Day 1 at Moi Hospital

The day started out with a nice 4 mile run at 615 with a med student who went to Lafayette College (she was a pole-vaulter there) and is a 4th year med student at Univ of Med and Dentistry of NJ/ School of Osteopathic Medicine. Small world- she has a scholarship for 1 year doing TB research.

Off to the hospital at 830 am. Take about a new world. I am assigned to a team on the woman's ward about 60 beds. Everything is open- no private rooms. Each section has 8 beds with most beds shared by 2 women- head to toe. They have to pay for the beds and can't afford a single one. In the first 3 hrs I saw TB, several young women with stroke from rheumatic heart disease, HIV etc. One woman has a large left neck mass and has been in the hospital for 2 months waiting to get a blood donation so they could operate. Meanwhile the mass is growing and pressing on her trachea.
Another has a large mediastinal mass (chest mass) and has been waiting 1 week for some one to biopsy it.
I saw an endocrine case of a woman found with hypoglycemia ( blood sugar <20) presenting in a coma. She was found to have this at another hospital , they gave her dextrose and sent her home. She has a large abdominal mass.
Some blood tests here take 2 weeks to come back and they ask the pt first if they can afford a CT scan since it is out of pocket. The Kenyan residents ("registrars") are frequently on their own and have teaching attendings twice a week. The nurses ("sisters") don't seem very reliable. The patients don't question the docs about their diagnosis or treatment plan. Most are very stoic despite the pain and illness. Families sit by and feed and position their relatives in bed.


This is all just day one- sorry for the detail, but I am using this as my diary.