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March 2021
 
Hi,
It’s hard to believe that just four weeks ago I was packing my bags, looking forward to my move to Kenya...In many ways it feels like I’ve been living here for 4 months already! My first week here in Kikuyu was challenging. I remember waking up on my first Monday morning and thinking ‘What on earth am I doing here, alone?!’ Kenyans are known for being welcoming and although I felt homesick for the first few days, that quickly passed as I hoped it would and I was encouraged to feel at home in the Kikuyu community.

I’m staying in a hostel on a compound of the hospital whilst living here. The main hospital compound is about a 10 minute walk from the compound on which I’m staying (which is only for orthopaedics). I have a private room which is a lot more luxurious than I had been expecting - complete with double bed, en suite, hot water and even a fridge! (Courtesy of Mission Africa). During the week there are three nursing students who also stay here. Generally things are quieter at the weekend although it’s not unusual to have a preacher or lecturer at a local church or university appearing either for a meal or to stay for a short time. The staff at the hostel are friendly and I’m getting to know them nicely. On my first day here, I was chatting to a couple of girls in the dining room when I noticed something dark running around the kitchen behind us. I had to bite my tongue when I realised it was an enormous rat ... running around the shelves and stoves of the kitchen. Oh well, probably good for the immune system.

The KIKUYU HOSPITAL

(Run by Presbyterian Church of East Africa)
 
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I’m spending the majority of the working week volunteering in the Emergency Department of Kikuyu Hospital, working both day and night shifts. As you can imagine, it is an entirely different world from that of an NHS A+E department. Generally, there are far fewer patients presenting per shift. However, all the patients are incredibly unwell. Healthcare here is horribly expensive and so patients wait until their situation is dire before reluctantly appearing at hospital. One of the biggest challenges for me is having to consider cost whilst formulating a management plan for a patient. It is very difficult to be looking after a patient who is unwell but unable to afford the tests and treatment they so desperately require. It really makes you feel helpless. 

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The Emergency team consists of 4 nurses and 1 doctor. The doctor is a ‘Medical Officer’ which is approximately the equivalent to my stage of training. All decisions rest with the Medical Officer, there are no registrar doctors or consultants to turn to for advice. This is a huge amount of responsibility put on a junior doctor and often I find myself having to make decisions which I would never have to consider independently in Scotland. Generally, Kikuyu hospital has only one consultant per specialty and often that consultant works in several different hospitals and only visits Kikuyu once or twice a week.


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When there are not enough beds in the wards the only option is to have people outside in a tent. 

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In terms of resources, Kikuyu hospital is varied. For instance there is a CT scanner, which surprised me. But no defibrillator or ECG. Like many things in the hospital, I can’t see the sense in that. But at least we have a departmental Bible.

The most common presentation from my experience thus far is definitely trauma, often secondary to a motorbike accident. During my first week I saw a young man casually walking into the department with a bone sticking out his leg having been hit off his bike by a lorry (Kenyans really make us Brits look like wimps!). Per shift, there could easily be half a dozen trauma patients, of varying severity. Another common presentation is chronic illness such as hypertension, diabetes, kidney disease. In the UK these conditions are monitored and managed largely in GPs. No such thing here in Kenya and so patients often present with hypertensive or diabetic emergencies; they can be very unwell and often in these situations I forewarn the family that their relative will likely not survive this illness.
 
A few memorable moments from my time so far...
Attempting to stitch a nasty arm wound using a needle so blunt it barely punctured the skin, plus the added complication of the electricity continually cutting out every 2 mins due to stormy weather conditions. Having to freeze in the pitch dark with a blunt instrument piercing the patient’s arm was a first for me!

A lady came in having been run over by a car whilst attending her father’s burial, subsequently breaking 2 bones in her leg. I thought this was such an unusual story I had to share it with the other doctor I was working with, to which he replied ‘Ah yes Doc, our burials can often be the most exciting of events to this day.'   I have no clue if he was being serious or not!

And one very sad story...a 12 year old girl was brought to hospital with severe headaches after being caned at school a few days earlier. She had several significant bleeds on her brain. Thankfully her family were able to afford her immediate transfer to a Nairobi private hospital for paediatric intensive care. However, she died 24 hours after transfer. The story made it into the National news.


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This is Lucy - a nurse in Casualty. She's been here for several years and knows everyone and everything worth knowing in Kikuyu Hospital

CHURCH


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Church of the Torch (CoTT) is the church I will be attending regularly whilst living in Kikuyu. The church was built by Scottish Missionaries in the early 1900s. It is an enormous, cathedral-like building.

However, just across the road there is a small white church (see photo) This was the first church ever to be built in this area of Kenya. Scottish missionaries travelled to Kenya in 1902, carrying with them the building materials required to build the first church in what was then an unreached people group. The area became known as Thogoto, allegedly because the Kenyans struggled to pronounce Scotland! The congregation at CoTT have been really welcoming and I’ve volunteered to help with the Sunday school during the Kikuyu service. During the week I have been attending a young adult fellowship at a local church called Thirime. I’ve already formed one or two good friendships with the girls there and it’s a really nice group of 20s-30s. I’m looking forward to spending more time with them and getting to know them well.

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Some new friends from the youth group at church.
 

THE WEE SCHOOL

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Across the road from the hospital is ‘The Wee School’.
Education in Kenya comes at a cost, even for government schools. The Wee School is a fully funded school aiming to seek out children from impoverished backgrounds. form Monday to Friday it functions as a school; on Saturday mornings it is a ‘development centre’ for kids aged 5-17. The morning starts with a devotion before each child is given breakfast and lessons begin, including teaching on spirituality and theology. The children are all given a hot lunch and a piece of fruit before leaving. I enjoy spending time with the 6-8 year olds.

The first morning I was there, I was amazed by how well behaved the kids were! They sat silently, paying absolute attention to the teacher. And then the bell rang and they were allowed outside to play ... and suddenly they were screaming and clinging on to me and rubbing my hair and forcing me to push each of them on the swings! The Wee School is a fantastic place in Kikuyu and I enjoy spending Saturday mornings there.
 

And finally...

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Something I wasn’t expecting to find when I arrived in Kikuyu was a fitness group... but in fact I found a fitness group before I found the hospital!

There is an outdoor fitness group that meets every morning right outside the gates of the compound where I’m staying - I couldn’t believe it when I saw them! The group calls themselves ’Muscle Lab’ and they were very excited for me to become a member as this gives them ‘international status’ - Haha!

Thank you for all your support .

I really appreciate it, and it’s very encouraging to know that there are so many people praying for me back home in Scotland.

Rebecca