Ashley Shira’s Blog

Day Six…sorry these titles aren’t more exciting! :)

Well I’ll start by catching everyone up on the events of last night.  We experienced power outages for the first time last night.  They say it happens fairly regularly but it was only out for about 10 minutes both times last night.  It happened again this morning a few times too.  The new students arrived last night.  I got up about 11pm to get some water and found them downstairs checking the place out.  It is a guy and a girl.  They are 4th year med students from Virginia. I introduced myself and chatted for a little while before going back to bed. When we woke up this morning the water wasn’t working.  We found out that water is delivered to large tanks at each house and the water has to be pumped into a smaller tank for heating.  Apparently the pump has to be turned on occassionally to move water into the tank and it hadn’t been done at the mission house since we arrived. So it had to be turned on this morning so we could have running water again.  Thankfully, I showered last night before going to bed!! We got a bit of a late start because Emily had to help with the water situation and Kim needed to shower, but we got to the hospital around 8:30. All four of us (the new students aren’t working today) went to the wards to see what was going on.  They were finishing up a c-section and had one other lady in labor.  We all got to spend time holding the new baby while they doctors were sewing up the mother after her c-section.  They don’t have to twist my arm very hard for me to stand around and hold babies. The second lady wasn’t dilating so they started her on oxytocin.  It could be a while before she delivers so we went in search of something else to do.  Kim and Kaitlyn went to the lab and reviewed smears and stuff with the lab techs.  Emily and I went to see what was going on with a patient we heard vomiting in the treatment room.  I was so glad we went looking…..it turned out he was a Type I diabetic and was possibly in DKA (diabetic ketoacidosis).  The doctor there explained to me how they treat DKA here.  At home they would go to the ICU for an insulin drip and rehydration, but here they don’t have IV pumps to titrate things. So this particular patient would be admitted, get aggressive rehydration, and sliding scale insulin. He had been compliant with his insulin at home so we knew he probably had some illness that exaccerbated his diabetes so we sent blood to the lab to check for malaria, typhoid, and a few other things.  We also sent urine to check for ketones. It is amazing how new and exciting it can be to treat something I’ve seen a million times at home.  I enjoy learning how they go about things here without all the high tech stuff we use in the states.  It is almost 1pm and we are leaving early today to go with Kaitlyn and Emily to a nearby beach hotel for lunch and maybe a dip in the pool.  We will be sad when they are gone.  We also have to take the new students into town to pick up some items.  We found out today that they will be leaving tomorrow to spend 10 days on a boat doing some rural medicine.  They aren’t here through INMED and really won’t be working much here at the hospital.  I was wondering what they were going to do with so many medical students.  There are 4 more students coming in two weeks, but they are from UVA as well and will be doing the same thing as the other students. Well we are off to change before leaving for La Palm Hotel.  I miss and love everyone very much!!