Well today was the day we had been looking forward to – our first day working here in Kenya.
We went to morning devotions in the chapel where we were introduced. After a lecture and a roasting of the medical students by the resident, Stella the pharmacist took us to get the IT portion of clinic sorted out. I was pleasantly surprised they use an EMR.
Clinic didnt start until about 10.00 … but what a clinic!! Working through a translator was hard. My first patient had malaria, the second severe ascites which needed tapping and I saw lots of uncontrolled diabetes and hypertension. I sent 5 patients to be admitted. I also saw lots of arthritis and the usual back pain. The challenge is the medication and the cost of tests. Apparently the average local worker earns the equivilant of $4 CAD a day. Each test showed how much it cost – and at $16.00 for a Fhb (Full hemaglobin)/ cbc, and similar amount for Na, K and cl (creatinine is seperate). Xrays were about $90 and ultrasound scan was $110. It certainly made you be cautious about the tests you ordered. The results were back within an hour which was nice, but lots of patients couldnt afford the tests so hadn’t had blood work for years.
I worked hard until about 6.00pm as the patients wanted to see the “Canadian Doctor” Then when I got back to my house I saw the advertisment that had gone up around the village…no wonder I saw lots of chronic diseases and arthritis ….where were the kids?!
Tomorrow I am in Pediatric rounds? I hope then to have an easier day.
Ric had a good day. He hung around the resident electrician and started to plan out the pipework for the electrical install in the summer.