Donating Blood

There is no blood in the hospital.  This is especially concerning given the number of patients I see each day with incredibly low hemoglobin levels.  Patients wait until they're deathly ill before seeking care, making for a greater challenge with our limited resources.  This week, I admitted my record low hemoglobin of 1.8 (normal is 12-18) along with several others with levels of 2.  When I ordered fluids to help give them some intravascular volume, I received some doubting looks and questions of concern as the other staff were worried about diluting the patient's already low blood level.  No worries, I tried to explain, patients need the fluid to help their blood pressure and move those few red blood cells around the body.  Reluctantly, they gave the fluids, but the biggest battle was getting these patients some blood. 

I offered to donate my own blood for any one of these patients, but was not a match.  All I could do was encourage their family members to donate their blood to help their loved one or another sick patient in the hospital.  While on rounds, a friend of mine offered to donate blood for one of the pediatric heme-onc patients but had the same problem.  Interestingly, immediately afterwards, she had two Kenyan medical student "volunteers" being pushed by the registrars (residents) to donate their blood for the patient.  Aww, the joys of being a medical student, always forced to do whatever is needed for the team and/or patients.  Even at the IU House, there are signs advertising for a blood drive here in Eldoret.  Hopefully, we will be able to get a group to donate some blood, provide a supply for the hospital, and make a difference for the patients.

Much Needed Vaccines

Last week was a reminder of the importance of vaccinations.  Maybe it's because people think I have pertussis with a terrible relentless cough over the past two weeks...but no, I thankfully have been diligent about getting my pertussis booster.  The TB cough monitors around the hospital have been keeping a close eye on me, so apparently that's going to be next on the work-up.  Anyhow, this week brought me several patients with measles in sick child clinic.  Insistent that the mzungu see his child, one father carried his limp, ill son over to me for care.  With a fever, injected eyes, runny nose, spots in his mouth, and a rash spreading from the head down to his chest, I was reminded of the 4 C's of measles (cough, coryza, conjunctivitis, and Koplik spots - I know the last one doesn't start with a C, annoying huh?).  He was weak and having difficulty breathing as he had developed pneumonia from the illness.  Having  never seen measles in the US, I was struck by how sick these children can get.  It is estimated that measles kills about 175,000 children each year, including 18,000 each year in Kenya.  This is especially sad given the availability of an effective vaccine that prevents children from getting such deadly diseases.

Within the same day, I received an e-mail alert about managing a measles outbreak in Indiana.  Vaccinate your children Indiana!  No child deserves to suffer or die from such preventable illnesses.  And let's not even get into the myth about MMR causing autism.  There is a lot of good scientific evidence debunking this myth as well as evidence of fraud regarding the original perpetuator of this myth, Andrew Wakefield.  If depite the evidence, some are still convinced we are harming children with this vaccine, I invite you to come here and see just what suffering can result from the lack of vaccines.

Termites

The rainy season has arrived in full force this week...cold temperatures, rain every evening, and muddy paths every morning.  With the heavy rains, there has been a plague of termites, swarming around the house and through my room in the evenings.  Little did I know I should be eating these insects instead of killing them.  These flying termites are a delicacy enjoyed by some communities in the Western region of Kenya, especially the Luhya tribe.  Eli, our guard, is of the Luhya tribe and enjoyed teaching me about the art of termite eating.  Kenyans will either eat the termites "fresh", meaning live, or fried.  While I might be willing
to try these insects fried or covered in chocolate, I only had the offer of live termites.  Eli picked one up from the ground, plucked off the wings and placed the termite in his mouth.  The worst part was him showing me the termite moving around on his tongue before he finally decided to crunch the termite between his teeth, spraying termite guts everywhere.  Blech, I nearly lost my lunch!  Later that day, I went to Nakumatt for some groceries and found hoards of them flying around while several Kenyans were grabbing them from the air and having a mid-shopping snack, kind of like going to Costco.  =)  While I am usually very open to trying the local foods and traditions, I think I'll pass on this one.   

Signs of the Times

The signs you see around Africa are awesome and can't help but make you smile.  Whether it be the name of one of the hotels or shops, like the Fresh n Fleshy Butchery, or warning signs around town, they speak to the culture and state of this beautiful country. 

Mmmm...just where you want to stay, a delicious hotel.  Many of the establishments have names like this.  Other examples include the Gracious Salon or Blessed Hardware



Not sure this would be my choice for a "Grossary" store but the kids are cute



Not really sure what this means...I figure morning sex would be safer than evening sex when someone might go home with a random partner.  Any ideas?  It's not because they're worried about being late for work.

Signs are often individually done, so they all vary in appearance...love that this guy's wearing a hat

Even at the hospital, the signs are great:

Most Kenyans just squat  wherever to use the bathroom, so it can be confusing when there's actually a real toilet seat. 

And when you're done, please use the running water to wash your hands...no spitting please.

I love this sign trying to depict what illnesses for which you might need to seek care.  Nice graphics!

The collection continues to grow as Kenya continues to educate me on life and culture.  Hope these make you smile as much as I did!