Some Final New Experiences: From Arrows to Weddings

This past Thursday, I spent my first full day with the eye team when I discovered that they were taking a trip out to the Mau forest area to set up a clinic. We packed eight of us into a Land Rover and drove an hour and a half to a small governmental clinic. I helped to do the first stage of the clinic: a general visual exam, where we put a letter chart up on a concrete wall and approximated their vision, just like we do in the US. For the illiterate, we had one side of the chart that simply had a "W" turned different ways, and they had to indicate which was the letter was pointing. After we recorded vision numbers and any complaints or remarks, the patients went to see the ophthalmologist to receive reading glasses, medications, or a referral to Tenwek if their situation was very severe. I also had my first true Kenyan toilet experience: the restrooms are stalls with concrete flooring covered in gunk and a hole in the middle for toilet usage. Fun stuff!

Helping with visual exams! At this point, I was in charge of covering each eye so that no pressure was applied to it, and writing down vision assessments.

Friday, I was back in the OR for most of the day because I'd heard about a few interesting cases going on. The first was a two year old who was born without a normal rectum opening (called an imperforate anus); as an infant, he had a colostomy (where his large intestine is cut and the two ends are brought outside the body to act as a bathroom device), but now that he had reached the potty-training age, the surgeons were going in to basically re-create his rear end and, eventually, will reverse the colostomy. That afternoon, I got to scrub in on a thyroidectomy (thyroid removal) and help to hold retractors, cut sutures, etc. This woman's thyroid gland was almost as big as my two fists put together! As we were finishing that case, we heard that there was a new patient in Casualty who needed surgery immediately: he had been shot with an arrow in his abdomen! As the doctors wheeled the young man into the OR, I learned that the man's father had given a lump sum of cattle to him and his older brother to split amongst themselves. Our patient's share was 73 cattle, but when he only received 72 (and because he was Maasai, which makes cattle extra important to him), he got in an argument with his brother, who shot him. One of the Kenyan surgical residents joked that at least the arrow wasn't poisonous, since Maasai warriors will dip their arrow tips in poison before shooting outsiders. This arrow, however, was metal, several inches long, and had pierced his large intestine! I suppose the poison would have certainly made it worse, but like the patient humorously informed me when he was brought into the OR, he definitely "had a problem."

Here's the arrow, after its removal! How would you like that thing stuck your abdomen for several hours? No, thank you!

Yesterday was another first for me: I attended a Kenyan wedding! The Japanese surgical nurse, Anna, knows the pastor at the church where the wedding was being held, and she invited me to come along. The ceremony was supposed to begin at 10am and even though we arrived around 11, we were still the first guests there! We were invited to eat lunch with the pastors in attendance, which comprised of ugali (the staple Kipsigis food, made of crushed corn and water), cooked boga (a bitter wild green), and mursik (traditional Kipsigis "yogurt"; they mix fresh milk with ash and then let it sit out for a few days. All I could do was try it because it tastes like lumpy, very bitter yogurt). After lunch, I realized how completely packed the church was: there were a few hundred people inside, with another hundred outside, looking in door ways and windows, or just listening to the speaker on the lawn. The wedding started after 1, with fifteen or so bridesmaids and almost as many groomsmen parading through the front of the church and then walking back out to bring in the bride, in her poofy satin dress, extra long veil, and tiara with a heart that flashed pink lights) and groom. The wedding then showed some similarities to American weddings: the exchanging of vows and rings, led by the pastor. The couple also signed their marriage certificate, which the bride traditionally tucks in the groom's pocket, and then they knelt in front of the altar while their family prayed over them. While the pastor was giving his concluding sermon for the couple, we had to slip out because it had started to rain and the roads would be impossible to drive on if we waited long!

The bride's parents giving their final words before handing their daughter over to the groom.

We made it back safely, and this morning I attended my last church service at Tenwek, which I'm certainly going to miss. Then a few of us hiked up to Silibwet, a town about 1.5-2 miles away from the hospital, and looked around the market and stores for a while. We got caught in some rain on our way back and got a bit wet and exceptionally muddy on the dirt roads, but it was great to make one last hike there before I leave this week!