By day 3, we were a well oiled machine, loading the van, setting up and starting with minimal fusses.
Everyday started with an introduction to the community leaders, a song and a prayer, to bless the day and all the people taking part in it.
We rotated through triage, meds, learning opportunities, and assisting with various other tasks.
Meds turned out to be a lot harder than I expected at the start. Just trying to locate the specific medication and correct dosing you were looking for was difficult… but then came all the (albeit basic but still challenging) math. We all seemed to catch on quick, because our brains were truly put to the test with pediatric dosing calculations. Thank goodness for the buddy system for checking medication orders. And really, if anything, a little organized chaos is the spice to life. That, and music.
Sarah, one of the Kenyan nurses also provided us with the opportunity to see a birth control rod inserted into a patient’s inner arm. The insertion itself was fairly straightforward, and nothing a little lidocaine couldn’t fix. Lidocaine was inserted into the arm directly under the skin first to numb the area, and then a rod was inserted in to the same location on an application device, which was slowly retracted until only the rod was left in place. This rod lasted 3 years before needing removal and could then be reassessed by the woman whether she wanted another one implanted or not.
Johnstone, our local jiggers expert, provided us with some highly educational jigger removal demonstrations, all with the help of some potassium permanganate. The potassium permanganate is a soak that kills the flea without causing further pain or discomfort to the patient.
Jiggers are local sandfleas that burrows into the skin, especially beneath the fingers and toenails. This leads to extreme itchiness, lesions, infection and inflammation, to the point where people are unable to walk or use their extremities for everyday tasks. This can also lead to secondary infections which can be life threatening. There is a huge social stigma associated with jiggers, as these people are perceived as “unclean”, and are often hesitating to come for treatment. Sometimes it only takes one treatment for people to be cured, but often changes need to be made in the home in order to prevent the reoccurrence of these fleas.
All while Johnstone was doing his thing, our lovely Lynn and Sarah were teaching the girls about the birds and the bees and giving out handmade reusable sanitary napkins and teaching about the importance of being informed about your sexual health. These girls were very knowledgeable about the process of ovulation, conception, etc, but sometimes just need some extra empowering in taking a stand on their own bodies which can be challenging in society.
We transferred an incredibly sick kid with malaria to hospital, who Sabrina had to syringe feed oral rehydration solution as he was so lethargic and starting to become rigorous. Of the 52 RDTs we did today, 33 were positive. He was just one of that 63% who tested positive for malaria, but was thankfully the only one out of all of those patients sick enough to need hospitalization.
All in all, a tremendously successful clinic for day three, treating 612 patients.