Day 3

This is Phillip, he was one of the three or four nurses who were just awesome to work with. We frankly couldn't have done it with out them. They helped us translate, an really for a lot of the time were right by us tapping chest tubes, giving meds, etc. just all of the regular nursing things. Phillip helped me through my two night shifts. He was great to work with.

This family above right was a family that brought their child to the clinic.

Well it is about 15min to 9:00, on Day 3, I have a second to post because I am in the clinic today. I forgot to mention yesterday that I was assigned to the cardiac clinic. It was a great day I had a lot of fun. CArdiac clinic involves checking in patients who either have appointments or a suspected cardiac history, many also come because they have heard that we are in town and just come to hopefully be seen. We usually see everyone but it makes for a long day for our two

cardiologist doing echo's and screening patients.

I get to take vitals on these patients as I check them in and get a health history. This can be a challange due to the obvious language barrier, luckly we have many translators who help us. After I am done I get to give them things that many of you helped to purchase, stickers, baby dolls, markers, crayons, etc. They really appreciate the gifts, it is sort of fun to watch them take one marker and just get sooooo excited. The parents are also very excited. About half of them don't want to be examined, as soon as you ask them to lay back on the bed they immediatley start crying, so it becomes my job to help calm them down. I want you all to know yesterday I because a human bubble machine. We saw about 20 patients all of which also had echo's done on them (keeps the cardiologist really busy).

(Here is a great picture, one would think that this patient was sedated for this ECHO, no no, no harm was done in the screening of this patient, he just got so comfortable with the procedure and fell asleep. This was certainly an exception and much appreciated).

I suppose the most difficult part of clinic is that about 4-5 of the patients that we saw yesterday were told that nothing more can be done and one was told that she may only have a few more months of life left due to an abnormal heart condition that causes her to heart to beat in an irregular manner. If not corrected then she would die. The cost here is $200 and the cost in Nairobi would be $4,000-$5,000. This was so sad and just created a sadness in the room as our team was just very matter of fact with the family in a kind and compassionate way.
The other 3 patients that were seen just were told to maintain the current medication treatment and that nothing else could be done. This mothers face is imprinted on my mind, she was very happy and talkative in the beginning and then was clearly just sad by the news. The medical director told us that it isn't uncommon for families who find out this information to abandon their children.

For about 6 hours this morning I also spent in clinic, it was great. For some reason I was more emotional than the day before. The father of one of the patients said, "so you mean that this condition could have been prevented?" It is just sad that a simple strep test, or education and penicillin could completely stop this.

It is 0407 on Day 4, and we have 6 patients in the ICU. I am up with Rebekah and Dr. Tzanetos. We are having a busy night. We extubated two patients, and both are doing well. The unit if full and we are running out of places and equipement. We will see what will happen today. There are supposed to be 3 surgeries today.