WEEK OF JUNE 15 - 19, 2015 (4th
Week)
Gave a talk this week on Diabetes for the staff here – nurses, clinical
officers (like PA’s in the USA) and the Medical Officer (MD in the
States). There is so much of it here as
I’ve mentioned and our MO, Dr. Ernesti, filled us in on some African
physiology, ie., that because of poor nutrition and the poor agriculture in
this reason, the pancreas does not develop the necessary amount of cells that
produce insulin, and therefore that is the main reason why we see a lot of
diabetes here. Instead of wheat, maize
(corn), rice, or oats/barley, this
region is dependent upon cassava, millet, and sorghum, inferior to the other
grains for its carbohydrates and therefore that’s why the diet from as early as
6 months old is poor and continues to be poor.
That is the reason why there is so much anemia here too. This region around Lake Victoria does grow
some rice, but it is too expensive for the local people to buy, so they have to
rely on inferior grains to feed themselves.
It is interesting that we in the West have so much in the way of good
food and many of us choose sugar-filled foods that lead to obesity and then
diabetes – obesity is the most common cause of adult onset diabetes in the
Western World – with the USA being the No. 1 Obese Capital of the World and the
UK the No. 2.
What else last week – again, many women have to have surgery for ob/gyn
reasons and the wards are filled here.
Thank God we have Dr. Ernesti here to do the emergency C Sections
because before he came, many women had to travel over 2 hours to find a
hospital and surgeon over very pothole filled roads. Well, that’s all for now. I need to make notes along the way about
individual patients because I forget . . .
pole sana – so sorry – old age, I think!
WEEK OF JUNE 22 – 26, 2015 (5th
Week)
A funny thing happened in the Maternity Ward this week . . . a mother gave birth naturally to her 8th
child – she was 45 years old and usually we keep the women with multiple births
in the hospital for 24 to 48 hours. We
see if their lower abdomen is tender and if so, we wait until it resolves
naturally or by medicine. Well, I told
this lady she was going to stay for another day and didn’t think much about
it. The Mother seemed to like the idea
of a day off from home choirs.
However, a few hours later, her husband came in demanding his wife
“enda nymbani (go home).” Well, the
matron took over for me because of my mediocre language skills . . . the husband was still irate wanting his wife
home to take care of the family chores, but most of all, cook his dinner!! We kept the woman in the hospital for the
prescribed 48 hours.
Took a drive over the weekend to Musoma with Tom to visit Tembo Beach
(tembo meaning elephant) which is overlooking eastern Lake Victoria. It was a pleasure to sit on the beach, read,
do a little computer work, have a drink, watch the weaver birds build their
nests in the tree above us and watch the waves coming into the shore.
I’ve hired a private tutor to teach me better Kiswahili so I can
converse with the patients and although I had 3 months of language school in
Nairobi back in 2008, much has been lost in the ensuing years, hence the tutor
and she is helping me a lot, particularly in conversing with medical sentences
and phrases. We also had a visiting
priest from the Diocese of Musoma for lunch this past week and he told me of
his gastric ulcer problems, longstanding conditions, for a young man. Anyhow, I was able to figure out what the
problem was and guide him with his medications and the reason for taking
certain ones and also his diet. So much
health education is not done here – it’s the old fashioned “take two aspirins
and call me in the morning” approach here and the patient suffer from lack of
understanding.
WEEK OF JUNE 30 TO JULY 5,
2015 (6th Week)
This week we were again very busy in the surgical ward. A very young girl, only 16 years, had twins
via C Section because the babies were in the breech and transverse
positions. The girl was very young, innocent
looking and further inquiry found that she was the third wife of a local man 3
times her age . . . unfortunately, a
common occurrence here. But she is
young and pulled through the operation and is doing well with breastfeeding the
babies and is looking forward to going home within 7 days. We keep the post op patients here for at
least 7 days because the conditions at home are so unhygienic and the wounds
would get infected causing all sorts of post op problems. This way we can control the environment
ourselves in the hospital at least until the Mama recovers. It also gives the new mothers time to learn
how to breastfeed and when to get the babies vaccinated, etc.
Here in Tanzania, the Government has declared that new mothers may have
their first babies in a hospital of their choice and they will only be charged
TZ Shillings 5,000 (US$2.50). This way,
the Government is making the effort to ensure that the maternal and baby death
rates are reduced to the lowest possible.
We also admit mothers who are pregnant but have malaria, a urinary
tract infection, etc., because of the high rate of miscarriages if these
conditions are not treated with IV medicines.
Better safe than sorry . . .
For the 4th of July, Tom and I went to celebrate with fellow
Maryknoll missioners in Mwanza, the second largest city in Tanzania on shores
of Lake Victoria. They had set up a
large table on the Lake (almost in it!!) and sang patriotic songs and a good
time was had by all – hot dogs, hamburgers, pasta salads, chips, popcorn – all
the good things in life. After that,
the next day, we took a trip to the Serengeti National Park with a fellow lay
missioner, Liz Mach, and saw four lions basking in the noonday sun, crocodiles,
hippos doing the same, lots of zebras, wildebeests, cape buffalo – so many
animals – it was a wonderful outing and we came home exhausted but happy!
WEEK OF JULY 6 to JULY 12,
2015 ( 7Th Week Final)
This will be my last full week here at Kowak Hospital. I’ve decided to go home as originally
planned on July 21 – back to the USA via New York to North Carolina. I had a fainting spell about two weeks ago
and felt it better to get a check up in the USA, since there is no insurance
here or in Kenya that would cover the cost of a specialist. If all checks out ok, I may decide to come
back next year, God willing, as I have enjoyed helping at the hospital and have
thoroughly enjoyed working with the staff.
Prior to leaving Africa, I am taking a trip to my old stomping grounds,
Kitale, Kenya, to see old friends and most of all, the Maryknoll Lay Missioners
who are still there: the Korbs, Russ
Brine, and John O’Donoghue. So I plan
to leave here on July 15, travel to Kitale and come back to Nairobi for my
flight back on July 21.
This week at Kowak Hospital saw Dr. Ernest gone for two days at a
regional meeting of hospital medical officers.
When he came back on Wednesday, he did about 20 Ultrasounds in one day
and then the next day, he did four surgeries right in a row in one day! He finished about 7pm and the next day while
I was doing post op rounds, his patients were doing well. In all the time I have been here, there was
only one post op complication: a young
HIV positive patient with a fairly low blood count had her lower abdominal
wound open up on the fifth day post op.
And this is operating undersome pretty primitive conditions here. Hats off to Dr. Ernest!
We found out that there have been over 400 circumcisions performed here
at Kowak during the month of June. There
is a big push to circumcise the men, young men, and even small boys surgically,
rather than wait until the usual time when the boys are about 11 or 12 years
old. This is because the predominant
tribe here is Luo and their custom is not to circumcise their men at all. Consequently, it has been proved that the HIV
rate is much higher in the population that does not circumcise their men. We are lucky to have a community advocate
working as a liaison between the hospital, Government officials and the
community leaders to educate community members on the urgent need to circumcise
all their males. We will see the
results of this effort with the drop in the HIV rate in this area, but most
certainly in the generation to come.
I leave Kowak reluctantly and will miss the many colleagues and friends
I have made here. In particular, I
would like to thank Tom Scott for helping me “adjust” and get me started in the
hospital as well as Fr. Conard to allowing me to come here. Asante sana, Tom and Jim! Nashakuru!
