There’s going to be a lot of variety in the type of medical work I’ll be doing in Kenya, a lot like what I’m doing now as a resident. In classic family-doctor style, I’m going to bounce between different areas of the hospital and the clinic. Each place I go, I’ll be supervising and teaching residents who are learning to be family doctors themselves, as well as mid-level medical providers (“officers”) who get a year of supervised training, and then are turned loose to practice on their own. I’m hoping to take everything I’ve been blessed to have learned through experience, teaching, mentoring and study in medical and residency here and pass it along to them.
Some weeks I will be in the Obstetrics-Gynecology area, AKA the Maternity Ward. The nurses do a lot of the heavy lifting, and I will be available to troubleshoot complications. I’m also planning to be trained to do C-sections, since there aren’t a lot of OB providers as back up like there are in the U.S. Prayers as I learn surgical skills would be appreciated.
Some weeks I will be in the Adult medicine wards – this is a general medicine inpatient floor. It looks different – see the picture of the Coast General Province Hospital I rotated through in Mombasa as a student back in 2014/15 – but the rhythm and flow of the work is similar. The men are in one ward together, the women in another, since there aren’t private rooms or much privacy at all. The residents and medical officers will watch over the patients around the clock, and I will round with them as a team each day when I’m assigned to that ward (“rounding” involves reviewing each patient’s medical information and current issues with the team that’s taken care of them so far, talking to the patient for an update on how they’re doing and discussing the best plan going forward).
Some weeks I will be in a pediatrics ward – like the adult ward as far as how the day goes, with a mix of problems. Common problems for children include dehydration, diarrhea, fevers, trauma, broken bones, etc. This often includes a nursery for newborns with complications that need to be in the hospital; difficulty feeding, infection, prematurity.
Sometimes I will help in the clinic – ambulatory medicine. I’ve always loved clinic in the states, getting to see so many different problems, seeing familiar patients and their families over time, and hopefully a lot of the medical problems will be similar to what I’m used to seeing in Chicago. I’m planning to brush up on tropical medicine (diseases like Tuberculosis, Malaria, parasitic diseases, etc.) and HIV/AIDS care before I go.
It’s going to be a very mixed set of skills required, and I’m so grateful there are some very experienced physicians at the hospital to be good role models as I adjust. Each day is going to bring something different and challenging, but I love having the chance to pay forward what I’ve been taught and be part of a new generation in medicine, and that makes the challenge rewarding.