Man vs Matatu

"Man vs Matatu" sounds like it might make a great new TV show.  Instead I have come to dread these all too frequent encounters.  This episode would star my friend Eli after being challenged by a matatu (a mini bus that serves as the main public transportation in Kenya).

Eli and his eldest daughter

The Matatu

Eli, also known as Eli Kubwa (Swahili for Big Eli), is our favorite guard that is stationed six days a week at the gate outside our home.  He is one of the all-stars in our weekly dodgeball and wiffle ball games.  More than anything, I love our daily conversations and the continual lessons he gives me in Swahili. 

Friday night, I was out with friends when I received a call from Sonak (Pharmacist) and Laura (Med/Peds physician), both living here long term.  They were with Eli in Casualty still waiting to be seen; the medical officer had left for dinner.  He was complaining of severe abdominal, back and hip pain.  So back to Casualty I go to care for our trusty guard.

As soon as I walked into the room, I heard Eli calling for me..."Nyumba" (Swahili for House).  He was lying on a stretcher covered in dirt with multiple abrasions on his head and extremities.  I joked with him in Swahili as I began to examine him.  I agreed with Laura's assessement and began the process of starting an IV, drawing blood, ordering films, and getting him pain medication.  The x-rays were normal.  With his continued pain, I wanted to get an abdominal/pelvis CT. 

Little did I know what I was asking for with the CT.  Sadly, the technicians for radiology are not in the hospital during the evening/overnight hours.  There is always someone on call, but they are difficult to get to come to the hospital.  Thankfully, the technician returned my page, but then began to argue with me about not being able to do the CT.  He first asked if the patient had his bowel prep. I tried to explain that for a trauma patient, he only needs IV contrast; no bowel prep is necessary.  This argument went on for a while.  After we agreed on IV contrast only, he then said we couldn't do it because he needed two people, one to push the IV contrast and another to run the scan.  Easy fix I said, I'll push the IV contrast while he runs the scan.  He then stated that there's no radiologist to read the scan at night so we can't do it.  No problem, I can read the CT.  Back and forth we went.  Finally, he said he wouldn't come unless I got approval from his boss.  Fine, I'll talk to the boss.  So another page and conversation later, I got the approval to do the CT.  Still not sure if and when this guy was coming, Sonak and Laura drove to the private hospital to see if they had CT available at night.  It was the same situation there so I decided to keep him in Casualty. 

Not much later, I was pleasantly surprised to see the radiology technician.  We worked out the payment issues for the CT (patients are required to pay before they can get any test) and took Eli for his scan.  Thankfully, the scan looked pretty good with only a few injuries, a couple stable lumbar fractures and an acetabular fracture.  I thanked the technician for his work and went back to Casualty to get Eli admitted with some pain medicine and an orthopedics consult.  Sure that I had upset enough of the hospital staff for the night, we went home.  Another adventure...Oh Casualty, how you challenge me. 

I rounded on Eli the next morning.  Although still in pain, he looked much better and was in good spirits.  He was able to be released from the hospital that next evening with ortho follow-up.  Although sad that he won't be around for a while as he recovers, I am thankful he is doing well and that the matatu didn't win.