Leah's Rwanda

I spent this morning sleeping, in the hopes that I would continue to recover from food poisoning. I was able to go to the hospital at noontime where I DID NOT EAT THEIR FOOD. Now I am suspicious of everything, even the soda. I am going out to dinner tonight and I plan to eat well, but I will continue to eat carefully.

Our postoperative patients are roomed together at the hospital, which is staffed by 1 nurse. The patients don’t really wear hospital gowns on the first day or two post-op, but cover with a sheet and blanket. It was near 90 degrees today and they are completely covered up. This is also true of patients we see in the clinic–they wear multiple layers of fabric and skirts and shirts. This makes for a beautiful rainbow of color, albeit a jumble of patterns. And if you ever wondered where your donated t-shirts go, wonder no longer.

Several of the post-op patients have an infant, who stays in the room with the woman. One of the patients was breastfeeding while we rounded. A few patients have family members to help them, but the others must rely on the kindness of the (Rwandan) nurse. I have heard that the nurses tend to disappear, which is very frustrating to our MDs. One nurse for 7 freshly post-op patients is not enough, especially if she comes and goes.

I spent the afternoon seeing a few fistula patients, and when we had no more fistula patients we saw general gynecology patients. One of the women, in her 70s, complained of vaginal bleeding for 1 year. Unfortunately she had a large mass in her pelvis, likely cervical cancer.

As I was walking back from the OR to the clinic area, a white man approached me. He explained that he was trying to find care for an 81 year old man who needs a pacemaker. He wondered if any of our MDs could do this surgery. I explained that we are gynecologists and have no knowledge about cardiac surgery. He then asked if he could fly in a doctor from Nigeria and use the operating rooms. I don’t know if he was a doctor or a friend of the man, but he was clearly frantic to find help. I hope he finds it.

One more patient story today. We saw a 40 year old woman with diabetes who complained of constant urine leakage. Saying “constant leakage” usually means fistula, but we could not find a fistula on her exam. As we asked more questions, it became clear that she had run out of insulin several months before, so her urine leakage was probably related to very high blood sugar levels. She was very thin and looked at least 20 years older than her stated age. Another reminder of how lucky I am to have access to insulin and testing supplies and doctors.

Ok, I said only one more story, but I heard a very funny one at dinner. We were told to bring granola bars to give to the patients; most of these women are malnourished, which can impact healing. Unfortunately, granola bars are not a favorite Rwandan food. One of the MDs gave a patient a granola bar; she took a bite and spit it out. She said, “What is this civilized chocolate? I do not want this!”. Note to future missions: don’t bring granola bars!