The public/government run hospitals in Kenya are definitely not something we’re accustomed to, especially based on some of the beautiful hospitals back in North America. In Kenya, specifically in our town, if the children’s ward is full, it is very common to see two to three children sharing a bed. The mothers, as they are usually the ones that stay in the hospital with their sick children, take turns lying on the bed. The beds are old white metal singles with a very thin mattress covered in plastic. This is the most sanitary as it restricts the fluids, such as urine, feces and blood to seep into the mattress.
The hospitals simply provide a bed along with the nurses and doctors. You, as a patient, must provide when entering the hospital, the following items:
· Bed sheets
· Blankets
· Plate, cup, cutlery (for eating, if staying for a few days)
· Basin and soap (to bathe yourself or to vomit in if not made in time to the bathroom)
If you are in need of medical care, such as injections, blood drawn, IV, etc., you, as the patient, are hoping that you have a family member or friend that is along there with you. For it is the responsibility of the patient (or hopefully the family member/friend) to go to the pharmacy and get the necessary items needed to do the medical care. For example, if blood is to be drawn, you need to go to the pharmacy and get the syringes needed, the bandage/cotton to cover the area being “stabbed”, the rubber gloves for the doctor to wear and anything else needed to perform the blood drawn.
There have been many sad stories of children dying due to lack of money from the parents, time of the doctors, etc. There was one story of a baby who needed oxygen in the middle of the night, but the staff said that they had run out of oxygen tanks. The baby died. A few hours later, in the morning, an oxygen tank appeared. It turned out that there were full oxygen tanks available when that baby needed it but the keys to the room where the tanks were, went home with one of the staff members.
I, Meredith, am not really keen on the government run hospitals here but I’m really keen on the children who have to come to them.
On Friday mornings, the interns go to the hospital and spend a few hours in the children’s ward. They bring colouring books, story books, bracelets or whatever else they need for them and the children to do together.
It’s an uncomfortable, out of the comfort zone kind of place for most people, probably except for some of those who work in the medical field and enjoy their job. I, however, LOVE the children and they become my total focus when at the hospital.
On Friday, October 1st, we went to the children’s ward of the hospital. There is one massive room divided into four sections, fitting four beds on each side of the wall in each section. The entire ward smells like urine, feces and vomit most of the time.
We separated into groups of two and went into the four different sections of the ward. I usually go around the section and meet the children and mom’s first, introduce myself and then spend an amount of time with each child. With my basic Swahili skills, I can communicate with the children and the moms which does help a lot. On this particular Friday, we brought I SPY books to do with the children in the ward.
When Rebekah and I went to our designated section, there was a child screaming something as she was crying. I went over to see what was going on and I realized the little girl was getting a needle stuck in her back. I asked another mother in the bed next to this little girl, what was happening and she said that the little girl was getting tested for meningitis. This is done by removing fluid from the spine; a spinal tap. The little girl was screaming, “It’s painful.” in Swahili, over and over again.
The doctor finally got the amount of fluid he needed and within moments, the little girl was asleep, exhausted (and drugged up) from the event. I went over and prayed for this little girl; my heart broke over the pain that she had been going through.
As I looked up from that, down the main hallway, was a little body, completely covered, being taken out of the ward and a mother walking behind it, crying. A child had just died. It took everything in me not to cry at that moment; cry for the pain of the mother.
I sat down on the bed of a little four-year boy named Given. His mother, Margaret, was the one that I had asked about the little girl getting the spinal tap. Given and I read over an I SPY book and he was such a smart little boy. Margaret and I talked about why Given was in the hospital, she felt that he too had meningitis. A little while later, another child, a few beds down, was getting ready for the spinal tap and the child was starting to cry. Given looked at his mother, tears welled up in his eyes, his lower lip quivering and said to her in Swahili that he wanted to go home, he didn’t want to be at the hospital anymore. Given knew why he was there and he knew that he would be next on the list to get the spinal tap.
I told Given that I didn’t like needles either but that I knew that he was a strong little boy and that everything would end up being okay. I told him that I would be there with him when he got the needles. I told Given that he could hold my hand and if the needle hurt, he could squeeze my hand as hard as he could. His mom translated it for me and when she was done, he looked at me with this big, beautiful smile and said in Swahili, “Mama, Mary is my friend.” And then in English, said “Thank you.”
A little while later, the doctor came and injected a drug into Given’s IV. I was told it was to make him become numb; it made him become drugged but definitely not numb. The drug worked in a matter of seconds; Given was slurring his words, couldn’t keep his head up and barely keeping his eyes open.
Given, even in his state of dopiness, was still begging his mom to go home.
The doctor asked Margaret and I to hold him down. Margaret’s position was to bend Given forward so that the spine was as close to the skin layer as possible. My job was to hold Given’s legs down. The doctor leaned over and dabbed the area that he would be injecting the needle; Given wasn’t too pleased with this and arched his back. Margaret had to get an even more firm grip on Given and I then needed to hold down his legs and at the same time, pull his arms forward to get maximum bending of his spine.
Given kept fighting, screaming, squirming and the doctor would give him another injection of the drug that was to make him “numb”. But Given still felt the pain and at one point of us holding him down, his mother’s arm was right in front of his mouth. I don’t know why but Given bit down on his mom’s arm with extreme force, so much so that she screamed in pain and we had to stop so that she could compose herself.
We started again; Margaret held her son in a headlock; I held his legs down with his arms pulled toward me. He fought, screamed, squirmed and cried. He looked up at me at one point and although heavily medication, I saw hatred in his eyes at me. I was holding him down; I was pinning him to the bed so that he could get a needle in the spine.
Even though I told him that I would be there with him while he got the needles, even as I continually told him what a good job he was doing and what a good boy he was, I hated that I was part of the hurting process.
The doctor kept saying how stubborn Given was, that Given just wouldn’t cooperate by sitting still and allowing the doctor to work quick and get out of there. The doctor wanted to switch beds; I don’t know why; maybe he thought the different height of the next bed or thickness of the next mattress would be make it easier. I don’t know. But it dragged on and on; Given was being poked over and over again.
At one point, I had hit a brick wall. We were taking a break for a second; the doctor had to go and compose himself as he was very frustrated. I stood up straight, my arms and legs were shaking due to the angle I was standing and the pressure that I had to put on Given to hold him down. I was sweating. Robin, one of our interns, looked at me and asked me if I was all right. I said I felt like I was going to throw up. The emotion of it all; the crying and begging from Given was breaking my heart. I was exhausted.
The whole ordeal lasted about an hour and the doctor still never got the fluid but Given was so stubborn, so drugged up and so exhausted that they had to stop. Within seconds, Given was fast asleep.
I sat with Margaret for awhile; she had sweat around her hairline and over her nose and above her lip. She too was exhausted. I asked her if she was okay and she said that she was tired and that she was sorry that Given had to be in so much pain. I sat and prayed for her and then hugged her. I leaned over that sweet little boy’s bed, said a prayer and gave him a kiss. We had to go.
I couldn’t even walk home; I was emotionally and physically exhausted after that. I took a piki-piki (pick-ee, pick-ee), also known as a motorcycle taxi, home. That night, I crawled in to bed and for about an hour, all that was going through my head was Given’s crying and screaming. I couldn’t get it out of my head; and I cried; I finally broke.
I’ll probably never see Given again; the next time I go to the hospital, he won’t be there...hopefully because he is better and at his home. But I did get a few hours with him; I did keep my promise to him; I did get some good laughter out of him for a little while and I did get to be there for his mom.
Although emotional, it was a good day; it was what I was supposed to do; it was what I was there for.