A Final Note

Today was my last day at the hospital. It is hard to imagine that I will be home in less than a week and back to a normal lifestyle. I have adjusted to Kenya so well, that it will take me some time to adjust back. To think that I will no longer be the only white person in a town just boggles my mind. I have gotten used to being a minor celebrity here and having everyone say "jambo" to me as I walk up and down the street. In no way am I looking forward to living in a rude and uptight society again. I guess every good thing must come to an end.

Since my last post, I have seen various types of excisions and a skin graft, which is when patches of healthy skin on a patient are shaved off to cover up a wound on a different part of that patients body. In the case that I saw, the patient had necrotizing fasciitis, more commonly known as flesh eating bacteria. The wound spread from her ankle to half way up her shin, and was almost completely wrapped around her leg. In the United States, and most well developed countries, this procedure is very easy given the technology used. Since Kenya is a third world country, this technology does not exist, they are slightly behind. Rather than using an electronic skin shaving device, which harvests perfect skin, all at the same depth, we used a special cutting tool that cuts at the same depth, but it is all manual. This is just as easy and harvests around the same quality skin,the only problem is, every patient has to buy their own blade for the procedure. They cost around 850 ksh, an amount that many citizens here could only dream of having. Luckily, the lady had the money to buy the blade. We gave here the spinal anesthesia and were ready to harvest some skin. This is when we ran into the worst problem of them all, the blade was dull and couldn't cut through any layer of skin. I am sure you are wondering why a blade that was brand new is dull? We were all wondering the same thing, you are not alone. The blade was so dull that even the doctor tried to cut his own skin and it wouldn't. At this time the assistants tried to sharpen the blade at any means possible. I couldn't believe what I was seeing. After failing to sharpen the blade, we gave up and went on to our last option, to manually cut skin off using a normal surgical knife and scissors. This brings many problems though. Try to imagine how thin skin is and how impossible it would be to cut off only the top layer without the use of a special instrument. It just cant be done. The surgeon did his best, but in the end, the chunk of skin that was taken, which happened to be from the thigh, contained some fat as well. The good news was that it could still be used to cover up the wound. The bad news was that the wound we created would have to be stitched up, leaving a very nasty scar. One can only feel terrible for the patient, since she will most likely have to return to the surgical theater, after trying to buy several new blades of course.

Now you may think that things couldn't get much worse than this. I thought the same exact thing, but the next day when we showed up about to attempt a small procedure, we realized that the hospital had no blades. There was not one sterile blade in the hospital to cut with! Suppose there was an emergency, what would we have done then? It is a government hospital, and there were no blades anywhere in the hospital. All we could do was laugh, including the surgeon, at how pathetic it was. The government just doesn't care enough to make sure its hospitals are stocked with enough blades to carry out procedures. I will never forget these two unbelievably shocking moments.

On a semi-happier note, I will be returning to the orphanage tomorrow to say farewell to all the children. I have been trying to prepare for this moment for awhile now, and still haven't figured out how I will explain to them that I will not be coming back next weekend. I plan to spend the majority of my day there and take as many pictures and last minute video as I can. They are amazing children, and I am sure I can speak for everyone when I say that they will certainly be missed.

My time here in Mombasa, Kenya has been a remarkable and life changing experience. If I could do it all over, I wouldn't change a thing. I have learned how little I actually knew. I feel I have grown as a person and will no longer be blinded by all the materialism in our country. When I return, I know I will be quizzed on whether or not medicine is something I would like to pursue still. I will not have an answer. Truthfully, I still need some time to think it through when I return. Part of the reason for this is because the medical procedures I saw were mostly completely different from the procedures done in the states. To add on to this, I witnessed plenty of surgery, when in reality, I don't think I see myself as a surgeon. It was more of a test to see if I could handle the intensity, I think. To sum things up, I did enjoy learning about all the anatomy behind everything. Once again, it just made me realize how much I don't know and how much I will have to learn. This upcoming year at college will be interesting. If I succeed in school, then yea, I will continue to pursue medical school, but if i don't, I will have to start thinking of alternatives.

To everyone who has been reading my blogs weekly, I thank you. I am glad I could share my experiences with you in some way. I hope that I have made each and every one of you more aware of what the world is like outside our bubble. I cant wait to join everyone back in the states and share some more stories over a well cooked meal. See you soon!