A Sunday in Mutomo

The first day went well, though it’s a bit disorienting to be in a foreign hospital.  I worked on the medical ward yesterday.  Before starting work in the morning, I had a chance to study some of the medical abbreviations approved for use at the hospital.  Here are just a few:

Mutomo Mission Hospital. It's much bigger than it looks here.

OD = once daily

TDS = three times daily

BD = twice daily

QDS = four times daily

RTI = road traffic injury

Rx = treatment

COD = change of dressing

x/7 = x number of days

x/52 = x number of weeks

x/12 = x number of months

CCF = Congestive cardiac failure

HB = haemoblobin (spelled differently from U.S.)

It’s like speaking a foreign language!  They’re all different from the ones we use in the U.S.

Kenyan culture is mush slower and relaxed than in America.  The emphasis on punctuality and speediness is nowhere near as stringent here as it is at home. The amount of time I get for breaks is way too much!  I get 30 minutes for tea break, and another hour and a half for lunch… and the shift only lasts from 8am to 5:30pm!!  Working in the U.S. I usually spent 13 hours at the hospital, and only 30 minutes were allotted for lunch (plus a 10 minute break if you’re lucky).  I’m so used to the stress of running and rushing at home.  It will definitely take some getting used to. 

I’ve also noticed that the nurses here don’t carry or use stethoscopes.  I asked about that, and apparently it’s beyond their scope of practice in Kenya; interesting.

It’s going to take me time to learn the different procedure for everything in this hospital.  IVs (or “cannulas” as they call them) are similar to ones in the U.S., but the IV fluids come in plastic bottles here, and you have to poke several holes in them with a needle to start the flow.  IV tubing is saved and reused throughout a patient’s entire admission (unlike the U.S. where we discard them almost daily).  The names of drugs used are different.  There are some drugs which I’ve never heard of.  The most common medication used for pain control seems to be paracetamol.  From the name, I guessed it was related to acetaminophen (Tylenol), but I had to go home and look it up to confirm.  Morphine is not available here in Mutomo, and they have never even heard of drugs like hydromorphone, hydrocodone, oxycodone, etc., all the standard meds we use for pain in medical units back home.  When patients are admitted with anaemia (anemia), one of the most common causes which the physicians test for is malaria.

The documentation is straightforward, simple.  They use a cardex system here for charting.  Unfortunately there are a few bits of the charting that I won’t be able to do because I speak neither Kiswahili nor Kikamba (the local dialect, or “mother tongue”) to take a patient’s medical and social history.  For that I’ll have to rely on translators and notes from the doctors (which they call “medical officers”).  When taking vital signs (which are done only once during the day), I’ll have to carry my phone around to do metric temperature conversions until I get a feel for the number system.  The scale used used to measure blood glucose levels is completely different (and diabetes is pretty common here).  Fortunately I was able to program another handy conversion formula into my phone to figure out the blood sugars. 

I have SO MUCH to learn!  Please pray for me, that I can learn well and be of service to the hospital.

Mutomo Catholic Parish

I attended mass today for the first time since my arrival in Kenya.  The church is Mutomo Catholic Parish.  There are many Christian churches throughout Mutomo, and on Sunday morning you can hear the sound of singing congregations from every direction.  The music at mass was possibly the most beautiful thing I’ve ever heard.  There are no hymn books, but everyone knows what to sing.  Although the mass is done in English (thank God!), the music is still sung in Kiswahili.  There is so much energy in the music.  Everyone harmonizes together perfectly, and there is a lot of dancing and clapping.  No piano or organ, only a single drum.  I really wish I was able to sing along.  The English service I attended was made up mostly of young school children, so they had no shame in staring at me throughout the entire two-hour service.  Before mass began, one boy sat in my pew about halfway down the row.  He stared at me a while, then gradually scooted closer and closer until the church was full and we were all shoulder to shoulder.  He was curious about me and eventually worked up the courage to ask me questions: where was I from?  What did I do at the hospital?  I think a lot of them spent more time staring at me than paying attention to the priest.  After a long week in a foreign country, it was a comfort to be surrounded by the familiarity of mass again… I’ve never been so out of place, and yet felt so at home.

Simple... but I felt pretty good about myself for cooking.

Today was also the first time I’ve cooked since arriving.  I have so far been getting my meals from the hospital canteen, which is like a cafeteria.  Unfortunately it’s closed on Sunday.  So I was forced to venture into town on my own to the supermarket (which is about the size of an average American living room) and bought bread, 2 lbs. of rice, a vegetable called sukuma wiki (which is like collard greens), cooking oil, some sort of unrefrigerated margarine spread, tomatoes, and a box of milk (also unrefrigerated before opening).  The total was about $6 USD.  I also stopped by one of the outdoor market vendors for a bag of potatoes (about 50 cents for 2 lbs).  It took me a minute to figure out how to light and use the stove, and I kept my first meal simple: fried tomatoes and toast (plus an apple I bought from Nairobi).  Now I have to figure out how they wash dishes here.  Maybe soon I’ll take a trip to the local butchery to buy some meat and then learn how to cook goat.

A street in Mutomo.

In the afternoon I decided on going for a walk around town.  I passed by the church again to take a photo.  There were a few kids inside who spotted me and ran outside.  One of them was the boy who sat beside me during mass in the morning; his name is Kennedy.  They asked me to take a picture of them and were thrilled to see themselves on camera.  As I walked around town, I again drew stares everywhere, but people were friendly and gave me a smile and a “hello” when they passed.  My walk took me in a loop around town, through the airstrip, and back to the hospital.  When I returned to the hospital, the security guards spotted my camera, and they also asked if I would take their picture.  They even went back into their guardhouse to put on their uniforms and tuck in their shirts for the photo.  I didn’t realize seeing your picture would be so rare here.  If I can figure out a way to print them, maybe I can go back and give them a copy.  I might get a second job as the town photographer.

My new friends from church.

An intersection; kind of like the Times Square of Mutomo.

Goats and donkeys are tied up everywhere along the road.

The local airstrip where the occasional plane will land.

Security guards at the hospital... you can't tell from their faces, but they were excited.

.