Kwa nini uma kuji hospital?

Most of you who are reading this probably know me pretty well. You may not know, however, that high stress situations involving blood and guts don’t necessarily suit me.

Since the day I began this program, I was told the causality ward (better known in the U.S. as the Emergency Room) is where I would find the most hands on experience. I was unsure about this idea especially after hearing the horror stories from the others. It probably wouldn’t be as scary if the hospital we volunteered at had more money. In the ER, construction paper is used to wipe dirty hands, the scalpel doesn’t have a proper handle, there are no scissors and any metal tools are rusted. I know in my heart that despite the unfortunate conditions, we are all here to dedicate our time and knowledge to Mt. Meru Regional Hospital; and we did just that last night.

Five others and myself decided to work the causality night shift last night. We were picked up by our driver around eight (half an hour after we were meant to leave) and arrived at the hospital ready to work, with the doctor nowhere to be found. Two patients lie on the bed. Patient no. 1 had just been in an accident; patient no. 2 had not urinated in a full day. Patient no. 1 was carried out by his brother (caca) and sister (dada) after two hours of not being treated. We understood the family’s pain and frustration. We knew the English-Swahili language barrier did not allow us to respond to what he needed.

The language barrier makes it so difficult for us to carry out normal tasks at the hospital. When one is in pain and needs help in an instant, communication is everything. Think of all the things communication allows in the hospital: an explanation as to why the patient came to the hospital, a full history, a means to talk through treatment with the doctor/nurse, and a way to console the patient and family. But, as I said before, we do what we can, because that’s all we can do.

After the first two patients were cared for were gone, we all stood around waiting for the doctor. Nine o’clock passed like molasses. In that time we met the lead doctor on shift, Dr. Line (Lean-Ah), and some of the nurses.

Finally some action appeared with the introduction of a drunk patient who had just been in a motorbike accident. He needed three sutures above his left eye. He also had burns on his right arm and knee, and superficial cuts all around his head. Ben, who is a fifth year med student, talked me through a full body physical. Next, I watched Ben perform the suturing job on the man’s eye, providing comfort to the patient by holding his hand.  Let me mention the blood was GUSHING out of this mans deep cut. Heather had explained to me following her first night of causality, “After the first gruesome scene you see, they all begin to look the same.” I felt confident that I could stomach anything.

 I didn’t know what I had coming…

11:30p.

Ane and I were looking on as a mother talked to Dr. Line about her child’s symptoms of pneumonia. Suddenly, a woman ran in yelling, screaming and pointing to her chest. Five seconds later a man was wheeled in with a trail of blood behind him. The doctor looks to Ane and I and says, “bullet wounds.” I then watched as the man took off his first layer of clothes to show an underdress DRENCHED in bright red blood, neck to knee. I turned around for about five seconds, before I got a rush of adrenaline. I walked to the end of the bed where he lay in shock. The family is surrounding him; the surgeon joins the circle around him. The surgeon shows us the entry and exit of a bullet in the ankle, two more in the thorax, and one in the arm. Whoever shot this man wanted him dead.

Not even two minutes later two psychosis patients came in screaming and yelling. They we sedated with diazepam and taken on a stretcher to general med.

A minute after that a female victim of domestic violence came in. I was hovering over the doctors shoulder during this time and she turned to me and said in a whisper, “bite, her husband bit her.” She had a large gash above her left eye. I was told that I would see domestic violence while I was her in TZ. My heart broke as a looked at this woman’s sad, embarrassed face. Another perspective put into place for me… In America girl’s fuss when they don’t receive flowers “just because,” while in other parts of the world women fight for their lives in disputes that could end like this one.

At 12a our night ended reluctantly. We all talked about our busy night on the car ride home with enthusiasm.

Today I am heading to the general medicine ward with four others. This is the in-patient ward. Time to throw on my scrubs and get to Mt. Meru! xo