These blog entries are the views and opinions of the residents during and after their international experiences, and do not necessarily reflect the opinions or positions of VIA or VUMC.
It was an adventure arriving in Kijabe, to say the least! Every leg of our flight itinerary added an extra flair to our story. Sara La Rosa goes into more detail about our escapades in her blog post, so I’ll just say that I am thankful that we made it safely (and eventually so did everyone’s luggage). I am also grateful for new friends (here’s looking at you Chris Sizemore and Cat Voorhees!) who made getting stuck feel like just another plot twist bursting with laughs and good company. The morning after we arrived, we met with Dr. Matt Kynes for our orientation to Kijabe Hospital. After our tour of the hospital, Sara and I each picked one OR to see the work flow. I picked OR 3, which typically is the OB/GYN room, because the in-room KRNA asked if I could help with TAP blocks for the hysterectomies scheduled later in the afternoon.
My first case is a Cesarean section for di-di twins. The KRNA and I oversaw the student KRNA as she performed the spinal anesthetic. The spinal block set up well and we performed our time-out for the surgery. We prayed for the patient, introduced everyone on the anesthesiology and surgery teams, and reviewed the patient’s name as well as anesthetic and surgical concerns. When the babies were delivered, they were taken to a neonatal resuscitation room down the hall where they were examined by the pediatrics team. The KRNA left the room for a break and I stayed with the student after the babies were delivered.
When the KRNA came back into the room, she asked me if I liked pediatric anesthesiology. She told me I could go down the hall to see the twins if I was interested. I walked over and saw that the second twin had been intubated and there was a large team struggling in a cramped room. I asked how I could help, and the doctor who was managing the airway asked me if I could get umbilical vein access. I had never done that before, so I tried my best to cannulate the saphenous vein in the legs but it was unsuccessful. We switched places and I took over the airway while he looked for IV access. I saw that our monitor showed that the baby’s heart rate was too slow and our oxygen saturations were around 60%. I started chest compressions and we called for help from the pediatric ICU. There were no available ventilators in the ICU, which meant there was nowhere to take the baby.
And that was my first experience on my first day at the hospital. I prayed with the team and after a debrief I popped in and out of other ORs to see where I could be helpful. To be honest, I was looking for a menial task I could do to keep my hands busy and to ground myself. Anyone need an IV? Can I fetch something for you? It felt surreal to be walking in and out of the ORs. It felt like I was flipping through channels on a TV, and I felt detached as I watched each channel pass by. I was humbled by the limitations of what I could offer. I also felt paralyzed by how much our brothers and sisters in Kenya, and around the world, suffer in ways that I am lucky to have never experienced.
Later in the day, I was able to shake off how stunned I felt and that’s when my stomach started grumbling. The daily routine includes Chai time at 10:30 AM and lunch at 2:00 PM. In between cases, the student KRNA asked me to follow her. She took me upstairs to the Chai room and told me to sit down. She made me a cup of Chai, my first one in Kenya. It was made with fresh cow milk and loaded up with sugar. The warmth and sweetness were comforting and it reminded me of when I visit my family in India. Cadi didn’t sit next to me; she told me she would be back. She opened her bag and gave me her chappati, which was her lunch and was meant to be eaten later that afternoon. She told me she could eat anytime, but I should eat now. I was so grateful for my first friend in Kijabe.
When it was lunchtime, the KRNA took me to the Chai room again where lunch was served. Lunch was rice, lentils, and cabbage. The KRNA sat with me and she taught me again how to say her name. Bedjouk and I talked a little bit, rested a little bit more, and ate the most. We wrapped up our day and I headed home. The next day, Bedjouk found me at lunch and told me to open her bag. She brought me a banana. She told me she wanted to know how African bananas compare to American ones. As I ate it, she told me the story of how she loved a man she met in college, who was from a different tribe, and how her family’s house was burned down because of it. She had planned to marry someone else, who was of the same tribe, to save her family. But in the end, she married the love of her life and they moved from their hometown in South Sudan to Kenya. She worked during the week in Kijabe and on the weekends she visited Nairobi to see her husband and their beautiful 2-year-old daughter named Blessing. She showed me pictures of her wedding and her family on her phone. It was in this moment, eating an African banana in the Chai room and listening to a modern love story, that I saw the beauty of Kenya and how rich its people truly are.