12/31

I the day rotating through the general and trauma surgery wards. I have not [yet] shadowed surgeons in the US, so I am unfortunately able to com First thing in the morning, I was most surprised to see several policemen (armed with machine guns) surrounding a young child with a severely swollen abdomen and several bruises on his face. I later learned that he had been abused by his mother, and would be taken to a shelter after surgery.

One surgery had to be rescheduled because the hospital was low on potassium solution. The surgeons informed me that this occurs at least twice a month. Orthopedics allowed me to see engineering meet medicine, and I was amazed by the level of creativity surgeons must possess in the "simplest" of fractures. Leg braces were stabilized by actual weights (i.e. standardized hunks of metal) hung at calculated angles. One individual has the job of conducting these calculations; to be qualified for his job, he had to complete a one-year certificate program after high school.

One patient was leaking fecal matter and fluids through an abdominal tear. Surgeons repaired the tear, created a stoma until the point of surgery heals completely, and told the patient to come back in 3 weeks.

Another was brought for a post-surgical follow-up. He had been born without an anal opening. Surgeons created the opening, but he had to return every day for a period of three months so the anus could be dilated with a standardized piece of metal. There were four additional patients throughout the day who needed this procedure. The last was unable to pay for future visits, so the surgeon gave her the instrument to take home and do at home. This woman was more comfortable in my native tongue of Hindi, so I discussed with her the importance of continuing to use the instrument even if it makes the child uncomfortable--the anal opening would clinch shut and another surgery would be necessary without daily perturbation.

At the end of the day, we booked the operating theather for three patients. One had a worsening aganglionic megacolon and would undergo a colectomy. Another had hypospadias and needed surgery due to fertility issues. The third had an ascended testicle due to a sports injury and required immediate intervention.

My time in Kenya so far has been a flurry of emotions. I have witnessed grave medical consequences of ignoring symptoms, as well as severe repercussions of being malnourished and impoverished. I'm looking forward to being back on US soil within a week or so and reflecting on my trip. Unfortunately, I will be without internet for the rest of my time here.