Hospital Shock

by Tywonn

A third world hospital turned out to be quite . . . shall we say, a learning experience. I was given the grand tour of Kijabe Hospital in the small town of Kijabe, Kenya. Several of the staff members are missionaries. The units that house men, women, children, and intensive care patients have multiple patients all in the same room, sometimes with 8 beds lined up close enough that one patient could reach out and touch the other next to him or her. A few curtains are strung across the rooms, but not enough to provide each patient with privacy. Some of the units smell foul, mostly of body odor.

In the theater (surgery department) I changed into scrubs with a hat, booties, and mask, and was given free reign to observe any of the surgeries in progress. Several people even suggested that I scrub in. I was impressed by some of the ingenuity that I saw which allows the surgery department to function and a little mortified by other things that I saw. For everyone out there who works in surgery, you’ll find this to be interesting.

There are not enough nurses for each room to have a nurse and a scrub tech like is typical in the United States. Some rooms have 2 scrub techs and no nurses. Either way, 2 people are assigned to each room to fill the responsibilities of scrubbing and circulating with the two staff members switching roles for each case.

The hospital does not have heat or air conditioning, so if fresh air circulation is needed, the windows of the operating rooms (OR) to the outside are opened; however, if any flying insects enter the OR, they are chased down and killed. I have to say, even though I felt quite hot at times (and I wasn’t even wearing a jacket), I never once heard a surgeon complain that it was too hot.

Some of the machines used are the same as what are used in the OR I work, while others are just older versions. You will be comforted to know that items such as syringes, hypodermic needles, suture needles, IV tubing, and gloves are treated as disposable items just as they should be. Cloth gowns, drapes, and metal basins are used and are, of course, reusable. Items such as electrocautery pencils, bovie tips, grounding pads, suction tubing, suction canisters, laparotomy sponges, and anesthesia masks and tubing are treated as reusable items (here in the U.S., these items are disposable). Laparotomy sponges are laundered and then resterilized. Electrocautery pencils and tips are soaked in a solution for an hour and then considered sterile. The anesthesia items are also soaked for an hour, hung to dry, and then reused.

The hospital does not have sponges with an x-ray detectable strip for surgery. A cotton roll is purchased, cut to the appropriate size, grouped by fives, and then sterilized in metal containers that remind me of the television show M.A.S.H. where they are removed from the sterilized container by the circulator using a sponge stick that soaked in a solution and then placed on the back table for use.

As shocking as all this sounds, I am told by the other missionaries, that Kijabe Hospital conditions are much better than most of the other hospitals.

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Filed under hospital, Kijabe, patients

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