Day One in Kijabe

     We arrived in Kijabe at about 10 or 11am on Wednesday the 18th. We dropped our stuff of at the house and went to the hospital to get our pagers and phones. Our orientation was thorough, but a bit of a whirlwind. We discovered early that I was to be taking ICU call the first night there. Dr. Newton met us and showed us around. Here's some highlights from our first day:

This is the Emergency Department (called Casualty). There are (obviously) only a few beds, and most of the  patients who come through here are victims of traffic accidents. Apparently, the country has been flooded by motorcycles imported from China, and helmets are not required.

The windows and doors are always open at Kijabe. Here Dr. Newton is pointing out the Ultrasound Room on the right, and the stairs on the left lead to the medical Director's office. There is no roof over the stairs, and you'll note the drainage ditch under the stairs.

This is the blood bank. All blood products are whole blood, and families have to donate for elective surgeries with significant anticipated blood loss.

This is the men's ward. The wards are often overflowing, and multiple people are packed together in small spaces. The nursing rations peak at 15:1.

The Chai Room: 'nuff said.

Here's one of those ambulances I mentioned earlier. This is actually the Cadillac edition ambulance because it has oxygen tanks (which the others often don't). 

This is the metal shop. The hospital makes everything on it's own for the ORs and wards. Electronic equipment is frowned upon due to the fact that it can't be easily upgraded or modified.

This is downtown Kijabe. Everything you need can be found here.

This is the ICU. There are 5 beds total. I admitted two patient's my first night and filled the unit. One of the guys arrested in the OR from abdominal compartment syndrome (hyperdistention of the abdominal cavity by fluid that basically prevents blood returning to your heart). He received some CPR in the OR and came out all hopped up on epinephrine. He gradually deteriorated overnight, but is doing much better in the AM with some thoughtful care.

The crash cart. Also handy for tool storage.

This is the anesthetic care record for the guy that arrested in the OR. Kenya is a deeply religious place, and prayers are said before every surgery. As you can see, prayer is a checkbox for the pre-procedural time-out.

A glowworm we found on an evening walk the first night.

Evening settling down on Kijabe. The evenings are cool and breezy (Kijabe means "Place of Wind")