I had one especially good day this week. I think this is partly because of who I was operating on, and partly due to the operations I was performing. I am delighted to report that the six-month old baby who I operated on back at the beginning of February, and who I was disappointed that he hadn’t returned last week, arrived back at Kiwoko with his mother on Wednesday. He had even managed to put on a couple of kilograms in the last two weeks since he went home. You may recall my sense of being completely out of my depth when I had to operate on him, and my joy when he survived.
The family had no spare money, so the delay in returning by a week was apparently while they tried to get enough together to afford the cost of travel (probably only about a pound!). This is precisely the type of patient who is in most need of healthcare, and who this hospital tries to help. Our “Good Samaritan Fund” will cover the cost of this admission, hopefully allowing this baby to be restored to health. So many thanks to those generous people who contribute financially to enable this to happen.
So Thursday was a day of general surgery – what I am actually trained to so. I operated on this baby in the morning. It was again a bit of a shock to find out just how small he was, but the procedure went well. For the medical minded amongst you, there were very few adhesions, I was able to mobilise the rectal stump easily, and then joined it to the end of his small bowel which had until then been protruding through his abdominal wall for the previous six weeks. Dr Peter was kind enough to assist me, but I think he was interested in the technique I was using – the type of anastomosis I have been taught is different from his own way of joining bowel. So far the baby has recovered well. He is moving his bowels, and is feeding well. I have high hopes that he will continue to get better and may get home again later this week.
The other good general surgical case was later on Thursday afternoon. A new admission with acute abdominal pain, a gas-filled mass in the centre of her stomach and vomiting suggested obstruction. I decided that an operation was required as her symptoms had been ongoing for 24 hours, and found that she had twisted part of her bowel on itself – a caecal volvulus. Although not gangrenous, the bowel was starting to split open, so resection and re-joining was required. Again, an operation I have actually been trained to do. One right hemicolectomy later, and the patient is already much better. Again Dr Peter was observing my technique – whether he adopts it, I am not sure, but he seemed to like it. It is good that now I have been here a couple of months, we are working together as a team – some things he is more experienced at, some things I am. I hope we will continue to learn from each other.
I have been on-call this weekend too – yesterday was busy with a couple of caesarian sections and an acute obstructed hernia. I was in theatre most of the day, which meant I missed most of the excitement of the nursing school sports day. This all-day competition was taken very seriously, and with great enthusiasm. It involved various sports such as volleyball, football, athletics, an eating competition, and even a traditional dance competition – apparently one team performed a traditional circumcision ritual complete with mock-blood! I did witness the most exciting part – the prize-giving, with individual winners getting household implements such as basins and plates!!! However, the prize for the overall winning team was a bull – I think there will be another party in a week or two where this animal will be slaughtered and eaten…
I myself am going on retreat this week. Skillshare International, who are kindly supporting me financially while I am here, are having a get together for all their East Africa development workers. We are meeting in Kilifi, north of Mombasa on the coast of Kenya. I suspect it will be hot, but I’m looking forward to a short break. I leave tomorrow, and get back on Saturday. Must remember the swimming shorts, and the suncream!
So as you can see, the hard work is balance by hard play – precisely the way life should be. I hope this blog finds you in a similar condition!
Steve
No comments:
Post a Comment