Sikukuu

Today is a sikukuu (holiday) here in Lindi. I'm not sure if its a national holiday or just a regional one, and I'm not sure what the holiday is celebrating. In any event I went into work today to check on the patients.

This morning my hospital driver didn't show up (because the hospital car had a "flat tire") so I started walking to the hospital. Half way to the hospital I ran into the electrician who was on his way to my house to install wiring to fix the water pump.

I turned around and walked back to my house with the electrician and waited while he installed the wiring (surprisingly only took him about 15 minutes). When he finished, I called the hospital and requested that a car come pick me up. By about 9:30 a driver came and took me to the hospital.

Arrived in maternity department and was surprised to see one of the assistant medical officers in the middle of examining a patient. I figured on a sikukuu he would be at home "resting" but I was pleasantly surprised. He is very committed and motivated to give good patient care....

The patient he was examining had a full term pregnancy with the fetus in footling breech presentation (in other words, the baby was sitting upright in the uterus with one of the legs extended and foot protruding through the cervix). Luckily there was no cord prolapse and the fetal heart tones were normal so we took the patient for a cesarian section.

Usually the anesthestists and nurses are really good about being efficient in transporting the patients from maternity to the OR and they were good again today; however, being a sikukuu today we had to call the anesthetist in from home.

Long story short, we waited about an hour for the anesthetist to arrive. Luckily the baby did fine with good apgars....

After the c-section, we had one post partum tubal ligation to do. The assistant medical officer told me he does this procedure under local anesthesia. I was surprised to hear he does this procedure under local, as I have always done this under spinal. I watched to see how much pain the patient would have and like I had expected, the patient had more pain once the AMO entered the peritoneal cavity; however, she didn't seem to be in a whole lot of pain.... After the tubal ligation, the patient walked back to the ward by herself:)

I passed back to Maternity to check on everything, and things were quiet, so I went back to reception to wait for the driver to take me back home. The driver almost arrived when a nurse said that two patients needed ultrasounds.

The first patient was really sick! She delivered a nonviable baby at another hospital about three weeks ago. Now she came with fevers, nausea/vomiting, abdominal pain and a very distended abdomen! The ultrasound showed very dilated loops of bowel suggesting an ileus. We admitted the patient to receive antibiotics and to get a nasogastric tube.....

The next patient came with abdominal pain and a large pelvic mass per the chart - the ultrasound showed a intrauterine pregnancy of 22 weeks. The patient was admitted for a further workup......

I went back home and fed my dogs (Bush, Obama and McCain). Then called for transport to take me into the town to run a few errands.

This weekend I'm going to go to Ndanda for a regional meeting. Just found out there was change in venue. I'm looking forward to returning to Ndanda and seeing everyone (almost everyone) and my old house......

I'm heading to a restaurant down the street to eat nyama ya kukuu and chipsi (chicken and chips).....next time I'm putting up pictures of my new dog Bush (who btw has had a bloody nose for the past two days:() She still wags her tail everytime I see her - nice of her to pretend she is happy to see me.....