Proceed with Caution

For all my medical friends, here's a few stories from the hospital. If you are not medical and do not appreciate the types of things medical people discuss at the dinner table, feel free to skip this post (this one is not for you, Josh! :) ). There are some really tough stories coming, only read if you really think you can handle it and want to know.

Obviously, medicine here only vaguely resembles medicine at home. While I did know what I was in for, it still makes some amazing stories when you experience it for real. One thing to get used to is new terminology. We, however, have a slight advantage over the Americans, as since Zimbabwe was colonized by the British, they use quite a few British terms for things, as does Canada. For instance, the OR is the "theatre", a term not uncommon at home. I had to laugh, though, when I was looking for some alcohol swabs, and found the jar marked "spirited swabs", lol!! This far into the trip, that one still makes me smile. On a more serious note, the acuity of the patients can be devastating. Women in their 20's get mistaken for "Ambuyas"  (grandmothers), the death rate is horrifying, and many wait so long for treatment there's little we can do. Reasons range from lack of education to lack of funds to pay hospital bills. Our ward is full of TB, HIV/AIDS, malaria, and cancer. One lady had a huge radical mastectomy with a large skin graft for breast cancer, but in the heat and the area being so large, it soon began to smell. Flies came. It didn't take to long to find more than just skin graft under those dressings we were changing every day! I pointed out that there is a lot of good research about maggots in wounds, but that's for cleaning up dead tissue, not for when you're trying to heal a skin graft. We've finally convinced her to use her mosquito netting during the day to keep the flies off. Another was in an advanced stage of HIV/AIDS, and suffering from HIV wasting disease. She was nothing but skin and bones, with an "abdominal mass". It turned out she was 19 weeks pregnant, but she died in the night, and of course, her baby, too. This was probably one of the hardest cases I've seen so far, as the ultrasound had showed a growing, live baby. There was nothing we could do, as the baby was not far enough in gestation to survive if we had done a c-section. There was a lady that came in the other day to OPD with some shortness of breath and cough. After finding not much for breath sounds on the rt side, the Dr ordered a chest xray. The CXR showed that her entire rt side of her lungs was completely whited out, and her trachea was obviously deviated. A few of the American doctors took pictures of that one - I'll have to see if I can get a copy of it, as you'd be amazed to see it. A chest tube was inserted and drained over 2 L of fluid. Thankfully, she'll be okay, at least for a while.


It's not all bad, and we're able to help many patients, and lots and lots of education gets done. We have a good supply of anti-retroviral meds, TB meds, and malaria is very treatable, especially if it's caught early. There are new initiatives coming out for cervical cancer screening in "resource-limited" countries, as cervical cancer is so much more common here than at home, solely for the reasons of good education and frequent screening. I saw a young woman in her 20's the other day with a huge tumor on her cervix, so big now that it's inoperable. I swear I will never try to weasel out of a pap ever again, it's terrible to see what it's capable of at such a young age. Cervical cancer is extremely treatable when caught early.

We do find lots to laugh about, most often my attempts at speaking Shona to the patients! I was trying so hard one day to ask a patient if she was having pain in Shona, and she just looked at me with this confused look on her face, then said "it's okay, I speak English". I laughed pretty hard at that one!

Another interesting thing about nursing here is that there is such a severe shortage of nurses that the lifeblood of the hospital is actually the students. It's so very convenient to have a nursing school on the same compound! Today, actually, out of the whole ward, I was the only "graduated" nurse on staff apart from the boss. Suddenly I became quite popular as the students all needed the one with credentials to observe them doing various skills to sign off their books. Thankfully, it wasn't a crazy busy day for what I had to do, which gave me more time for teaching - it was quite fun! I even had an American student following me today! Wow, what a way to feel smart for a day. :) Anyways, I hope that gives you a small look into the medical side of things at Karanda.