went in to view the body. The coffin was in a small dark room. Some women were wailing (correct term) on one side and his father was standing there as well. Only the head was visible, the rest was covered. Unfortunately, the body was starting to smell because he had died on Friday (and it was now Monday) and they do not balm the bodies in anything here.
After the viewing of the body, some men picked up the casket and everyone followed to the burial site. 200-300 people walked over and I mean walked. We went through fields and up and down hills until we finally came to the site. Turns out they had to go so far because the ground is so hard here that they wanted to bury him in an ant hill because it is softer. The men had gotten up at 4 am to start digging the hole. Everyone came and sat down- we were really pretty far away and we were sitting in shrubs and leaves- literally in the bush. Some men and women stood around the hole. Some prayers were said and the coffin was placed in the ground. Then there was a lot of singing and dancing for about an hour while they covered the coffin. Let's just say that coffin is not going anywhere. Women lined up with stones and they were placed on top with wood and dirt.
Finally when it was all covered everyone walked back (to start eating- I had seen a goat's head sitting in a bowl in the yard). We went back to the hospital.
Apparently there is usually more wailing- I think we missed most of it. Also it is interesting because people walk around shaking hands and that was discouraged for awhile because of cholera. I thought the funeral was interesting and I was very sad for the young man's family. I must say I would want a funeral like this- I liked that everyone was singing and dancing in celebration of life. It would have been nice to understand more of what people were saying though.
Tomorrow is my last day at the hospital- I can't believe how fast my time here went. I am sad to leave here and I will really miss everyone that I have met. It is hard to imagine that when I came here almost 6 weeks ago I didn't know a single person in the country and had no clue what language they even spoke. Now I have people saying remember me from Kapfunde? and I am learning a few (very few) Shona words. I am looking forward to travelling around Zimbabwe in the week and then going to Cape Town with my mom.
Monday was a very busy day and I was so tired by the end I fell asleep at 8:15. My day started off early in the morning in theatre. A baby girl had an abscess on her neck and needed an incision and drainage (IND). Noe told Dr. Kajesi that I was going to do it- I hadn't asked for this but I was excited. This was going to be my second one. Last time however I did it in the outpatient department under local anesthesia and this time it was in the operating room and we put the baby to sleep. I felt pretty confident with what I was doing- after double checking I was well away from the jugular vein. Last time though I did the IND with Dr. Kabonzi. Turns out they want it done slightly differently... but the adjustments were simple and working together we got all of the pus out by expressing the abscess.
After the baby was done a man walked in (yes lots of them that can just walk into the theatre and lay down on the bed). He had some pretty deep cuts on the back of his hand and his palm and he needed stitches to close them. He got the wounds from an RTA (Road Traffic Accident) which at 95% of the time at Chidamoyo means scotchcart accident. Dr. Kajesi showed me an interrupted suture and then had me do some. I have been watching them suture a lot of people but steady hands are harder than I thought! The needle we used was very thick and wasn't a cutting needle so it was a bit tough on the back of the hand. I did the palm with a smaller needle and it was easier. Dr. Kajesi ended up finishing the sutures because in the middle we were told that they were beginning the funeral.
The funeral was for one of the drivers that works at Chidamoyo's son. He had died on Friday and they were bringing the body here so they were expecting the funeral to begin any time. Actually from what I have learned the funeral can be days, people arrive as soon as they hear, everyone from the town seems to go (there were 200-300 people there). We arrived as people were giving speeches. When we got there everyone was seated on the ground (just sitting in the dirt). The women were on one side and the men on the other. It was really hot (so much for it being winter) and the sun was right in my eyes making it hard to focus on anything. Everyone talked in Shona for about an hour (who knows how long it had already been going on). Then everyone stood up and started singing and people went in to view the body. The coffin was in a small dark room. Some women were wailing (correct term) on one side and his father was standing there as well. Only the head was visible, the rest was covered. Unfortunately, the body was starting to smell because he had died on Friday (and it was now Monday) and they do not balm the bodies in anything here.
After the viewing of the body, some men picked up the casket and everyone followed to the burial site. 200-300 people walked over and I mean walked. We went through fields and up and down hills until we finally came to the site. Turns out they had to go so far because the ground is so hard here that they wanted to bury him in an ant hill because it is softer. The men had gotten up at 4 am to start digging the hole. Everyone came and sat down- we were really pretty far away and we were sitting in shrubs and leaves- literally in the bush. Some men and women stood around the hole. Some prayers were said and the coffin was placed in the ground. Then there was a lot of singing and dancing for about an hour while they covered the coffin. Let's just say that coffin is not going anywhere. Women lined up with stones and they were placed on top with wood and dirt.
Finally when it was all covered everyone walked back (to start eating- I had seen a goat's head sitting in a bowl in the yard). We went back to the hospital.
Apparently there is usually more wailing- I think we missed most of it. Also it is interesting because people walk around shaking hands and that was discouraged for awhile because of cholera. I thought the funeral was interesting and I was very sad for the young man's family. I must say I would want a funeral like this- I liked that everyone was singing and dancing in celebration of life. It would have been nice to understand more of what people were saying though.
Tomorrow is my last day at the hospital- I can't believe how fast my time here went. I am sad to leave here and I will really miss everyone that I have met. It is hard to imagine that when I came here almost 6 weeks ago I didn't know a single person in the country and had no clue what language they even spoke. Now I have people saying remember me from Kapfunde? and I am learning a few (very few) Shona words. I am looking forward to travelling around Zimbabwe in the week and then going to Cape Town with my mom.
Friday, July 27, 2012
A Taste of My Own Medicine
This blog post is from Wednesday.
In the morning I went on rounds with Dr. Kajesi in the hospital. There was another woman with a pleural effusion that needed to be drained. I got to drain it- I am becoming quite knowledgeable about them. In the afternoon, Jordan, Rick, Sue and I walked over to the primary school to watch a soccer game. It was a team from Chidamoyo playing another village's team. We arrived at 2:35 for a 2:30 game and no one was there. Typical Africa time. We walked around a group of school kids started following us because of our cameras. Then a truck zoomed up with a ton of people in the back blasting music and they all jumped out.
The teams started warming up and we asked which team was from Chidamoyo because the one person we knew on the team wasn't there yet (Tapson). Someone told us that it was the team in red. So the game started finally and more and more people kept coming to watch. The red team scored and we cheered. It was just about only us who cheered. It seemed very odd considering there were so many people there- wouldn't most of them be there for the home team? We kept asking people to make sure that the red team was ours but they didn't understand us. Finally Tapson got there and we asked him and he said the blue team was from Chidamoyo- it made so much more sense but we were all so embarrassed for having cheered for the wrong team. They ended up losing 1-0. There is another game tomorrow so hopefully they will win and we will now be supporting them! The game was really fun and it is quite a source of entertainment here- so many people came out for it. Everyone stands right on the lines- which are pretty difficult to distinguish so I'm not really sure where the field boundaries even are.
Home team arriving for the game
I had a great day- a good morning at the hospital and then it was really fun to go to the soccer game. That night however, I woke up scratching myself. I looked down at my legs because they felt really itchy and I had what looked like bug bites all over. I thought that maybe it was flea bites because Jordan and I had been playing with Dr. Kellert's new puppy right before we went to sleep. Then I realized that other places on my body were itching and I started looking and my arms and stomach were covered too. I started thinking that they looked too big to be flea bites and there were so many! I started putting Benedryl cream on like it was lotion but nothing seemed to be working. I looked at my bed and I didn't see any spiders or anything else there. I really didn't know what to do at this point. Everything itched so much, and I had no idea where they came from- was it safe to get back in my bed?
I decided that I had to wake Jordan up and see if she had any and then maybe I would know what I had. Jordan didn't have anything and agreed that they didn't look like flea bites. Also, there were so many that it didn't seem like something from my bed. She thought that they might be hives and that we should go see Dr. Kellert. She was still awake luckily because she had just come back from Harare. I showed her and she said that I needed to take Benedryl. Neither of us had any so she told me to get some from the hospital in the morning. By this point everything was itching so badly I knew it would be a horrible 6 hours.
Jordan and I walked up to the hospital and asked the nurse on the night shift for Benedryl. She didn't know what it was and we had to explain to her what hives were (typical with the nurses unfortunately). She said all that she could give me was a shot of hydrocortisone because the pharmacy was closed. I decided that since I didn't know much about that, I didn't really trust her to do it.
Jordan and I walked back down to the house and we ran into Major returning from Harare. He asked what we were doing walking around in the middle of the night and we told him. He said that I had to call Dr. Kajesi. I told Major that I didn't want to wake him up but he insisted. Jordan and I walked back up to the hospital and he met us there. I was really happy that I had called him after all because now the itching was spreading to my face and scalp. He got me some pills from the pharmacy and then said that I needed a drug IV and an injection. We went to the nurses station and I told him that I don't get IVs put in me- I only do it to patients! He laughed and said it won't be bad.... unless I miss. Which is a possibility because I'm not very good at it! I knew he was joking but he said it with such a straight face I almost doubted him. I did think it hurt and now I know what all of the patients go through. I definitely did not like being the patient! One of the nurses wanted to admit me and Dr. Kajesi said to put me next to the smelliest patient, I said thanks but no thanks.
I also got an injection in my arm and went home. Already I was starting to feel less itchy. When I was finally back in bed, then my arm started really hurting from the injection. It took another couple of hours for the pain to finally go away and I fell asleep.
Yesterday I slept almost the entire day because of the medicine. I am feeling much better today and the hives are almost all gone- only around my joints for some reason. I still do not know what caused it for sure- I was fine when I went to sleep. It might have been a tree I touched at the soccer game but I'm not sure.
This weekend I will be taking care of the Kajesi's new puppy while they are in Harare. I am thinking of it as kind of a trade off for waking him up in the middle of the night.
In the morning I went on rounds with Dr. Kajesi in the hospital. There was another woman with a pleural effusion that needed to be drained. I got to drain it- I am becoming quite knowledgeable about them. In the afternoon, Jordan, Rick, Sue and I walked over to the primary school to watch a soccer game. It was a team from Chidamoyo playing another village's team. We arrived at 2:35 for a 2:30 game and no one was there. Typical Africa time. We walked around a group of school kids started following us because of our cameras. Then a truck zoomed up with a ton of people in the back blasting music and they all jumped out.
The teams started warming up and we asked which team was from Chidamoyo because the one person we knew on the team wasn't there yet (Tapson). Someone told us that it was the team in red. So the game started finally and more and more people kept coming to watch. The red team scored and we cheered. It was just about only us who cheered. It seemed very odd considering there were so many people there- wouldn't most of them be there for the home team? We kept asking people to make sure that the red team was ours but they didn't understand us. Finally Tapson got there and we asked him and he said the blue team was from Chidamoyo- it made so much more sense but we were all so embarrassed for having cheered for the wrong team. They ended up losing 1-0. There is another game tomorrow so hopefully they will win and we will now be supporting them! The game was really fun and it is quite a source of entertainment here- so many people came out for it. Everyone stands right on the lines- which are pretty difficult to distinguish so I'm not really sure where the field boundaries even are.
I had a great day- a good morning at the hospital and then it was really fun to go to the soccer game. That night however, I woke up scratching myself. I looked down at my legs because they felt really itchy and I had what looked like bug bites all over. I thought that maybe it was flea bites because Jordan and I had been playing with Dr. Kellert's new puppy right before we went to sleep. Then I realized that other places on my body were itching and I started looking and my arms and stomach were covered too. I started thinking that they looked too big to be flea bites and there were so many! I started putting Benedryl cream on like it was lotion but nothing seemed to be working. I looked at my bed and I didn't see any spiders or anything else there. I really didn't know what to do at this point. Everything itched so much, and I had no idea where they came from- was it safe to get back in my bed?
I decided that I had to wake Jordan up and see if she had any and then maybe I would know what I had. Jordan didn't have anything and agreed that they didn't look like flea bites. Also, there were so many that it didn't seem like something from my bed. She thought that they might be hives and that we should go see Dr. Kellert. She was still awake luckily because she had just come back from Harare. I showed her and she said that I needed to take Benedryl. Neither of us had any so she told me to get some from the hospital in the morning. By this point everything was itching so badly I knew it would be a horrible 6 hours.
Jordan and I walked up to the hospital and asked the nurse on the night shift for Benedryl. She didn't know what it was and we had to explain to her what hives were (typical with the nurses unfortunately). She said all that she could give me was a shot of hydrocortisone because the pharmacy was closed. I decided that since I didn't know much about that, I didn't really trust her to do it.
Jordan and I walked back down to the house and we ran into Major returning from Harare. He asked what we were doing walking around in the middle of the night and we told him. He said that I had to call Dr. Kajesi. I told Major that I didn't want to wake him up but he insisted. Jordan and I walked back up to the hospital and he met us there. I was really happy that I had called him after all because now the itching was spreading to my face and scalp. He got me some pills from the pharmacy and then said that I needed a drug IV and an injection. We went to the nurses station and I told him that I don't get IVs put in me- I only do it to patients! He laughed and said it won't be bad.... unless I miss. Which is a possibility because I'm not very good at it! I knew he was joking but he said it with such a straight face I almost doubted him. I did think it hurt and now I know what all of the patients go through. I definitely did not like being the patient! One of the nurses wanted to admit me and Dr. Kajesi said to put me next to the smelliest patient, I said thanks but no thanks.
I also got an injection in my arm and went home. Already I was starting to feel less itchy. When I was finally back in bed, then my arm started really hurting from the injection. It took another couple of hours for the pain to finally go away and I fell asleep.
Yesterday I slept almost the entire day because of the medicine. I am feeling much better today and the hives are almost all gone- only around my joints for some reason. I still do not know what caused it for sure- I was fine when I went to sleep. It might have been a tree I touched at the soccer game but I'm not sure.
This weekend I will be taking care of the Kajesi's new puppy while they are in Harare. I am thinking of it as kind of a trade off for waking him up in the middle of the night.
Tuesday, July 24, 2012
Witch Doctors
Today I was very intrigued by one particular patient. A man and his wife walked into the outpatient department and sat down in the chairs across from Dr. Kabonzi and I, as all of the patients do. Patients are almost always accompanied by someone here- a spouse, a parent, a son, daughter, brother, sister, cousin etc. The patient sits down in the chair closest to the dest where the doctor is (it is often obvious which person is there to be seen). Today was no exception.
The man was using a walking stick, obviously handmade. His right foot was not in a shoe was wrapped in a scrap of cloth. As soon as he walked in you could smell that something was very very wrong. Dr. Kabonzi sprayed Febreeze into the fan but it didn't really help. The man then undid the scrap of cloth and revealed something that I did not expect. Last week a man came in with a similar foot wrapping and his toe was split open. I was expecting something similar. Instead, there was a HUGE tumor growing between the big toe and the second toe. It was so large that it had pushed all of the other toes to the side (although they were all still visible). Dr. Kabonzi and I just stared for a second and then he said "take a picture!!" (I always have my camera in my pocket).
It turns out the tumor had started growing 2 years ago and the patient had never been to the hospital until today to have it seen. That is very common here. You ask yourself, why today after all this time? Did they come across some money, did his wife decide it smelled too badly, did he get sick of walking around with only one shoe? The questions are endless. It really is mindblowing. In the U.S. one would go to the doctor as soon as something started to grow anywhere on their body. But this man had let it grow for 2 years! It was impossible for him to even set the front of his foot down on the ground. And it dripped and smelled, if the sight, smell, and discomfort of it weren't enough....
But the sad truth is that many people here first go to the "witch doctors" or traditional healers. These healers instill fear in the people. So and so is bewitching you because he is jealous of your cattle and wants you dead. People will spend all their money and cattle and crops going to these healers, many are afraid that if they leave them they will die. But really they are dying because they don't go to the hospital.
Dr. Kajese took a biopsy of his foot in theatre in the afternoon. Definitely something I did not want to miss. If it is cancerous (and it most likely is), his foot will have to be amputated. It is the sad reality of so many cases here. But just because it has been this way for years I don't think means it should continue this way.
In the afternoon Jordan and I walked over to the soccer field and watched some of the high school team's practice. I went over and kicked the ball and dribbled with a few of them and I think they were surprised a white girl could play at all. I am hoping that they have a game soon before I leave. Many of them play barefoot even in the games which seems so painful because there are a lot of sharp rocks on the dirt field.
P.S. if anyone wants to see the picture of the foot just email me... it was not appropriate to post on my blog :)
The man was using a walking stick, obviously handmade. His right foot was not in a shoe was wrapped in a scrap of cloth. As soon as he walked in you could smell that something was very very wrong. Dr. Kabonzi sprayed Febreeze into the fan but it didn't really help. The man then undid the scrap of cloth and revealed something that I did not expect. Last week a man came in with a similar foot wrapping and his toe was split open. I was expecting something similar. Instead, there was a HUGE tumor growing between the big toe and the second toe. It was so large that it had pushed all of the other toes to the side (although they were all still visible). Dr. Kabonzi and I just stared for a second and then he said "take a picture!!" (I always have my camera in my pocket).
It turns out the tumor had started growing 2 years ago and the patient had never been to the hospital until today to have it seen. That is very common here. You ask yourself, why today after all this time? Did they come across some money, did his wife decide it smelled too badly, did he get sick of walking around with only one shoe? The questions are endless. It really is mindblowing. In the U.S. one would go to the doctor as soon as something started to grow anywhere on their body. But this man had let it grow for 2 years! It was impossible for him to even set the front of his foot down on the ground. And it dripped and smelled, if the sight, smell, and discomfort of it weren't enough....
But the sad truth is that many people here first go to the "witch doctors" or traditional healers. These healers instill fear in the people. So and so is bewitching you because he is jealous of your cattle and wants you dead. People will spend all their money and cattle and crops going to these healers, many are afraid that if they leave them they will die. But really they are dying because they don't go to the hospital.
Dr. Kajese took a biopsy of his foot in theatre in the afternoon. Definitely something I did not want to miss. If it is cancerous (and it most likely is), his foot will have to be amputated. It is the sad reality of so many cases here. But just because it has been this way for years I don't think means it should continue this way.
In the afternoon Jordan and I walked over to the soccer field and watched some of the high school team's practice. I went over and kicked the ball and dribbled with a few of them and I think they were surprised a white girl could play at all. I am hoping that they have a game soon before I leave. Many of them play barefoot even in the games which seems so painful because there are a lot of sharp rocks on the dirt field.
P.S. if anyone wants to see the picture of the foot just email me... it was not appropriate to post on my blog :)
Sunday, July 22, 2012
Today in Pictures
Trying to comfort a toddler after Buddy (Kathy's dog) scared her
Women walking with suitcases on their heads! (and Buddy walking along)
Young kids carrying their clean laundry back from the dam
Jordan showing the kids pictures she took of them (they always love looking at their picture)
People dancing at the hospital during Church
Climbing over the hospital fence after Church because someone accidentally forgot the keys...
Procedures
This week at the hospital I got to do a couple of procedure type things. Over the past week I had seen 4 patients with pleural effusions (basically fluid in the lungs). They all came through the outpatient department so by the 4th one I had been taught by the doctors to diagnose pleural effusions based on looking at X-rays, auscultating and percussing the lungs. I had also watched Dr. Kajese insert a chest tube and Dr. Kabonzi insert a catheter into the lung to drain the fluid.
One of the patients who was now in the ward was brought in to have her lung drained right before lunch. Jordan came to get me and Dr. Kabonzi said that I couldn't leave yet because I was going to drain her lung! I thought he was kidding so I laughed but he said "no really" and handed me a pair of gloves. The needle that needs to be inserted with the cannula is very thick. I needed to insert it at the 5th intercostal space on her left side. Dr. Kabonzi put in the shot of local anesthetic and then aspirated some of me the pus/fluid and said now you can't say you can't get anything out! I was nervous to push the needle in because I felt like lungs were a big deal and that I was going to stab the heart (even though that wouldn't happen).
For once I was thankful that the patient spoke Shona because I felt badly that I was asking the doctor how to do the procedure while I was doing it to the patient haha. I pushed in the needle and nothing came out. Then Dr. Kabonzi couldn't get anything out either (thankfully because then I wasn't doing it wrong!). So I tried again in the 6th intercostal space and straw colored fluid began flowing out- success! We taped the catheter in to let the fluid drain for awhile. I felt like skipping all the way back to the house I was so excited that I got to do something like that.
Later in the afternoon we had a young child with an abscess behind his right ear. He came into the outpatient department to have the abscess taken care of. I got to the IND (incision and drainage). I put on the sterile gloves and the nurses aid set up my sterile field with the surgical tools. I had to put the blade on the handle and I couldn't figure out how to get it on at first (I don't usually play around with surgical knives haha). But I got it on and cut into the abscess. Then I expressed it to get all of the pus out. It probably seems very gross to most people but I really like doing things like this.
I was so excited for everything I got to do that day. It is going to make it even harder to return home and not be able to do things like this! Being able to do these procedures helps me with nursing too because I really understand the whole process from diagnosis, to the procedure, to care for the patient after. I can't believe I only have 2 weeks left at the hospital, it is going to be so hard to leave.
One of the patients who was now in the ward was brought in to have her lung drained right before lunch. Jordan came to get me and Dr. Kabonzi said that I couldn't leave yet because I was going to drain her lung! I thought he was kidding so I laughed but he said "no really" and handed me a pair of gloves. The needle that needs to be inserted with the cannula is very thick. I needed to insert it at the 5th intercostal space on her left side. Dr. Kabonzi put in the shot of local anesthetic and then aspirated some of me the pus/fluid and said now you can't say you can't get anything out! I was nervous to push the needle in because I felt like lungs were a big deal and that I was going to stab the heart (even though that wouldn't happen).
For once I was thankful that the patient spoke Shona because I felt badly that I was asking the doctor how to do the procedure while I was doing it to the patient haha. I pushed in the needle and nothing came out. Then Dr. Kabonzi couldn't get anything out either (thankfully because then I wasn't doing it wrong!). So I tried again in the 6th intercostal space and straw colored fluid began flowing out- success! We taped the catheter in to let the fluid drain for awhile. I felt like skipping all the way back to the house I was so excited that I got to do something like that.
Later in the afternoon we had a young child with an abscess behind his right ear. He came into the outpatient department to have the abscess taken care of. I got to the IND (incision and drainage). I put on the sterile gloves and the nurses aid set up my sterile field with the surgical tools. I had to put the blade on the handle and I couldn't figure out how to get it on at first (I don't usually play around with surgical knives haha). But I got it on and cut into the abscess. Then I expressed it to get all of the pus out. It probably seems very gross to most people but I really like doing things like this.
I was so excited for everything I got to do that day. It is going to make it even harder to return home and not be able to do things like this! Being able to do these procedures helps me with nursing too because I really understand the whole process from diagnosis, to the procedure, to care for the patient after. I can't believe I only have 2 weeks left at the hospital, it is going to be so hard to leave.
Doing the IND
Saturday, July 21, 2012
ART Outreach
On Tuesday I went on ART Outreach to Kapfunde. ART (anti retroviral treatment for AIDS) Outreach is so that people living in the surrounding villages can have access to the medication that they need. Chidamoyo runs 6 different outreach clinics with about 3,500 people on ART. The people have to take their medicine every single day for the REST OF THEIR LIVES once they begin. It is very important that they do not miss any pills because it gives the virus a chance to become resistant to the medicine. Most of the time the people also have more than one pill that they need to take.
People are started on the medicine when they have HIV and their CD4 count is less than 350. This is because they are now at risk for many other infections that are life threatening with AIDS (TB, pneumonia, Karposi Sarcoma, etc). The government in Zimbabwe provides the medication (they actually get the medicine from the Global AIDS Fund). Only hospitals can start people on the medication however clinics can then give people their medicine. People must always go to the same place to get their meds (here they get them for 2 months at a time).
Sister McCarty starts people on the medications here. I have sat in with her on her counseling sessions that she does when starting people and it is very interesting. Kathy will not start people unless they bring their spouse or a responsible adult that they live with. This is to ensure that someone will help make sure the person takes all of their pills. She also insists that their spouse and all of their children are tested before starting them. It is a huge committment for these people to start the meds because it is for the rest of their life (which can now be many many years because of the medicine).
I went on the ART Outreach with 3 other nurses and a nurse's aid (Mooty, Benny, Juliette, and Mother). The clinic at Kapfunde is by the high school and the primary school their but they actually have their own building for the clinic. When we arrived a crowd of men, women and children were waiting out front for us. We unloaded all of the medicine (two large chests of it). Mother said good morning to everyone and they started dancing and singing. Then Mother made sure that everyone knew all of the nurses. They want to make sure to make a connection with the people at these clinics so that they keep coming. Of course they had never seen me before so she introduced me to all of them. She told them that I was from America and that I would tell people at home about the clinic and what we do here. They believe here that if you trip over a rock it means someone is talking about you. So she told them if that happens it means I am talking about them.
After the singing and introductions we had to pass out all of the charts for people (there were about 300 people there). There were so many people that we divided up the charts and had to call out all of their names. People were laughing when I tried to pronounce their names and I kept having to ask Juliette.
Once the people had gotten their cards, they got in line to be weighed by Mother. Then they came into the room where we were to get their pill bottles. Benny and Mooty filled out all of their medical cards and then Juliette and I handed them their pills depending on what regimen they were on. It took almost 4 hours to pass out all of the medicine (over 1,000 pill bottles). When one woman was leaving, she turned to me and in English said, "Thank you for giving us a second chance at life." I was a little embarrassed because I felt like I had nothing to do with it really, I was at the very end of the line distributing it (and it had been going on without me). But I wish that I could be making an impact like that and it reminded me why I love doing this.
We packed up to leave. Juliette asked me if I had ever used a Blair toilet. I said I hadn't yet. Luckily at the hospital and the guest house we have real toilets- but everywhere else around here they only have Blair toilets. These "toilets" are really just holes in the ground. I went in and looked and decided to hold it until we got back to the hospital.
On our way out the Sub Chief said hello to us, he was an old man with clouded blue eyes (made it almost look blind but he wasn't). All around here are tribal lands so there are chiefs.
People are started on the medicine when they have HIV and their CD4 count is less than 350. This is because they are now at risk for many other infections that are life threatening with AIDS (TB, pneumonia, Karposi Sarcoma, etc). The government in Zimbabwe provides the medication (they actually get the medicine from the Global AIDS Fund). Only hospitals can start people on the medication however clinics can then give people their medicine. People must always go to the same place to get their meds (here they get them for 2 months at a time).
Sister McCarty starts people on the medications here. I have sat in with her on her counseling sessions that she does when starting people and it is very interesting. Kathy will not start people unless they bring their spouse or a responsible adult that they live with. This is to ensure that someone will help make sure the person takes all of their pills. She also insists that their spouse and all of their children are tested before starting them. It is a huge committment for these people to start the meds because it is for the rest of their life (which can now be many many years because of the medicine).
I went on the ART Outreach with 3 other nurses and a nurse's aid (Mooty, Benny, Juliette, and Mother). The clinic at Kapfunde is by the high school and the primary school their but they actually have their own building for the clinic. When we arrived a crowd of men, women and children were waiting out front for us. We unloaded all of the medicine (two large chests of it). Mother said good morning to everyone and they started dancing and singing. Then Mother made sure that everyone knew all of the nurses. They want to make sure to make a connection with the people at these clinics so that they keep coming. Of course they had never seen me before so she introduced me to all of them. She told them that I was from America and that I would tell people at home about the clinic and what we do here. They believe here that if you trip over a rock it means someone is talking about you. So she told them if that happens it means I am talking about them.
After the singing and introductions we had to pass out all of the charts for people (there were about 300 people there). There were so many people that we divided up the charts and had to call out all of their names. People were laughing when I tried to pronounce their names and I kept having to ask Juliette.
Once the people had gotten their cards, they got in line to be weighed by Mother. Then they came into the room where we were to get their pill bottles. Benny and Mooty filled out all of their medical cards and then Juliette and I handed them their pills depending on what regimen they were on. It took almost 4 hours to pass out all of the medicine (over 1,000 pill bottles). When one woman was leaving, she turned to me and in English said, "Thank you for giving us a second chance at life." I was a little embarrassed because I felt like I had nothing to do with it really, I was at the very end of the line distributing it (and it had been going on without me). But I wish that I could be making an impact like that and it reminded me why I love doing this.
We packed up to leave. Juliette asked me if I had ever used a Blair toilet. I said I hadn't yet. Luckily at the hospital and the guest house we have real toilets- but everywhere else around here they only have Blair toilets. These "toilets" are really just holes in the ground. I went in and looked and decided to hold it until we got back to the hospital.
On our way out the Sub Chief said hello to us, he was an old man with clouded blue eyes (made it almost look blind but he wasn't). All around here are tribal lands so there are chiefs.
Passing out medicine at the ART Outreach in Kapfunde
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