Saturday, August 25, 2012

Saturday - Flying Home

I am still absolutely in awe that my trip is coming to an end. I woke up unusually early this morning. I think I am just anxious about the next 20 hours I get to spend in a plane. We are going to get ready and make sure the bags are all packed and under that 50lb limit. The vans will be here to get us at 12:30 this afternoon and then the journey back home begins. I am excited to see my family and get a Big Mac, but there is so much here that I am going to miss as well. I feel like I have done so much and experienced more than I could have even imagined.
The Lion King has been a common theme this whole trip, and the words from the song “The Circle of Life” seem fitting as I pack my bags to leave. 

“There's more to see than can ever be seen
More to do than can ever be done.
There's far too much to take in here
More to find than can ever be found.” 

Friday - Last night in Kenya

Friday was more or less a day of bonding for us. While leaving the hospital and Kenya will be hard, leaving these wonderful people will be the hardest. For the last month we eat, work, and sleep right next to the same group of people, and it will be hard to go back to the busy life we all have back home. We will certainly do our best to keep in touch with each other. So Friday we spent much of the morning and early afternoon hanging out by the pool and reminiscing about all the things we have done and seen together while we have been here. I wanted to get a head start on packing since I knew I would be mad at myself if I left it all to do Saturday morning. It took me a while, but I got most of it back in the suitcases and they zipped! We made dinner plans at one of the best seafood restaurants in Mombasa. The food was absolutely amazing! Once again, we spent most of the meal talking about how hard it is to believe that our time here is done.
            After dinner a group of us took off for the hospital, for one last go around. Luckily it was a slow evening in casualty. We spent most of the time taking vitals of patients waiting to see the doctor. We went up to Main Theatre to see if there was anything going on, but we had just missed the surgery and they were just closing up. Before we left we gave all of our scrubs to the nurses there and they were very grateful for them. It was a little after midnight when we made it back to the compound. We discussed plans for Saturday, and headed to bed. It would be my last nights sleep in Kenya.

Friday, August 24, 2012

Thursday - Hospital and Party

This morning was kind of a sad realization that this was our last morning at the hospital. Thursdays and Fridays are the days that surgeons from around the world come to Coast General, so first thing this morning a group of us headed up to main theater to check out the surgery list. We didn’t really care what the surgery was so we just jumped in on the first one that started. The patient was a man with esophageal cancer. The surgeon operating was a cardiothoracic surgeon, and his plan was to open up the man’s abdomen and attempt to reach the part of the esophagus that needed to be removed by going up through the diaphragm and into the chest cavity. After nearly two hours of searching, the surgeon said that he was unable to find the section of the esophagus and they were going to close him up. That wasn’t the end, however. He was going to keep trying. They stitched up the abdomen and rotated the man so that the surgeon could then attempt to reach the esophagus by going through the side of the chest cavity in between the man’s ribs on his right side. As much as I wanted to see them open up the chest cavity, we had told our driver to be there to pick us up at noon so we had to leave.
            As we are getting ready to walk out the door, Alexa tells me to go peak into casualty. The night before there had been a massacre in Tana River just up the coast from Mombasa. There had been a feud between two tribes over pastureland and water. Warriors attacked the unsuspecting villagers in the early morning hours on Wednesday. In total, they reported that the warriors killed 31 women, 11 children, and 6 men. When I walked into casualty, the doctors were unwrapping the wounds on a woman lying on the bed. Words can’t tell you how horrified I was by what I was about to see. Keep in mind, at this point, nearly a day and a half has gone by since this woman was attacked. She was originally taken to a hospital in Malindi, further north up the coast. She was then transferred here because they didn’t have the medical capabilities to treat her. Not that Coast General is much further ahead. They unwrapped the woman’s head to reveal a four-inch gash on the top of her skull, still wide open, but no longer bleeding. Her entire head seemed lopsided due to the massive swelling around the gash. The doctors continued and my stomach clenched. The woman had been sliced with a machete across her face. From her right ear diagonally across her face, above her lips, to the lower portion of her left cheek. Her upper left jawbone had been broken so badly that it was upside down and her top left molar teeth were sticking out of her face upside down. It was difficult to even make sense of what body parts were supposed to be where. Her lips were intact, but located in the lower left corner of her face now. I just stood there in awe, trying to hold back the tears. Next they went to her right arm and hand, which were also bandaged up. At this point, I was ready for almost anything. She had been sliced open on the inside of her forearm so deep that muscles, tendons, and even bone were showing. Even though they had given her some pain medication, she winced and mumbled as the doctors attempted to pull the bandage out of her wound. It was painful to watch her try to speak because her lips would move, but her mangled jawbone and exposed teeth remained still. Next they moved to her hand wound. Her entire palm had been sliced open on her right hand. From between her thumb and index finger, all the way to the outer corner of her wrist. When they opened it up I could see the bone from her forearm sticking out through the wound. Every tendon in her had had been severed and were visible through the gash. The cut caused her to lose all function of her fingers on that hand. It looked as though she had attempted to grab the blade of the knife. While, it was painful to even look at, it was amazing that the woman was still alive. The doctor informed us that her entire family had been killed in the attack and a stranger had taken her to the hospital.
I had seen about all I could handle, and our ride was waiting outside. All of us made the assumption that they would clean her wounds and then send her for emergency surgery right away. Chris, one of the guys with our group, wants to go into reconstructive dental surgery so he stayed with the hopes that he would get to watch her surgery.
Later that afternoon, Chris came back to the compound frustrated. The doctors had sutured together the wounds that they could, and that was it. She didn’t have money to pay for the surgery so she wouldn’t get it. The surgery costs 6000 Kenyan Shillings: about 71 USD. Omar, one of the doctors we have been working with here, said they would most likely put in a feeding tube since she is unable to eat with the damage to her face.
I apologize for the graphic detail, but even now, as I type it out, the image of this innocent woman lying there burns in my mind. There is nothing more frustrating to me than to have to sit back and watch as absolutely nothing is done to help her. Most of us had a hard time ignoring the fact that it was bothering us that evening.
            After leaving the hospital that afternoon, a group of us wanted to make one more trip to Old Town to enjoy the tourist area of Mombasa once more before we leave. We spent a few hours there before heading back to the compound for dinner. We had a get-together planned for the evening as kind of a going away party. We invited Omar, the doctor from the hospital and the staff from the compound. We had fun sitting around the pool playing cards and talking about how we weren’t quite ready to leave Kenya.

Wednesday, August 22, 2012

Wednesday - Hospital, Henna, Beach

Once again, this morning was spent at the hospital. One of the last things I wanted to see while at Coast General Hospital was a live natural birth, so I started off in maternity. There were two women in labor one of which was expected to deliver naturally and the other was having some complications and would most likely be taken up to have a C-section. We hung out for a while (patience is key in this ward) and eventually the nurse came to tell us that she was ready to push. The whole experience was almost exactly what I would have expected, with one exception. The mothers don’t receive any medication while in labor and I have yet to hear one scream. They just act like it is no big deal. The natural birth completed my list of things I wanted to witness, and now the adoption route is looking much more enticing.
            The delivery process took a while, so it was noon before I left the maternity ward. A few of us girls had been planning to get some authentic henna tattoos. We were admiring one of the doctor’s tattoos and she referred us to her aunt to do them for us. Megan and I walked over there when we left the hospital and for only 200 shillings I got a tattoo on my arm and my foot! I love it! 

After the henna dries, you scratch off the paste and it leaves a temporary stain on your skin
 After lunch a few of us enjoyed one more day at the beach in the sun. When the tide came in and the shade covered our towels, we went back to the compound for dinner. We utilized the free WiFi at Café Mocha this evening, but I plan to call it an early evening tonight now that my blog is up to date once again! Sorry for the delay!

Tuesday - Back to the Hospital

Tuesday morning my sinus infection had settled to my lungs and every breath was painfully accompanied by a cough. Regardless, I was back to my normal routine and off to the hospital at 8am. I spent most of the day in Minor Theatre. I removed my first stitches. A man had been cut in four different places with a knife and had about 25 stitches to be removed. He was quite a character and spoke very limited English. Next, I was confronted with a very sad case, which I won’t soon forget. A woman, about 35 years old, came in for a dressing change. As she undressed, I could see the massive tumors in each of her armpits. I removed the bandage that covered the scar from having both of her breasts removed due to cancer. When the bandage was off I could see more tumors. Where the scar was, new tumors had begun to grow like little mountains of skin out through the opening. The cancer was eating her body alive. The doctor explained that the chemotherapy and radiation they have here is rather ineffective and outrageously expensive. After her surgery to remove the original breast cancer, she hadn’t been able to afford the therapy and the cancer had grown out of control. The doctor had me redress the tumors and gaping holes in her chest, and sent her to oncology. When she was gone the doctor confirmed what I had already suspected; she was sent to oncology for them to tell her that it was late stage wide spread cancer and she wasn’t going to receive much help. It was a really hard concept for me to accept. A few more wound dressings and a pretty insane debridement (removal of the infection and dead tissue) of a man’s foot ended my day in Minor.
            That afternoon we all headed to the beach for a drink and some sand time. Even though we have spent many days at the beach, every time I catch a view of the ocean down that path, it takes my breath away. It’s so naturally beautiful.

 Oh, by the way….I finally got to ride the camel!
 We headed home for dinner, and then off to Cafesserie for dessert. Since the café is in the City Mall, a few of us wandered the stores for a while. The City Mall is one of the most modern places I’ve been while here in Mombasa. It has escalators and four floors (even though each floor consists of only one small circle around the escalator – 3 or 4 stores). Our walk around the mall ties with the Dark Knight Movie going experience for “most American experiences” while in Kenya.

Monday - Travel and Sick Day

Monday morning came too soon, and we packed up once again to load the bus back to Nairobi at 9 am. The trip was long and to top things off, I had woken up with what felt like a horrible sinus infection. I couldn’t breath and felt like my eyeballs were literally going to pop out of my face. Even with sleeping pills, it was impossible for me to sleep or even get comfortable for that matter. We rolled back into Mombasa bus station around 6:30 pm where our drivers picked us up and took us back to the compound. A few people took off for the café that evening, but I was headed straight to bed.
            Sorry, it was a pretty uneventful day.

Sunday - Last day of Safari and Nairobi

Sunday morning we were instructed to be up for a cup of tea or coffee and then in the vans before the sun rose. We headed out to the park and were among the zebras and wildebeest when the sun peaked over the mountains. Absolutely one of the most beautiful things I’ve ever seen. 

The sun was up when we found a lioness feasting on her latest kill, a wildebeest. She was absolutely content to let us watch her and take pictures. When she was full she got up and wandered off as if we weren’t even there. 

We saw all our favorites one more time: lion, zebras, elephants, and giraffes before we headed back to camp for a full breakfast, shower, and packed up. We were back in the vans to tackle that awful two-hour stretch of road once again. When we finally cleared the gravel and were lifted onto pavement we broke out in cheers! We still had a two hour drive to get back to the same hostel we had stayed at Thursday night in Nairobi. When we finally made it there, most of us took a short nap since we had been up since 5:30 am and then got ready for our dinner reservations. That evening we ate at the world renown best restaurant in Kenya, “Carnivore”. We were all really excited to have some real meat after all the noodles, rice, and bread we had been eating since we arrived in Kenya.
            The restaurant was all you can eat, and as we walk in the door, we see a huge fire pit with tens of swords with huge slabs of meat cooking over the fire. We sat down and ordered a drink before we were served, bread, mini corncobs, and mini pizza as an appetizer. Then the salad showed up. Then rotating trays of special dipping sauces and salsas. Then the real fun began. The waiters flooded our table carrying swords of huge chunks of meat. They would set the tip of the sword on your plate and use their machete to slice you a section. We were served, pork sausages, roast beef, lamb, pork loin, pork ribs, crocodile, prime rib, ostrich meat, fried chicken, ox testicles (yes, I tried them), ostrich meatballs, chicken wings, and turkey. Since the meal was all you can eat, the rounds kept coming. I had had all I could take. There was a white flag on the table and when no one could eat any thing else, we waved the white flag in surrender. They cleared our plates and brought us the dessert menu. I topped off the night with a wonderful piece of cheesecake covered in passion fruit sauce. DELICIOUS. 
The circle fire pit where all the meat is cooked

            We headed back to our hostel and once again sat around the fire pit in the bar playing cards and talking. It was a great ending to an amazing safari.