No personal protective equipment

tb meningitis

Day one of rotations. In true African spirit, our ride to the hospital (2 blocks away) arrives 20 minutes late. We travel the congested streets to Kenyatta National Hospital to meet with Rosie, our preceptor during our week at Kenyatta. We have a brief tour of the hospital and main pharmacy before heading up to the ICU to attend rounds. Being a very critical care kind of guy, I'm really excited to see how things are different in Kenya versus back home. We arrive on the unit. Around 20 patients lay in beds in a large room, all attached to new Philips vital monitors, respectable ventilators, and IV lines. Not much different than a patient at Grady. There are no individual rooms here, but rather a large open space with patient areas separated by curtains when desired, which wasn't often. We start off in rounds, which has a team of about 12 people - pretty large by most standards. The consultant (Kenya's attendings) leads the teaching rounds with the rest of the registrars and house officers (residents and interns). He's not shy to include his American visitors also, asking us about monitoring parameters for high dose acyclovir, physiological mechanisms of paralytics, and mechanisms of action of antibiotics. We saw a variety of cases, from broken limbs to refractory seizures to TB meningitis to ascending paralysis from Guillain Barre Syndrome.  Treatments aren't too different from back home, and the team works quite similarly to its American counterpart. Oh, and they don't use personal protective equipment. Most infectious patients back home are locked down in isolation rooms. No such thing here.

The main pharmacy is different. Everything is completely manual. Orders are delivered to the pharmacy, reviewed manually, billed manually, pulled manually, compiled manually, and nurses pick up prepared meds. Their inventory is completely manually kept. Their refrigerator was a large room cooled to 2-8 degrees Celsius and enclosed by a large wooden door. 

vacation

We spent a little more time in the main pharmacy, but after a few questions, our preceptor lets up go early for the day. We also confirmed that we could leave early on Match Day and on Friday for our vacation. 

Speaking of which, we are OFFICIALLY going to Mombasa's Diani Beach Friday at 6:30pm! I booked my flight just before Erin, and naturally when Erin went to select her flights, our return flight wasn't available any more. I called up Kenya Airways to make sure this was true, and they said there were seats, but for nearly $100 more than my fare. After a little internet searching, we got her on the same flight for a little more money than my fare. Regardless, our trip is confirmed and we'll be drinking on the Indian Ocean Friday night! Trust that Saturday and Sunday will be spent lying under the equator's burning sun, occasionally cooling off in the cool ocean waters. Sorry in advance for having fun.

travelers

We explored another hostel night that's nearby just to see what else is out there since we're here for so long. Considering moving there next week when we're done rotating through Kenyatta. There were definitely a lot more travelers versus church workers at the other hostel than Flora. Would be much easier to meet travelers like us.

Anyway, we're settling into our room about to watch Pulp Fiction. I know it wasn't an interesting post, but thanks for reading!