Sunday, May 11, 2014

Childrens Ward


“A journey like this suggest some kind of personal transformation, but I am not sure that people really change in their basic character. It is probably true that they simply become more intensely themselves, or what they were meant to be all along.” Elisabeth Bumiller.

 
I don’t know why it has taken me nearly six months to comprehend how much a gift this experience is. I always knew that this experience would be a blessing, but, for the first time since I have been here I really feel it. Good and bad, I am learning so much about the world, myself and others. I’m beginning to see the world from a different perspective, in turn it’s affecting how I approach my life here. I am realizing that although I am a nurse, providing aid comes in many different forms. From being a nurse, to a blood donor, to a shoe repair women, to a shoulder to cry on, there are many ways to assist the people around you. You just have to keep your eyes open for opportunities.   
 

 
Just recently I was in a car that broke down
on the side of the road. We had to wait eight
hours before being rescued, but, at least I learned how
to eat sugarcane like a real Kenyan. Too bad
my AAA card doesn't work here.
 Note the child sitting on the motor bike behind me.
 
 
Many of the doctors and Fathers I work with.
 
 
I have adopted a cat here. She was born when
I arrived in November. Her name is mototo 
which means child in Kiswahili, but, I call her
 Moe for short. Look at how fierce she is.  
 
This picture represents my experience here perfectly.
Everyone is fascinated with my skin color and hair.
There is no such thing as a personal bubble.
Constantly my skin is being rubbed and my hair
is being played with.
 
The aftermath. White girl weave. I cant say
its my best look.
 

Two of the nursing students. They are trying to convince
me to eat dried minnows. Everyone says they are very
"sweet" but I cant get over the fact that in order to eat them
 you chew on bones.  
 
 
Like I said I have become a blood donor, let me elaborate. Last week I had a patient admitted with an hb of 4 (an hb that low can be life threating). Our lab has run out of blood and her parents were unable to donate because they are HIV positive. Out of curiosity I asked what her blood type was. Her blood type was AB+. I am also AB+. You may think I'm crazy to donate blood, but, I know if you were in the same situation you would have done the same thing. Donate blood! It saves lives!!
 
 


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Yet again I have transferred wards. I am now working on our pediatric ward. I have been asked to stay to compensate for the shortage of nurses. At first, I was disappointed. I really enjoyed female ward. I had grown accustom to my daily schedule. But, I’m glad the matron gave me the push I needed to leave my comfort zone.

At first I can sincerely say pediatrics intimated me. The smallest mistake can kill a patient. Children’s bodies function very different than adults. Vital signs are different, medication dosages are different, even a heart sound can be heard in their bellies because they are so tiny. Not to mention working with these tiny adults requires so much patience. I felt like I had been dropped onto a new planet of children, faced with the daunting task of keeping them alive. Several people have asked me if I enjoy working in peds. I always respond yes of course, instead of having plain throw up on me it’s now pink (thank you Panadol syrup). That joke usually goes right over their heads.

If you would have asked me before if I would have enjoyed working with children I probably would have said no. I consider myself more of a no nonsense type of person, but I am beginning to see a side of me full of patience and understanding. Although patience is not a strong virtue of mine, I still am capable of remaining calm and relaxed... even after being kicked in the face when trying to start an IV.
How can you not love these faces? Photo taken
in the pediatric ward.
 
One of my patients showing off his drawing.
His drawing is of a Masai man. Do
our children back home draw Masai people?

This look kills me! It screams don't you
touch me!

I am also learning about the strength we possess as human beings. These children are incredibly resilient, in both a physical and emotional sense. Most of my patients come to the ward extremely malnourished, dehydrated, and for lack of a better term, sick. In addition, almost all of them have coexisting family problems.  But, somehow, despite their dysfunctional home life, the hospitals lack of resources and lack of medication, most of them make a full recovery. It’s the best feeling to see a child walk out of your ward when only a week prior they were comatose and convulsing from malaria.
 
However, peds is not always full of happy and healthy children.  It’s extremely heart wrenching to have one of your patients die when it is a child. The death of a patient always reminds me how fragile the bonds are that tie us to life and how easily they are broken. Although I consider death a natural part of life, I can never justify the death of an innocent child. I use the term innocent because they are usually victims of a harsh living environment, traditional medicine or just plain ignorance.  My parents say this is the hardest job I will ever love… I’m beginning to think they are right.  
We have a future doctor or nurse here!

Besides nursing, I look forward to my daily interactions with them. Although children are so young and innocent if you pay attention to them it’s amazing how much you can learn. It’s easy to get bogged down in your daily life, but, if I have learned one thing from working with kids, it would be to approach your day from the perspective of a child. I have noticed most children regardless of their prognosis approach each day with enthusiasm, curiosity, and a smile. They question everything, they are pleased by the smallest acts of kindness, and yesterday’s problems mean nothing because today is a new day full of new adventures.
Brian. He is frequently admitted due to TB
relapses. He has lost both his parents from HIV.
However, this kid radiates optimism.

Ruth trying to get every ounce of uji.
 
They caught a bird and brought it to the
ward. I told them birds are meant to live outside and let it go.
 I should have just kept it, all the children were
infuriated with me.
 
 One child in particular I have really bonded with. His name is Tyson.  Tyson is a discharge in. In Kenya if you are unable to pay your hospital fees you are literally kept hostage until you pay. These patients are termed discharge ins. Over four months ago he was admitted for meningitis, malaria, and severe anemia. At that time I was working on the female ward, however, I have known this curious creature for some time now. He is constantly wreaking havoc by running up and down the corridors of the hospital. When I first met him I got the impression that he was very friendly, I can even venture to say overly friendly for a four year old. As our relationship grew I began to think where is this child’s mother and why is this child so friendly with people he doesn’t know; after all, children are taught to be cautious and even mistrust strangers. I  came to learn to two things, Tyson had previously sparked the attention of other short term (white) volunteers (creating friendships), and his mother had abandoned him.
Tyson. This little booger speaks Kisii and a little
bit of Kiswahili. He's forcing me to learn 
his tribal language.  

Tyson with a cellphone. He says he looks "smart".

The hospital has had to hire someone to
look after Tyson. Her name is Catherine.

What a beautiful women. Tyson now calls
her auntie.
 

Tysons behavior is very typically for many children in Africa. In my experiences working with abandoned and orphaned children in Rwanda and now Kenya I’m coming to the realizations that extreme friendliness is often a symptom of psychological trauma. These children desire so much love and attention they are becoming emotionally indiscriminate, hence why children like Tyson befriend anyone who willing to give them the slightest consideration.

 
Although I try keep our relationship one that is strictly professional, I can’t help but to bond with him when I spend every day taking care of him. He follows me around the ward when administering medication, he sits with me during admissions, he helps me collect drugs from the pharmacy, literally Tyson is my little shadow.
 
Tyson pushing the medication cart.

Despite our connection, I feel so much empathy for this child. He has no family, no home to go back to, and no shoes.  In fact, the other day he asked me if his mother had died because she has not come back for him. How do you explain reality to a four year old?
 
I also fear what our bond means to him. I know he has had white friends in the past who have all returned back to their countries. He even asks about them. What happens when he leaves this hospital, or what happens when I leave Kenya? The other day in church we were saying goodbye to another white volunteer. Tyson was convinced that it was I who was leaving. He broke down in tears and refused to talk to me. He needs a stable environment, this constant circle of forming bonds with white visitors and then routinely breaking them is having a devastating impact on his emotional health. This child has already been abandoned, repeated short term attachments is going to leave him feeling more of a sense of abandonment. I don’t want to continue this cycle.
 
 
They caught another bird on the ward. This time
he wouldn't let me touch it! Tyson even tied a string
around its leg and tied it to the bed so
the bird wouldn't fly away.
 
Although I love spending time with Tyson I realize his life cannot go on like this forever. Tabaka Mission Hospital is a hospital, not an orphanage. The administration is faced with a very difficult situation, Tyson’s life is a double edged sword. You pull in one way and he becomes one of the many children subjected to the harsh conditions of an African orphanage. You pull it the other way he returns back to an abusive home. Either way you position the sword he gets hurts. I would like to say I have the answer for this child but I don’t. However, one thing I do know is Tyson is a little fighter. In his four short years he has overcome difficulties most children never face in the states.  His situation seems grim but I have a few ideas on how to impact his life for the better. Stay posted.
Tyson and I. He is always whispering "nakupenda sana" in
my ear. It means I love you very much in Kiswahili.  
 
 
Excuse my broken Kiswahili. Tyson had a pair of broken shoes that were way beyond repair.  I fixed them a couple times without success. I decided to buy him a pair. You would have thought it was Christmas.