Friday, July 6, 2012

End of the first week and headed for the Mara

Today I was busted taking a picture of sheep on the side of the road today by Agnes, one of the first year Kenyan residents.  How embarrassing!  She pulled over and shouted my name from the drivers seat, offering me a ride. 

The residents here are cramming for their exams which will last Monday through Thursday next week.  So that leaves me to all the ultrasounds I can handle.  Sadly, there is a small volume of ultrasound guided procedures, something I was hoping to do a lot of here.  For the trickle of requests that come in, I was able to furnish a half large suitcase full of donated Cook Medical equipment, which the radiologists here graciously accepted.  So far I've done one targetted liver biopsy, of a huge liver mass just below the skin surface.  They reuse automated Bard biopsy devices here.  I have to say, it was quite dull compared with the new ones I am accustomed to.  I get the feeling that diagnoses are not such a mystery here by the time they present to the hospital. 

In the meantime, I'm scanning a lot, and suggesting a biopsy or other procedure as I see appropriate.  Working extremely independently, today I diagnosed more unbelievable pathology including a bulky cervical mass obstructing the cervical canal, retained products of conception, and free intraabdominal air in a patient who walked in on her own (this happened 2 days in a row!).  The need here is indescribable, and I get the feeling I'm just scratching the surface.  Hearing what the medicine residents have to say about the wards at mealtimes seems to resonate with the sentiment that resources here are simply inadequate.  It seems a matter of not just materials and money, but of man power.  So we are helping out with what we can.

There's red mud absolutely everywhere and all over my clothes!

Today after work, we all congregated at the IU House for some beer, market pineapple, and PB&J.  It's our day to fend for ourselves for dinner, and atleast for a while, the conversation is more interesting than searching for real food.  We are planning our 9 hour trek to the Masai Mara tomorrow, to begin at 6 a.m.  For all of our sakes tomorrow, I hope those out on the town mind their intake, as there will be hours of bumpy road to drive tomorrow!  My medicine counterpart, Dara, asks if I will give radiology lectures on the ride.  Lucky for her, I've brought several!

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