Jambo! I've now been in Kenya a little over a week and I'm starting to get into the swing of things. It's great to be a part of the IU-Kenya Partnership...there are so many amazing public health programs going on around here and I plan on learning much more about them during my stay. Right now I'm living in the Kenyan medical student dorms which are almost on par with Bard Hall accommodations at Columbia in November (though I do have to walk up to the third floor for bathrooms and there are no showers). Fortunately the IU House is nearby and offers warm water, laundry, and the internet!
My first day on the Labor and Delivery ward at Riley Mother and Baby Hospital was quite overwhelming (and not helped by the fact that I got up at 2:30 a.m. to watch the Packers win the Super Bowl). I got to participate in a C-Section within my first hour there before I even really knew where anything was and what was going on around me. Fortunately babies are born the same way where ever you are in the world, though the amount of support (and pain management) given to the mother varies dramatically (or is essentially non-existent here). The main difference with C-Sections here is that mothers are put under general anesthesia instead of receiving spinal anesthesia so you have to move even quicker to get the baby out before it goes to sleep too. I've never been that much of a surgery person, but C-Sections are fun! Since I'm working at Moi Teaching and Referral Hospital the C-Section rate is much higher than I expected...out of the ~700 deliveries per month almost a quarter of them are C-Sections. All of the mothers from small villages who are having problems or expected problems with labor are referred here so there are always interesting cases.
Fortunately there are a lot of normal, healthy births too. So far I've gotten to do 3 deliveries and I hope to do many more in the upcoming weeks. I've also seen a vaginal delivery of two breech twins (they would have had a C-Section in the U.S. and a C-Section here if there had been time) who were born in the chaos of the examination room soon after the mother came in. It's a great opportunity to learn about the normal progression of labor, but it's not necessarily the conditions under which I would want to give birth. There are 3-6 women to a room on rickety beds (though it should be noted that at least they get their own beds unlike the patients on the medicine wards) and supplies are never available when you need them. Yet, an amazing amount of the time things turn out well with few complications (though there is more post-partum hemorrhage). Now that I sort of have my bearings I really hope to learn a lot in the next couple of weeks on L&D.
Last weekend we went on a fantastic trip to Lake Naivasha and Hell's Gate. After a bumpy ride from Eldoret to Naivasha we took a late afternoon boat ride to Crescent Island where they filmed much of "Out of Africa". We saw many hippos lazing about in the water, elegant giraffes, and lots of zebras (the horses of Africa). The next day we went biking at Hell's Gate and saw many more animals (including warthogs and baboons) and hiked through the Njorowa Gorge near the Central Tower which is a volcanic plug much like Devil's Tower in Wyoming. Then we stopped at the equator on the way home. Hopefully I can post some pictures soon. This weekend I'm taking the opportunity to relax and explore Eldoret a little, but hopefully many more exciting trips are on the way!
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