March 11

DIRTY has been the theme of the week. We have been working for the last two days in a huge one room church with a bright red dirt floor. As if walking in red dust all day is not enough, we ride for an hour and a half one way in a non air conditioned van on a dirt road with the windows down. Most of us could pass for Latinos and in a few days would blend right in with our dear African patients and translators. Speaking of patients and translators, Rachel got to do her first pelvic exam today and I got to pull a molar. I spent the day in triage and found several enlarged spleens, interesting neuro cases (Dad and Dr. Ken would have been proud!), and mostly just enjoying hearing all the CRAZY stories people told to try and convince me they had malaria.  Rachel got to be with the doctors and PA’s all day and so learned some good diagnostic techniques and got to teach the PA students how to draw up and give an IM injection. Speaking of IM injections, I got to give two on Tuesday night. They were, unfortunately, on Rachel, but being the baby nurse that I am, I was excited anyways. She had a pretty bad migraine and the only thing that it seemed was going to work were two IM phenergan shots and I happily obliged. She woke up migraine free and was fortunately able to come to clinic (Rachel here: though 50 mg of phenergan and two ibuprofen pm and two regular ibuprofen may have been overkill...it was hard to keep my eyes open that day.)

(Rachel here) Back to today. We saw just over 200 patients and had to turn away at least that many. Since we were there for the second day in a row, word had spread that we were coming back and so the line stretched around the corner. We saw lots of coughs, heartburn and high blood pressure, but the day also included several children with seizures, a boy who had a broken arm with a piece of bone sticking out near his elbow (it had been broken for over a year) and a girl with a six inch infected abscess on her head that was eating away at her scalp. Not only is basic health care lacking, but education on how to care for wounds is as well. So many of the problems we saw today were due to a lack of hygiene. Patient after patient came through with bug bites that they had scratched and that had become infected with staph because they do not wash themselves or clean open sores. It was a particularly hot day and the flies swarmed on any open wound they found. Most of the time spent with patients was spent educating them on diet, hygiene and the cause of their discomfort or illness.

Tomorrow is the last day of clinic. It has flown by and although we had hoped to post something every night, by the end of each day we have been exhausted (not to mention that I kept Mandie up till almost two am the night I had a migraine. She was very kind and made a great nurse…I’m pretty sure I was not a great patient…though I did give her the opportunity to give not one, but two shots since the first one didn’t work). Anyway, my hope is that we will both be able to be with the doctors and physician assistants doing diagnosing and prescribing. It’s great practice for what we will do when we live here. I’m hoping to be able to pull a tooth and any wound care or exciting diagnostics will be exciting. On Saturday we will have a day off and relax and see the Nile River! We were hoping to spend some time with Michael and Amanda, the couple overseeing the building project. They won’t be there, unfortunately, but it will be good to spend time with the team, without the chaos of clinic. On Sunday morning we will start the journey home!