Blackbird

So I've already seen and heard a lot over the past couple of days.

Yesterday (7/8) was my first opportunity to visit the hospital that I will be working at for the next 7 weeks. To say that this place is incredible doesn't begin to do it justice. The programs that they have in place, from their mother-baby hospital (a partner of Riley Hospital, by the way) to their anticoagulation clinic, even their property is astounding. Anyone not familiar with hospitals and how they operate would probably be shocked and likely disgusted by the conditions here, but the costs of running a hospital the likes of which we are used to in the United States are tremendous. What they have managed to do here at AMPATH in such a "resource-constrained setting"--as they refer to it in their published research--is truly a testament to the willpower of people who share an unrivaled vision of global health care. Mind you, it's not a pretty hospital. The wards are less than sanitary, the funds are less than exuberant, and the patients are very, very sick. Fortunately, through the combined efforts of Kenyans and Americans alike, they are receiving care the likes of which still can't be found in a very large portion of the world.

Today (8/8) was our first opportunity to really get our feet wet in the wards. We will start rounding with the medical teams on Monday, but for now we are familiarizing ourselves with the medication records that are kept for patients here as well as our role on the team. I will be assigned to a team of medical interns, registrars (residents), and a consulting (attending) physician. As a team, we follow a share of the patients here and make sure they are on the most effective, appropriate treatment we can provide. I will have a lot of responsibility: I will be in charge of monitoring the medications they are prescribed, making sure that they are receiving them by communicating with the nursing staff, keeping accurate records of such activity, and making recommendations for optimal medication. If it sounds a little overwhelming, I assure you that it is; I am nervous but hopeful that I will rise to the occasion for the sake of my patients.

We also got to explore the town a little more in depth today. During our lunch break we walked around the city; it was crazy busy, people walking everywhere, covering the sidewalks selling goods and services. Even though I felt it was hot, it is rain season and considered chilly by the Kenyans who walk around in sweaters, jackets, and jeans. Shops are stuffed into buildings wherever they can fit. I purchased an umbrella since I didn't think to pack one and like I said it's rain season here. One of our preceptors and the Purdue Global Health resident showed us around town and gave us tips on where to find good souvenirs, how to bargain for them properly, and where to find specific things we may need throughout the rotation. It was a lot of walking; a classmate of mine with a Fitbit would later inform us we walked approximately 6 miles or so! But this was my first experience really sinking into a completely different culture. It was truly another world, and I am attempting to soak up as much as I can.

Lastly, today was my first experience with some of the hardships that I will face at the hospital. I don't know any patients yet, but while we were busy rewriting out medication record forms in the wards, I heard a woman begin to cry coming from the men's wards (wards are separated by gender). I have witnessed a lot of crying in my lifetime, but nothing has come close to the audible pain and agony that was emanating from this woman. I walked over to see what was going on, and I found her, completely inconsolable, sobbing onto a blanket covering what I can only speculate to be her now dead spouse or brother. Bear in mind: there are no single rooms in this hospital. There are wards that are divided into open cubes, which each have about 10 beds in them--usually with more than one patient in them lying head to toe--with no doors and a narrow path that connect them together. A curtain was pulled on one side of the bed, but that was all the privacy she was afforded--not that it mattered. Oblivious to the world around her, her anguished howls echoed through the entire hospital for what felt to me like an eternity. I will probably never forget it as long as I live.

Happy times and sad times alike are surely in store, but one thing is certain: I will come out all the better for it.

"The best time to plant a tree is twenty years ago. The second best time is now." ~ African proverb