The hospital we work at is called MTRH - Moi Teaching and Referral Hospital. It is much larger than I thought it would be. There are several wings, and many different units, including Adult wards, Pediatric wards, Hem/Onc Ward, OB/GYN Ward, Newborn Ward, Psychiatric ward, "Casualty" (the Emergency Department), and a few others I am forgetting. The wards are connected by long, outdoor hallways that are lined with beautiful flowering bushes and other lovely landscaping. The outside of the hospital is beautiful, fresh, and welcoming. This is in stark contrast to the inside, as the wards are somewhat dank and foreboding. The Adult wards are called the Nyayo wards. Men and women are in separate wards. Each ward is made up of six large rooms, or "Cubes", three Cubes on each side of the hallway. All three Cubes on one side make up a "Firm". Each rounding team rounds on one Firm within the hospital. The rounding team is made up of Kenyan interns, American doctors, Kenyan medical students, and Purdue pharmacy students. The rounding teams can become very large, and Kenyan people speak unusually softly, like a murmur. Within the hospital, there is so much hustle and bustle, with cacophonous noise interrupting from every direction, that it can be almost impossible to follow the rounds sometimes! Even still, we persevere and do our best.
In our preparatory Kenya class last semester, they warned us about the smells within the hospital. They advised that many times people feel faint and need to stop rounding and rest, since the smells, sights, and cultural differences can be overwhelming. I am glad they prepared us in this way, because I was expecting the worst. The smell is unpleasant, but not overpowering. The most difficult part for me has been dealing with the suffering of the people. Some patients are so sick, it is unlike anything I have seen. One patient was like a skeleton. I was surprised he could move at all, it looked like there was not a strand of muscle in his body. It is heart-wrenching to see the dire needs of these patients and not be able to treat them with the technology and medicines we are so accustomed to having in the US. I have learned about how much we take for granted.
Within each Cube, there are 8 beds - four on each side of the Cube. There is no privacy whatsoever. When necessary, patients are two to one bed. If they are both very ill, they lie head to foot. If one patient is stronger, they will sit on the bed while the other lays. Many times family members or caretakers are in the wards with their loved ones. There are many people cramped into small spaces. Also, if a patient is discharged from the hospital but cannot pay their bill, they must stay in the ward until they or their family can pay. This means that while we are rounding, sometimes we skip over patients. They are not ill, but they cannot go home.
Food for the patients is another issue altogether. There is no breakfast that I know of. Lunch is a thick slice of bread and some gruel. Dinner is not much better. My colleagues and I wonder how patients can gain strength when they are malnourished even in the hospital.
The last thing I will write about is the mops. Kenya is a land of rain and red mud-clay. This red mud-clay necessitates the unending efforts of a fleet of moppers. The moppers shut down half of a hallway to mop mop mop, only to have their efforts ruined when they must switch sides and the traffic takes its toll on their fresh handiwork. In the morning, there are men with buckets full of soapy water who simply throw the water down the outdoor walkways, and then use bristle sweepers to scrub the hallways down. It would be a whimsical sight for a bystander to see so many white coats on their tiptoes trying not to slip in the suds.
