Fun times in Zim

I had my fist day in OPD (outpatient department yesterday). Not too many people show up complaining of just the sniffles. I don't really deal with HIV, TB, and malaria that often in the states. I really was stretched- not only was I figuring out what needed to be done, but how to do it. You really have to dig and dig to get the full story from people too. For instance:

Patient: "I can't breathe right."

Me. "Oh, I'm sorry. Tell me about that."

Patient to translator: "unintelligible words to translator in Shona"

Me: "What?"

Translator: "He wants a TB test."

Me: " Oh. Have you had TB?"

Patient: "No".

Me: "hmmm (thumbing through patient's record). I see here that you do have TB, and your lungs have been full of fluid in the past. You need a chest X Ray."

Patient: "that's too expensive"

Translator: "No, he has HIV."

Me. "You have HIV?" (this changes entire treatment plan)

this went on...

On and on these interactions went. I was thankful that we had relatively few people lined up for OPD that day. hundreds of people could easily present any given day for OPD.

We (foolishly) asked for extra C section call last night, and call they did. At 3:30 AM, John and I tag teamed our first Zimbabwean C section. Praise the Lord, there were no complications. Mother and Baby did well. We walked home in the dark, completely enjoying the moment. We had a cold water toast when we got home. I was soon thereafter woken up to see a woman vomiting blood and an asthmatic in severe respiratory distress. True to form, medicine is just not straightforward here. The woman turned out to just have been discharged from the hospital following an admission for malaria. She now had "blackwater fever" (for you medical types). Her kidneys had stopped working- a rare but serious potential consequence of malaria. I'm still a little hazy on where the vomiting blood came from. She isn't vomiting now, but it will take a miracle for her to survive this. I got to pray with her before leaving the hospital today.

The man with "asthma" didn't have asthma. Upon digging in the chart (usually a well worn notebook), the man was found to have a history of a throat cancer (laryngeal mass). It had become so large, it had completely blocked his airway.

We took him to the operating room and I assisted in tracheostomy placement (a hole in the throat to breathe). He looked so relieved after the surgery, poor guy.

Immediately afterward I rounded on pediatrics. There are some very sick kids in there, many of whom have hydrocephalus. The sickest kid in there died today of what we presume was a brain abcess. It was sad, though not totally surprising. Death is a common occurrence here.

I got to get involved with lots of operations throughout the day. I'm very excited about the surgical and medical experience that is unavoidable in the next 5 months.

Through all of the power and water outages we are experiencing here, we are so thankful that everyone is healthy. We feel very safe in our surroundings. In all of this we are learning to appreciate the blessings of life: cool drinks of water, a refreshing shower, meals together. We love and miss all of you. For those of you worried about Abbi, know that she's getting along well. She's taking the heat in stride and is enjoying meeting lots of new people. She puts a smile on everyone's face that she meets and she is constantly with April or I! She's having a very rich experience here in Zim!