Muzungu Moments '11-4

Sorry I've been a little slow with my updates. It's been a busy week with a lot of things to do so I'll just give a short recap.
Yesterday Dorothy and Melba went to visit the Batwah Pygmie village with the hospital chaplian. Apparently it was quite the amazing experience but I have yet to see their pictures as yesterday afternoon and last night were so full.
Lisa and I finally got the 12 lead EKG machine working properly. The radiology tech is the one who does the EKGs here so we spent some time with Xavier showing him how to use the new machine. It will be interesting to do some follow up and see how often it is used and what kinds of patients are getting EKGs ordered.
I also had the opportunity to go out with the ambulance. We went to a nearby health center to pick a woman in labor with possible fetal distress. I don't really know much about OB so I couldn't really offer much in that department, but I was able to learn more about the actual ambulance, it's equipment and the transport system.
In the afternoon, my class did some ambulance drills. I think it's safe to say that everyone had a lot of fun. Our assigned pretent patients did a great job acting sick or injured and there was a lot of laughter involved. We drew quite the crowd!
It's now time to start heading out to Kigali where we will visit the Bourbon (Rwanda's Starbucks with the most wonderful Rwandan coffee ever!) and perhaps visit the genocide museum. We fly out to Kenya tomorrow afternoon. It's hard to believe that the trip is almost over.

Muzungu Moments '11-3 Ambulances in Africa

This morning after I finished my class I went down to the ER just to see what was going on. Communication is starting to get a bit better and I managed to get the point across that I needed to look at/in the ambulances. When I went out to the first ambulance I was pleasantly surprised to find a nearly full oxygen cylander, a working portable suction unit and a fully functional transport monitor complete with EKG cable and and SPO2 monitor, score!!!
Nobody seemed to know what the oxygen tank was or what to do with it so I'm assuming that is how it remains full. I found a few electrodes for the EKG monitor and we tested it out on John, the driver, who had never before seen an EKG. It was like Christmas for all of us! We couldn't stop smiling and laughing all over a simple EKG tracing. I must have spent about an hour in the back of just one of the rigs showing John and Dr. Bora how to turn off and on the O2 tank and what to do with all of the other exciting finds of the day.
The next time the rig goes out when I'm not teaching, I'm supposed to tag along. I guess I'm teaching an ambulance class at the end of the week.
Melba is having a good time with her quality improvement group and Lisa taught a clas about heart failure to the doctors today. Dorothy's got the backboard strap situation almost completely covered. We've been keeping busy here, I just wish there more hours to the day.

Muzungu Moments '11-2

Lightening is Striking Again...
Last night after my class session I went down to the emergency room to track down Lisa and to see what was going on. As I was walking down the hill, two ambulances went speeding past me. As I got down to the ER entry there was a lot of commotion. All of the ER beds were full and there were crying babies, and people moaning on stretchers all over. I couldn’t find anyone in the ER who spoke English and Lisa was nowhere to be found so I ran back up to house to see if I could find her and we could all go to the ER to help.
As it turns out,5 people who had just been stricken by lightening had been brought in from a village clinic; two little boys and three women. One of the women had a baby strapped to her back at the time of the strike and had been thrown to the ground baby and all. We examined all the patients for signs of arrhythmias and burns, looking for entries and exits of electricity. One of the boys had burns on his neck while another women was found to have burns on her back and yet another with burns on her legs. The infant was assessed for potential injuries from the mother’s fall but checked out as normal.
All of the patients were admitted for observation overnight. Lisa was able to do a little education about rhabdomyolysis and the importance of administering fluids and assessing labs. This morning when we went to round on the patients, no labs were available. We also had difficulty even finding the patients as nobody seemed to know where they got transferred to. Fortunately, when we found them, all of the patients appeared stable but the overall experience of watching how this situation was handled was quite interesting. The doctor we were working with had never seen lightening strike victims before and I had only seen one under very different circumstances. What an interesting day!

Muzungu Moments '11:1

I taught the trauma assessment class yesterday and used Melba as my patient for demonstration. Everyone thought she was my mom! Things went fairly well and in the afternoon session we had opportunity to practice, which is always fun to watch. It was the lone midwife in our class who seemed to pick up things the most quickly, a sharp woman she is!
Lisa and I were able to round with one of the doctors in internal medicine. We are seeing quite a few respiratory infections, cases of ascites and case of heart failure.
It would appear that our next assignment is to fix (figure out how it works) an EKG machine, teach basic EKG interpretation and prepare a basic curriculum on heart failure. This wouldn’t be a problem accept for the fact that poor Lisa is only given 2 hours to present 5 subjects! We shall see…
Dorothy is having a great time working with the malnutrition program. She may even get to go to a village to see the community nutrition programs! We have also charged her with the task of designing some backboard straps for the two new backboards that have been made here a Kibogora since I was here in 2008. (See blog posts of May 2008 to truly understand the excitement of this). Lisa also had the brilliant idea of making pinwheels for the patients to blow on (because there are no incentive spirometers) for pulmonary hygiene; another great way to put Dorothy’s creativity to work!

Hats off to Kibogora

We've made it to Kibogora with 323 crocheted or knitted hats! The hats were made by various women (including my mom, my sister, my old high school Spanish teacher and Julie's mom) around the state of Washington to be given out to children being treated for malnutrition at the hospital program. Before we left, people just kept loading us up with hats. We were able to vacuum pack them and take every hat we were given. When we got here, Dorothy counted 323 hats for Kibogora!

Mediwe From Rwanda!

Mediwe from Rwanda! Melba, Lisa, Dorothy and I made it safely to Kibogora last night. We have now had a good night's sleep and are being filled on the happenings around the hospital. This afternoon's assignment is to fix EKG machines! It looks like I'll be teaching the nurses the trauma curriculum in the mornings with practicum in the afternoons. I will also be working in the ER and with the ambulances. Apparently there is a need for some training regarding patient triage and transport in the ambulances, sounds like a fun project to me!
Lisa and I will be working together fairly closely on the teaching projects and we might just whip something up about cardiology also. Melba will be working with the nurse managers on quality improvement issues and she will also be working with Lisa and I in developing a disaster plan. Dorothy is already happily working away in the supply department and later she will be working with the child malnutrition program. She might also get to go to the villages to work with a community nutrition program as well. All in all we are doing well and are excited to get started working on things. The projects however, just seem to be getting bigger. I guess that just means that we'll have to come back again to continue them!
The internet here is a little scetchy so I don't know how often I'll be able to update this, but I hope to do it frequently. Thanks for reading and thinking of us on our journey!