First day at the hospital!

Today is our first day at placement! So excited!

We are placed at Lovolosi hospital. We took a dala dala with one of the placement managers, then walked for about 20 minutes through shops, and stations, and back roads. We are expected to find this place ourselves, so we tried to remember landmarks. The problem was, everything was so colorful, and crazy, that everything looked the same. Tomorrow will be interesting.

I am placed with Hugh (a retired MD), Milan (a pharmacist), and Tamara (a neuroscience researcher). We were given a tour of the hospital. It’s hard to explain what it was like…basically there is a big courtyard, with rooms facing the center. They have a dental clinic, and HIV testing area, laboratory, pharmacy, injections and wound dressings area, 3 doctor offices, and a labour and delivery ward. Each doctor’s office was about the size of my bathroom, with a small desk and examination bed. Each room had 2 doctors, each taking on a different patient at the same time. So 6 patients were seen at a time, in 3 rooms each the size of my bathroom. I can’t explain what the departments are like. In particular, the dressing room had a small bed, no linens or anything. There was one little table with unsterilized tools, big containers that said "soap water", "clean water" and a “jar” with gauze. I want to work here to see what it is like!

Hugh, Tamara, and I were assigned to the Labour and Delivery unit. I wore scrubs from back home, and the nurses came and grabbed at me and put their hands in my pockets, gabbing to eachother in Swahili, grabbing at my ear piercings. I was thinking my scrubs were inappropriate or something, but then they were like, “very nice!! You so nice!” So, I guess they approved.

We were told to change and scrub in for surgery. Tamara and I came out wearing XXL scrubs, and rubber boots. We “scrubbed in” using soap that smelt like straight vodka. We went into the “theatre” and were given cloth masks and hats that had been sterilized. We mostly just observed the c-section, but we didn’t get any gloves. The anesthetist and surgeon wore sterile gloves. The set up for the anesthetist was very basic, not quite what I am used to.  He performed a spinal, and things got started. I am glad I had on rubber boots.

So the young lady who was getting a c-section apparently had pre-eclampsia. I am not sure the history, and what was known, but she did begin to seize during the operation. She was then given a muscle relaxant that knocked her right out.  Baby was removed, suctioned, and smacked around a bit so he would cry. Super cute! I left for a bit, and assisted other nurses on the ward while they sewed her back up. I came back later to see her in recovery (the recovery room: an open room with a stretcher which is beside the OR). She had a Spo2 monitor on her finger, and when I came in, it was at 63%.  It appeared like her tongue was obstructing her airway. Her Spo2 was now 48%.  The anesthetist went into the OR and brought back an airway which he put in, then bagged her. He slapped her around a bit and told her to wake up. Her Spo2 slowly came up, and her heart rate slowly started to come down. When her Spo2 and heart rate were close to normal and she was able to follow commands by squeezing the doctor’s hand, she was taken to the ward. They only have one Spo2 monitor, and it was needed for the upcoming surgery.

Everyone was so calm, and relaxed. Things were done, but chaos wasn’t involved. I thought about how stressful situations like this are back home. Is it necessary?

I took her vital signs (manual BP, resps, and HR actually) once she got to the ward. The “ward” had 9 beds in a room smaller than a 4-bed room at RUH, with only a few feet between beds. There was an attached bathroom, but the sink was clogged and filled with flies. The nurse took me by the hand and told me to document. She would just point in a direction and talk to me in Swahili, so I was very lost. She told me she loved me though and kept touching my hair and earrings, so I knew I was in good hands.

 Supper that night was chapati (like naan bread, or lefse), lentils, and papaya fruit. Such a good meal! I am going to be seriously fat when I get home.

Then the power went out. We played cards by candlelight.