Health Care Strike

Kenya has been very interesting the last couple of weeks. The death of Nelson Mandela, Independence Day (December12th) and a nationwide health care strike, all affecting the wellbeing of Kenyans, Tabaka Mission Hospital and health care in general. It’s quite interesting being caught in the middle of it. It’s a true testimony as to how politics affect health care.

The strike began December 10th after health workers and the government could not agree on devolution of health services and the way their salaries would be paid. Health workers are opposed to devolution of health services to the counties and want their salaries paid by the national government. Honestly, the entire situation is confusing, but I believe it comes down to money. Because of the strike, several government hospitals have closed, kicking patients out and locking their doors. As a result Tabaka Mission Hospital has been packed.

These past couple of weeks I swear our OBGYN has not slept. C-sections and tricky delivers around the clock. I have had the pleasure of assisting in a few vaginal deliveries and C-sections.  I have also delivered a few babies of my own. In addition, I have had the pleasure of working with several preemies, some who have been born at Tabaka and others who have been kicked out of government hospitals to seek refuge at Tabaka or other private hospitals. In fact, I am working very closely with a preemie born 28 weeks 4 days gestation. He was born at one of the hospitals that has since shut down.

Although I enjoy how busy we are, I feel there is something morally wrong with this situation. I can only look at this situation from an objective point of view, and try not to take sides. However, I do know Tabaka is feeling the effects of inadequate health care and inadequate access around the country.  Although we are not at full capacity I can see the staff and resources are being stretched thin. Tuesday we ran out of blood for transfusions and we are running low on some supplies. For example, I spend more time looking for a cannula to start an IV than actually starting the IV itself.  

I’m still trying to get my bearings here. I would say it’s a lot to take in as a new nurse, but really it’s a lot to take in in general.

I have learned so much in my short time here. Unfortunately, sometimes it’s what not to do. Each day I’m on the unit I realize more and more how specialized maternity nursing is. I remember taking maternity in nursing school thinking how I was never going to use any of this information... I found it stupid and pointless. Now I find myself looking up medications, Apgar scoring, and disease that pertain to this population.

I am also trying really hard to learn Kiswahili. Partly because I want to be able to communicate with my patients but also because a couple of the nursing students refuse to speak to me in English, they say it’s for my own good. It’s extremely frustrating not being able to understand anything, but, in the last few weeks I have gone from completely clueless to only clueless. I have to admit I am thankful to have them as unofficial language teachers.

Although my week days are dedicated to work I have been able to go out into the village of Tabaka. It’s not the most exciting place, but, it is known for one thing, soap stone. This part of the country has an abundance of soap stone which the locals use to create carvings. I live amongst a village of artists, these carvings are absolutely incredible. This is the number one thing I love about traveling, you see the beauty in the world, whether that be through art, surroundings, or the people. Will continue to blog.

*Permission by patient or parent was given to take photo*

                                                     

Newspaper comic December 12th

 

 

After delivering this baby girl

Pre C-section

Soap Stone Carvings

 

Tabaka

I have arrived at Tabaka. Tabaka is small town located in western Kenya (Nyanza province). I would like to say the ride from Nariobi to Tabaka was uneventful but my car was involved in an accident. No one was injured (thank god) but it resulted in waiting four hours at a police station located in Rift Valley. Needless to say the situation made me nervous.

I have finally started working. I have been placed on the maternity ward. Never in a million years did I think I would be a maternity nurse. I never really thought I was “cut out” for mommies and babies. Although I just started, I know this ward is going to be full of emotions. Seeing life happen in front of you is truly a miracle, it’s the most amazing experiences to be a part of a healthy birth. Unfortunately, mother or baby death are far too common here. Today, I lost my first patient. Her name was Juliet. Juliet was born 30 weeks gestation. Despite being premature she lived 4 weeks and 5 days. In fact, she was getting strong and healthier by the day. Then, I arrived to work this morning and baby Juliet had died. The nurse had no explanation as to what happened, in fact looking through the notes baby Juliet had not been monitored all night. The doctor believes the mother fell asleep on her.

Situations like this are extremely frustration. In such a fragile state this baby should be monitored throughout the night and slept separate from her mother. How did this breakdown in care occur?

There are several other things I have witnessed that would never occur in the United States. Seeing this I am beginning to realize why I am here. To educate and hopefully set a good example as to what it means to monitor, access, and care for your patients.

Tabaka Mission Hospital (outside the maternity ward)

Delivery room

 

Looking way more important than I am

Nairobi

I spent about four days in Nairobi. While in Nairobi I had the opportunity to meet most of the CMMB staff in Kenya. We were able to eat pizza and have lots and lots of tea. I also had the opportunity to do some sightseeing in Nairobi. I visited the David Sheldrick Wildlife Trust that focuses on conservation, preservation, and protection of orphaned baby elephants. They maintain a safe environment away from poachers and provide education to all their visitors.  It was an incredible experience to watch the baby elephants in a safe and natural environment. I also was able to visit African Fund for endangered species. It’s a similar organization that protects giraffes. They also educate the public and provide protection for the giraffes. However, the giraffes are domesticated (with names) and enjoy being fed and kissed by the public. I never thought I would kiss a giraffe. I finished my stay in Nairobi by going into the City Center observing all the iconic buildings.  I will be starting work at Tabaka Mission Hospital this week.

After being kissed by Ed.

 

Orphaned Baby Elephant

 

Nairobi City Center