I started the day bright and early today, headed to the hospital to do rounds. There were no surgeries today as the fistula team took a well deserved day off. This also allowed the gyn team to do their surgeries, since there are only two operating rooms and the fistula team requires both.
I spent most of the time during rounds attending to a 17 year old patient who had a very long surgery yesterday. The surgeon thought she would need a quick surgery to open a scar in her vagina, but then realized once the surgery began that she actually did not have a vagina to open. This is a birth defect called vaginal atresia. She had a uterus and ovaries, but they were not connected to her vagina. This is not a common problem, and in the US she would have had an MRI before surgery to help plan her procedure. She did have an ultrasound, but it was not able to detect that her upper vagina was missing. Have I said vagina enough yet? Sorry–occupational hazard.
Anyway, she had not been given any pain meds or antibiotics overnight and was quite uncomfortable. We gave her some IV medications and crossed our fingers since we were leaving town. The gyn team will round on her tonight and tomorrow, and we all hope she will look better when we return.
Around 10AM, our group of 10 left Kigali in two Range Rovers, headed to the Nyungwe National Park to spend the night. Tomorrow morning, we will leave at 4:45AM to go and see some of the 270 species of birds, primates, and other animals that the park contains. The trip here was truly a feast for the eyes–up and down the beautiful rolling hills of Rwanda. We stopped at a breathtaking lodge on Lake Kivu for lunch. This lake runs along the western border of Rwanda, separating it from the Democratic Republic of Congo. I will post some photos soon.
We arrived at the hotel after dark so I could not see our surroundings, but it sits at the top of a very tall hill that looks out over the forest below. I have a huge room all to myself tonight, and I can hear the frogs and crickets outside. It’s probably around 60 degrees so no air conditioning is needed. I will definitely use the mosquito netting as I’ve already had some bites that are very itchy.