FOUND SOME INTERNET :)

I finally made it to Kagando, and it is way more rural than I expected.  I am wondering how I'm going to get the required paperwork to Drexel as fax/scanner aren't really accessible.  Praying they still let me graduate one time.  Eek.

It feels like I’ve been here forever, and we've done a lot (although I've only spent two days at the hospital).  So, now that I'm here, i can better explain the hospital:

Kagando Hospital is a 250 bed missionary hospital, where I am working as a medical student.  Eventually (by the end of the week), they expect me to be able to round on my own patients, which will be challenging as sometimes interpreters are hard to find and 80% of the population only speaks Lukonjo.  

So far, things are interesting, to say the least.  Medicine is different here.  There are "strange" medical decisions made here (ie.. adding on metronidazole for a UTI) and almost everyone gets treated for Malaria.  As often as this is done, however, and as often as I question their judgement, the patients get better, so I am practicing humility and spending a lot of time observing and trying to get my bearings.  I don't consider myself to know more than these physicians, especially considering there's a great deal of pathology I've never seen.  No nodding disease yet, though there appears to be a cholera outbreak right now.

My very first patient on Friday died in front of me.  She was suffering from cerebral malaria and was having a really hard time breathing.  Because she was so obtunded, the doctor told the nurse to place her on her side, so she wouldn’t aspirate.  As the nurse was doing so, the pt. stopped breathing.  The doctor came back and within 10 seconds (after not finding a pulse) said “we lost her”. And then went to the next patient.  Just like that.  ~30 seconds later, the patient started moving her arm, and only then did they decide to try to resuscitate.  (And by resuscitate, I mean give her bag O2 and chest compress for another 30 seconds.)  Meanwhile, the father has already left the room and started crying.  Showing grief is important to do here, so within seconds, you could hear people outside (I assumed family) wailing, and continued to do so for quite a while.  It was all very strange, especially since there are ~15 patients all in one room and they all lay there and watched this.  There was no stopping, and we continued rounding, and never spoke of our patient again.  It was a weird experience and though it has been 4 days and I'm still not sure I've processed it.

That is all for now.  I have much learning to do.  Pray I can absorb as much as possible now, as I'm not sure I'm ready to start rounding on my own later this week.  :)