Gap medic day -1,0,1

Up at 5am to catch our flights except today they aren't together. Mom is leaving to Paris and then home, I'm headed to DarEs Salaam to begin with gap medic. Mom goes to the washroom in the Dubai airport and the lineup was so long that her flight was boarding as she came out, our goodbye was cut short. A hug and she runs through her gate. Another long flight for me, I read my book, arrive, get my visa and meet up with our driver. 4 of us were on the flight from Dubai, 3 will continue on to Iringa. We stay that night in a hotel, collect a couple arrivals in the morning and take a van to a public bus and 9 hours later we arrive. There is 8 of us starting this week, current students leaving next week, and one long term student. We have an orientation, supper, and play some uno before heading to bed. Monday it begins.

I'm starting in the surgery department with Eenis and Toni. Me and Eenis are new and Toni on her last week is surprised we are starting in surgery, it is an intense way to start. Every morning once at the hospital starts with a meeting with the department you are in, the mentor head doctor a couple chiefs and a dozen or so nurses and trainees. Monday Wednesday and Friday we do rounds through the surgical wards, Tuesday and Thursday are for operations.

Day 1 Monday we start in the close care ward, the wards are all just single building separated by walkways, the first patient has a bullet in his cheek, he has had it for a couple days since he was shot we talk about is, plan to remove it on the next operations day. Another patient in that ward has flys around him, looks old and thin. He has a bowel obstruction, the doctor removes his blanket, and shoves a couple gloved lubed fingers in his rectum checking for stool, no stool thus complete blockage. Meanwhile the nurse is wiping thick yellow and red spit from his mouth, he has a couple lines of blood on his feet and body, the flys are almost only hovering around him.

The close care ward was pretty small and we soon moved to the female surgical ward. Over the next couple hours I was to cry, vomit, pass out, punch a wall until my hands are bleeding, and cry some more. Eenis has to leave a couple times for a few minutes then an hour feeling faint from the heat. There are babies and children with cages over them to keep their blankets off their burned bodies, open sores, scrapes, and cuts. Sometimes there is a little gauss, often there is nothing. A baby with her hands, feet and face covered in burns, screaming as a nurse removes some gauss from her foot, at the end the tip of her big toe and nails comes off with the bandage, she cried and cried. Another baby with abrasions covering her face, her nose ans ears missing skin, a fractured arm, vomiting everything she's been fed for over a day, they have to give her an IV so she can get some fluids to stop her worsening malnutrition and dehydration. The doctor ties a glove around her arm and spends 15 minutes over 3 attempts to get the vein.

Note at this point I'm using my iPad as a keyboard and not a text pad so I can type faster but I will be much more prone to missed spelling and grammar errors, especially due to the difficulty of making the auto correct not changing things I don't want changed. I only have so much fee time each day, and little of it with internet...

We came across next a middle aged woman with burns from a fire, the back oaf both legs anus to angles were covered in second and third degree burns, again a burn cage and blanket covering her. Next a woman with a neck abscess who has had it for 15+years! the size somewhere between a soft and baseball. Last week she came to the hospital and had it drained. Today it was cleaned , it has a looney sized hole, the doctor using a pair of tongs would soak some gauss in water and stick it inside scrape pull out and repeat. After a half dozen to a dozen blood and puss covered swabs a new bandage is placed and taped around her neck. Next s woman who 4 days prior had started feeling pain in her lower pelvic area, 2 days later it started to swell and within that day burst. She came to the hospital and is certain to have gangrene, that's where we are now with a palm sized area of deD tissue and puss, surgery scheduled for Tuesday.

The rest are a couple of constipation patients to be discharged that day, and a few femur fractures with crude traction splints with nothing but day to day monitoring happening. Average time in bed is 6-10 weeks before the bones set and reveal enough for discharge, that time is cut down to 24 or 72 hours if surgery can be done inserting rods and screws, but due to limited operating rooms, equipment, surgeons, money... Most. Re stuck eating the weeks. If the patient or family has the money, or if it is an emgergency there is often a small delay for surgery.

The traction splints are usually just a wrapping around the knee to under the foot attached by rings of gauss and tight wrappings around the leg. Then a rope attached from the knee wrap is placed over a small divet on the end of the bed and tied to a circular weight.they then spend the full time to recovery in a bed in the ward. Maybe a 1/4 of the female ward beds were taken by femur and pelvic fractures with traction splints simply waiting.

When it was fresh and raw I had more to write and was much more disparity than I am now, but damn one in the hospital ended by 1pm and the rest of the day was very relaxing and fun. By the end of the day I was in a much better state of mind, and by today(Wednesday) I am enjoying most every moment. I'll look to finish the rest of day one, and update my first surgery day, and ward runs day 2 tomorrow. Now that I've remembered to bring a pen in and not just my notebook I have notes on every patient examined so writing on them will be much better and easier, and I'll have more space in my mind to write about my other 12 waking hours And not only my 6 in the hospital.