African Queen!

Picture 1: Vigdis ventilating a woman getting a VP shunt due to hydrocephalus.
Picture 2: Muddy and Per working on a 12 year old boy with septic arthritis.
Picture 3: Victor giving epidural.
Picture 4: Muddy and a malnurished child with hydrocephalus.

Oh yeah!! I rocked operating theatre today... or at least I had a lot of fun! I will miss "my people" so much! Dr. Zakaria, anaesthesists Paulina and Victor, scrub nurses Juliana and Muddy, and of course Vigdis! And everybody else.

Today I did my first surgery on my own! Bilateral orchidectomy (fjerning av begge testikler), and i LOVED it! After that I assisted on tuboplasty. A woman that could not get pregnant, we opened her tubes. Hopefully she will get pregnant now.

Tmr is the big day! Safari here we come! Hope everything will go smoothly. The roads are pretty bad nowadays since its been raining alot. So please pray for us! We dont want to die yet, we are far too young! And me, Per, Clement and Muddy still dont have a place to sleep. Really hope something will show up, I dont want to sleep in the car or in a tent in the safari park. Please give me a hotelroom!!

Another thing, people keep writing to me on facebook. I DONT have facebook here. So please dont be mad that i dont answer!

Peace out for now!

Pole sana...

Some pictures from christmas eve and my trip to Lake Basuto

Yesterday was another horrible day in the operating theatre… At lunchtime we got to know that some people that were attacked by a hyena would come very soon. When we came back from lunch the people had arrived. It was actually a family that had been attacked by a crazy hyena with rabies. The hyena had gone into their house at 1am at night at attacked them. The small daughter was killed at the spot, the parents got fingers and hands bitten off and the 5 year old son was in a horrible condition. His arm was more of less bitten off, only thing still intact was the flexor tendon. So his hand was amputated. He was also bitten in the thigh, but the worst was his face. From his eyebrows up the back of his scalp the hyena had taken a big bite, skin and flesh was missing. Also an area of his scull was missing and you could see straight into his brain. So this child is not expected to live… really tragic story. I usually don’t have problems looking at disgusting things, but this was too much for me. I just had to turn away, have never seen anything that horrible in my life. I have some photos but its not so appropriate to publish them on internet like this… but if anyone is interested, just let me know.

There’s also this young girl, 23 years old. She most likely has a soft tissue tumor, sarcoma, that are eating up her face. She has an open cavity into her tounge and pharynx, no nose, lips or cheeks left. Cant belive she waited 1,5 year to go to the doctor. Now she probably just has a few months left to live…

Enough of the bad news! There are also some good ones! I have decided to go on a safari on new years eve to Tarangire national park. We will look at some animals during the day and celebrate new years in the evening inside the park. Really hoping for some good food and drinks! Have been missing that! I am going with Vigdis (anathetic nurse), Bjørg (scrub nurse), Stine (Bjørgs daughter), Per (retired surgeon), Clement (Tanzanian that used to live in Norway and speaks Norwegian) and Mohammed, my favourite tanzanian scrub nurse! Will be a lot of fun I think! We will drop Bjørg, Vigdis and Stine off in Arusha the 1st of January. They are flying to Zanzibar. Me and my boys will spend the night in Arusha or Karatu before we head back to Haydom and more surgeries!

Rain, rain and rain again...

A small update of the minor things that have happened the last week. I usually don’t have so much time to write but now it’s a long weekend and I am trying to take some time off. And its raining so I cant go out... boring!

Last weekend I went on this piknik with Clement, Martina and Victor to Lake Basotu. It was really nice. We ate grilled catfish and chips and just chilled. We also saw 3 craters made of meteors and we visited a datoga family. That’s a tribe that lives in really primitive houses. Somehow we picked up these 2 datoga women on the road and drove them home and that’s how we got invited into their house. Not bad! Can’t say they smelled so nice though…

Sunday was the big confirmation day in town. I was invited to the confirmation of one of the anaesthetists, Youtham’s, son. First there was a 4 hour ceremony at the church. Crazy. Luckily I came 1,5 hour too late and I went home to have lunch after 1,5 hour. Smart move! After that we went to Youthams home, ate some African food (surprisingly they had spoons so we didn’t have to eat with our hands) and met a lot of nice people. Next time I will drop out of the church thing and go straight to the afterparty, that’s for sure!

Christmas eve is a day with a lot of things going on here. After the morning rounds we all divided into the different wards and were we sang some Christmas songs, gave the patients some tee and cakes and just celebrated with them for a while. I decided to go to Lena ward which is the pediatric ward. I brought a lot of balloons and pens to give out to the children. Was a lot of fun!
We were told that Christmas eve was going to be the nicest Christmas ever in the guesthouse were we eat our meals. We got a lot of Christmas decoration that we decorated together with the people working there. It really looks like a collision of American, Norwegian, Chinese, Hawaiian and African Christmas. A lot of blinking lights and crazy colors, it really looks like shit but its also cosy! We were expecting this supernice dinner with pork meat, potatoes, carrots, sauce, surkål and much more. (That’s what we were told we were getting!) Dinner was served at 7pm… and what did we get? Fiskegrateng og surkål/A nasty fish dish and sour cabbage. (And that’s not the good fiskegrateng we get in Norway, NO, this is some disgusting spaghetti fish shit.) We didn’t get potatoes or anything. SUCH a disappointment. But we made the best out of it and we had a lot of fun. I got a present from Magne (he is a 70 year old plummer, really nice and funny guy) that said: To Kristin, From Him. And it was this really ugly ring with some green paint on and in the middle it said: LOVE. Funny! Still, I were it every day! Here in Tanzania they think its really pretty.

Other than that its raining and raining here. Today I am going in another confirmation but it needs to stop raining! Cant walk several kilometres in this weather. Yesterday I went to Clements place, watched a movie and had a small party with him and his friends. He lives 2 km from the hospital area and there are no taxis here and its not safe to walk alone in the dark. So I got this ambulance driver to take me in his ambulance car. And more than money he wanted alcohol. Yes, he drinks and drives an ambulance. Crazy. What can i say... This is Africa!

My christmas gift

1: The result and my Pepsi treat!
2: Baby Cristiani and Mama Bertha

23rd of December I scrubbed in on a surgery with doctor Zakaria. It was supposed to be a psoas abscess. Usually he lets me be the surgeon and he is the assistant, but luckily this time he opened up and did most of the work. When we opened up we found some old blood, so we figured it might be a hematoma in stead on an abscess. Suddenly it started to bleed a lot and Zakaria pulled out a lot of debries from inside the woman. Then she started to bleed even more. I have never seen so much blood in my life. I looked at the things he pulled out and it looked a lot like vessel wall… So… aneurysm, not an abscess! The bleeding continued and the woman went into shock very fast. And I understood where this was going. I started feeling very bad, felt really pale, started to feel cold and sweat, my vision got blurry… so I sat down for a while, and then 2 other experienced surgeons came to try to repair the aneurysm. The woman died, she was only 38 years old… Would not have happened at home.

In the other operating theatre another woman was also bleeding out. She just had a cesarian and she went in shock before the baby got out. So the baby was not doing very well and just accidentally I passed by after the baby was out of the uterus. He had an OK color, but was completely floppy and didn’t cry. And the nurses didn’t do anything about it. So I started stimulating him and we did the suction aspiration. And after some time he got better and in the end he cried a little as well.

The mother was sutured up and sendt to ICU. At the ICU the bled very heavily from her vagina and the nurses there sent her back to the operating theatre. She went into shock and she was intubated, and she kept on bleeding. In the end they decided to take out the uterus. A little bit too late I thought… nobody thought she would survive. Her bloodpressure was so low it was not possible to measure it and she started gasping for air like people do just before they die. So I just left, I didn’t want to see another young mother die on the table that die. There was no doubt in my mind that she would die.

Later in the evening I heard that she had been transferred to ICU again, and she was barely alive. They didn’t think she would make it unless she got some more blood transfused. She already got 1,5 liters from her relatives. Here in Tanzania there is no blood bank, the relatives have to provide the blood. So everything was used, no more blood left. And she would probably not make it without another half a liter of blood. So I checked her bloodtype and I was pretty sure we had the same; A +. At 8pm I went to the laboratory and told them I wanted to give blood to this woman. They said; No problem, hamna shida! I waited, they tested my blood, A +, HIV negative. Then they said I should come back in the morning since they didn’t have all the necessary equipment. I begged and asked if there was no way I could give blod today. Then another woman came and asked if I could buy then sodas. So I asked if I could give blood if I bought them sodas. No no, this is not how it works, they said. But I still bought them sodas and after that it was no problem and I could give a bottle of blood. When I was done I took the blood to the ICU but there they said it was not necessary, her haemoglobin was 8,0. I really wanted her to have the blood as soon as possible since it was so fresh. So I stopped by the doctor that operated her and she also wanted her to have the blood now since the platelets and coagulation factors were still good to go and that’s what she needed. So she got my blood. The next morning when I came, she was extubated, she produces urin, she could talk a little bit. My Christmas miracle! Really amazing! And now they have named the little baby boy after me: Cristiani! Today I have him some baby clothes and I have decided that I want to support him with some money every month so he can have a good education.
So my only Christmas present this year was a bottle of blood! But it was the best ever! 4 children still have a mother and her husband still has a wife.

Straight after I gave blood Dr. Zakaria called me asking if I wanted to assist on a Cesarian. So I went there. Pale as a dead body, but of course the blacks think I am pale no matter what so they didnt notice. I pulled through but it was really good to go to bed that night.

Mzungu life!

Picture 1: Disgusting food at the marked.
Picture 2: Soda time at the marked!
Picture 3: The marked
Picture 4: Singing at the doctors-meeting

Another week is finished. Don’t think I will go to the hospital this weekend, really exhausted. Last few days hasn’t been that exciting at the hospital really. Just a bunch of cesarian sections. Now I have somehow ended up being in charge of the labour ward. Its ok and I learn a lot, but I really feel stuck there. I would rather spend my time in the operating theatre.

Thursday we went to a big marked 7 km outside town. Didn’t buy anything, but it was interesting to see. They sold a lot of used shooes and clothes, tobacco mixed with cowdirt and stone, grilled meet, maize-beer, cooked intestines with bloodsauce. Pretty nasty. There was even a Tanzanian woman that liked my legs so much that she wanted to touch them and marry me! I politely said no!

Yesterday I had dinner and drinks with 3 Tanzanians, Clement, Victor and Martina. Good food, good company! Can’t complain! After that I went for a beer with the Norwegians Vigdis and Magne. Good start of the weekend. Today me, Martina, Clement and Victor are supposed to go to Lake Basuto but the car we were supposed to borrow broke down. But now we got to borrow another one so I guess we will be on our way soon! Thank god I was exposed to some African Time in Hungary! (And then I am especially thinking about Enddie!!) If not it would have been hard for me here!

Other than that we are now practising our performance for Christmas. Every ward have their own thing they show at the Christmas celebration. And the doctors and clinical officers are singing a song and doing some dancemoves. So nowadays the morningmeeint consists of 10 minutes of information about newly admitted patients, and then 20 minutes of singing and dancing. This guy always comes in after a few minutes with this big ass keyboard on his shoulder and he starts playing this bad discobeat! And we have to sing, and we sing in 3 different groups with different tones. Its actually nice. The Tanzanians really can sing. I cant!

Sunday I am invited to a confirmation to a 16 year old boy. He is the son of one of the anesthesists in the operating theatre. Can be interessting! As long as I dont get any badly cooked goatmeat I am good to go!

Africa works!

Pic 1: Whats left of the arm of the mining accident guy.
Pic 2: Closing up after a C-section.
Pic 3: The very bad open fracture of the mining accident guy.
Pic 4: The very bad spine fracture of a 12 year old girl that fell down from a mango tree. We reduced it and but cast on it and amazinglt she can still move her legs.
Pic 5: Dr. Per and anesthesia nurse Vigdis

Africa workds, but very slowly! And now I have started doing some work as well! And I like it! But the injuries here is not like home where the old people fracture bones falling on the icy rods and kids fall on skateboards and trampolines. No, here the patients fall from mango trees and fracture their spine, get kicked in the stomach by donkyes and perforate their bowels and get arrows shot in their heads.

In the weekend I tried to get myself some operations, but it wasn't that easy. Went on rounds on saturday and it was ok. But no operations and there was no deliveries either. And every time I went to the orphanage the kids were sleeping.

Sunday I just chilled and tanned in the backyard with 3rd year med. student Mark from Sweden and doctor Johan from Denmark. Not bad either, but I prefer my surgeries!

Monday I decided to not miss ANY operation. I wanted in on everything! So I ended up waiting in the operation theatre for hours and hours... Everything is in African time, which is very very slowly and inefficiently. I think they would have been shocked if they came to Norway or Europe and saw the speed people are working at there. But in the end of the day when eveything is delayed by 4 hours they start to speed up since they want to walk their 20 km home before it gets dark.

There's this amazing anesthetist in the operating theatre. His name is Victor and he is pretty damn good!! I went home on monday at 4pm but I gave my number to Victor since ha was on call. 30 min later my phone called and it was VICTOR, my hero!

There was a evactuation of a missed abortion and a laparotomy of a 20 year old man with volvulus (tarmslyng). Started off with the young man and I have never seen anything like it. His intestines just popped out of his abdomen when we opened him up, and it looked like 6 meters of really thick good smoked sausage!! (I was hungry, I actually missed my dinner that day). No wonder he was in pain... Everthing went well, untwisted the volvulus and emptied his intestines. But the next day we got to know that he had died during the night due to aspritation of vomit... so unnecessary and sad.

After that there was 2 curettages (utskrapning etter spontanabort). The doctor on call was buzy so Victor asked if I felt comfortable doing it. And I said yes. And it went very well! So i did one today as well!

Monday night was my roommate Meredith's last night and she had planned a night out at a pub in town. But I totally forgot about time and when I got home from the hospital at 9pm everybody was gone. Its not really safe to walk alone in this village at night, so I called up my favorite tanzanian Victor, and he wanted to come with me. He got an ambulance car to drive us up to town where we met the others! It was a good night and I was completely high on adrenaline after my night in the operating theatre.

Today there was 5 cesarian sections, and almost at the same time. One was actually twins and they didn't know it until the 2 babies popped out. Crazy! One of the tanzanian doctors wanted me to do the whole thing and take the baby out but in the end he did it. And I am really happy he did since that baby was really stuck and the nurse had to push the baby back up through the vagina.

There was also this really nasty case today where a young man got blown pretty badly up by an explosion in a gold mine. Poor man, open fractures all over the place, amputations, wounds...

So I have seen alot so far! A good beginning of this week! Hope it continues like this! And its really best to stick with the Tanzanian doctors. They actually let us do things, compared to others...

I'm a surgery junkie...

I'm hunting surgeries like crazy! I'm actually hoping people will get ill so I can scrub in! I want to see some blood here!

I’ve had my first few days here at the hospital and there hasn’t really been that much for me to do yet. But I am sure hunting! Was really hoping to get my hands dirty here! But it will come, I’m sure!

I’m trying to scrub in on as many surgeries as possible but so far I only managed to scrub in on two. That’s why I decided to stick to the doctor on call this weekend as glue! I am sacrificing my beloved sleep to hang out at the hospital just in case there will be an operation!

The doctor on call this weekend is Dr. Nuwas. He finished medical school 3 years ago and now he is doing all kinds of surgeries, even brain surgery! He is really good. So now I am just waiting for him to give me a call, most likely there will be a laparotomy of a 6 year old boy with intestinal obstruction and possible perforation. I really hope so!! (Not for his sake of course, but for mine!)

It’s kind of special here. Before every surgery we have to pray. So we are standing there all scrubbed in and dressed up with our masks,gloves and hats with our hands folded, praying. Don’t know if it helps, but its just a rule here! No one died during the surgeries I was in on so far, but we nearly lost this 9 days old girl that was operated for occipital menigocele. But she is still alive, but kind of unstable. Hope she will make it!

Really bored today… My two roommates Meredith (U.S.) and Mark (Sweden) were going on safari this weekend. But Meredith ended up going alone since Mark has foodpoisening. So I’m kind of one my own here… Not so many people. So I am killing time with walking between the delivery room checking if there is any deliveries for me and visiting the orphanage. But somehow I always come when the kids are sleeping. Was there today and only 1 child was awake and crying. A newborn little girl, gave her a bottle of milk and then she slept again. So not much for me there either.

Haven’t been able to take so many pictures yet, will do better in the future. But I will add some! Otherwise I'm good and today its pizza for dinner! Cant get any better! Guess they are just making up for the fact that we had rice and beans for lunch! (But I should not complain, beans is my new source of proteins!)

Finally I'm back in the bush!

Finally at Haydom Hospital! Took some time to get here!

Took the bus from Nairobi to Arusha on Monday, it’s was a long trip. On the bus I met a guy from America and a Norwegian couple actually. I really tried to hide my identity as Norwegian as far as I could. The reason for this was that I saw that this couple was Jehovas Witnesses, or most likely at least. They had this sign on their jackets and there was really no doubt…
But I had to change seats in order to stretch my legs and avoid DVT and ended up next to them. So I thought I might as well talk a little bit to them. And believe it or not, they were really really nice. AND (most importantly): They didn’t try to save me! So I am still the same old Kristin, not a “Witness” yet!

Met up with Ingar Kvia in Arusha. He is… well, lets say he is a very active man! He talks a lot and he never sits still. So a day following him around was kind of exhausting. But got to see some new places in Arusha and not just only Impala Hotel!

Missed the landcruiser from Arusha to Haydom so I had to stay one extra day in Arusha, but that was ok. Went out to dinner with Ingar and this other Norwegian guy and had a good nights sleep.

The landcruiser… that’s a chapter I would like to forget! It’s a normal Toyota Landcruiser and somehow they managed to put in 12 seats. Which is a lot in that car. But on that 7 hours drive we were 17 people, I reapeat 17 people in the car. NEVER AGAIN! I have decided to fly when I am leaving this place. Found out that every Monday there is a flight from Haydom to Dodoma. So I am saving my money for that flight.

No pictures this time. We are not allowed to upload photos, only during night. So I will try to upload some photos this weekend and write some words about my work at the hospital!

Life on the upper west side of Nairobi

After surviving a night with a kenyan horndog in the "slum" I was off to Scripture Mission. Thats a Norwegian christian organization (I think). At least there's mostly Norwegian people here and a Norwegian school for the kids. It was like coming to heaven! I had my own room, clean sheets, running water, a real toilet and a shower. The standard is simple but more than good enough!

That day I had to wake up at 6am at the "African experience guys's" place. We left his place 6.15am and arrived at Scripture Mission 8.30am. It was on the other side of town and traffic here is just terrible. And the roads even worse. It seems like all the 31 million inhabitants have a car, but thats probably not the case... Did I write in last blog that the William, the son of the "African experience guy" actually asked: "Can I call you mummy?" Crazy... well, like father like son!

The reason I came to Scripture Mission in the first place was actually because of another coincidence. A few days before I left I found out my old secondary school teacher was going to Nairobi with his wife 2 days after me to visit his son. So we decided to meet up. His son and wife and 3 sons have been living in Nairobi for more than a year. They work in an orphanage outside town. I met up with this son, Bjørn Kjetil, at lunch the day I arrived and he told me he was actually on his way to the orphanage in a few minutes and that I could join in.

In car he asked me if I could hold a first aid class for the kids. 60 kids from 4 to 16 years old. Of course I said yes! (What could I say!) I just talked about basic things like bleeding, faiting, fractures and stuff that the kids could actually remember. And it went ok! (The snake bite lecture wasnt exactly my strongest one!) After the class I had some balloons, pens and caps I gave out to the kids before we went home.

Saturday I went to a HUGE christmas fair with 20 year old Bardur from the Ferrow Islands and 17 year old Daniel from Iceland. Mostly white rich british kenyans there and it was all way overpriced. So all i ended up buying was a pair of Havaianas... very typical african!! ;-)

And I also managed to steal a hot dog. Fotgot to pay and didnt bother to go back...! After that we went to a big shoppingcenter, bought some overpriced icecream and went to the cinema and saw the craziest movie ever; "Gamer". In the evening I ate tacodinner with the Hellestræ family.

Thats pretty much what I've been up to lately... And I have actually gotten sick. Constantly nauseaus, been throwing up and I have no appetite at all. Got some anti-emetics at the pharmacy, domperidone. As far as I can remember, lactation can be a side-effect... so lets hope i dont start lactating here in Africa! I just hope I get well for the 6 hour bus-ride i have tomorrow. Going to Arusha in Tanzania. I think it must be because of the funky food I ate when I was with the Kenyan dude... From now on I will stick to beans as my source of proteins, meat here is disgusting.

Thats all for now! Stay put!

A true african experience!

Finally… my first blog! Africa here I am!

Arrived here in Nairobi Thursday morning. I had already booked a nice hotel in the center of the city, wanted to spend my first night in luxury and just relax and sleep! The same guy that arranged with my hotel booking was also picking me up at the airport. So I arrived, all my luggage was there, no problems. And the guy and his driver was standing waiting for me outside.

When we came to the car and started driving he told me that there was a problem. The hotel I had booked was not available after all but he arranged for me to sleep in another hotel. In the car he told me that he had people from all over the world staying in his private house all the time. And he also did some backpacking in south America some years ago. We arrive at the hotel he arranged for me. It was more or less in a slum area, far away from the center. And there was not a single white person in the hotel… (I know this is Africa but still…!) There wasn’t even a shower in the bathroom. And it was only 11am so what was I supposed to do all day?? Lock myself in the room not daring to go out??! So I tried to call this Norwegian place where I had booked to stay the 3 next nights, but of course they didn’t answer. Then the guy offered that I could stay with him. I was a bit sceptical, so I asked if he had a family, and he said he had a wife and 2 boys. So I said “OK, lets go!” Crazy… but i was thinking this might be an adventure!

On the way to his place we picked up his son at school, 7 years old William. His place was not exactly nice… To me it seemed like the slum but I guess it was more of a middleclass area. There was no running water, no shower, pretty much nothing. But I got a bedroom of my own, so it was doable. He cooked me some dinner and we ate. I asked where his wife and younger son was and he told me they would not come back today. They were in a village outside Nairobi. The next he said was: “For me and my religion its ok to have many girlfriends even though I am married. I once had 7 girlfriends. But of course I protect myself against HIV”. Hmm… I understood were this was going, and earlier I had been stupid enough to tell him that I didn’t have a boyfriend or husband.

After that he took me to a internet café so he could google his name to show me all the positive review people that had stayed with him had written on different blogs. Just so I could trust him! Well, that was ok. Then suddenly we had to leave. We had to make a short stop by his nephew that was having a graduation party. We jumped on this disco/cinema bus stuffed with people heading for the party! When we got there I understood that this guy was actually arranging the whole party. The party was for a 23 year old guy that graduated as a medical engineer. So I was stuck at that party for 5 hours because the guy couldn’t leave until everybody else had left. I had to hold a speech and I was fed cake by the graduate with a fork… I ate some crappy meat and some other random shit, of course with my hands. Thank god I had a raincoat on, because I don’t know how to eat with my hands. Food was everywhere! Finally we went home and I was extremely tired. Didn’t get much sleep on the plane the previous night. So I just went to bed straight away. Of couse he tried his luck and said that if I wanted company I could just let him know. I told him I was ok and that I didn’t need his company. I went to bed, fully dressed with pants, socks, t-shirt and a sweather with a hood, I don’t think his bed was very clean to be honest. And I don’t want scabies I have to admit! Then suddenly he knocked on the door and gave me a letter. And CHECK THIS OUT:

“Hey Kristin
I just wanted to ask if I could keep you company tonight.
I want to give you a true African experience.”

HAHA!!! I didn’t know what to say or do… of course I didn’t want to touch that guy even with a stick. So I waited a bit and I called on him. He came and I digged out one of my white lies: “I am so sorry, I know I told you that I don’t have a boyfriend but I have this guy that I really really like that I just started seeing, so I don’t think this is a good idea!” Didn’t want to make him mad either, suddenly he would rape me there. So I acted as nice as I could. Of course he pleaded and pleaded but I managed to turn him down finally and he left the room. Well… wouldn’t be that easy for me to sleep now I figured… And I needed my sleep and I just wanted the night to pass as quickly as possible to I could get out of there. So I swallowed a sleeping pill and slept all night!

So that was my first night in Nairobi! At least I got a “true African experience” but actually I should just be happy that I didn’t get raped, killed or robbed…

Well... what can i say... TIA - This is Africa!