Wednesday, March 19, 2008


Every morning at sunrise a huge round ball of sun peaks over the horizon as a loud music plays AAAAAAAAAAAAAAAAASAWENIAAAAAAAAAAAA bagithiti Baba!!!!! straight out of the Lion King. I don’t know where they hide those speakers but it is really dramatic. No, actually I haven’t been up in time for sunrise yet. But every morning a million birds chirping do wake me up. It is a constant potpourri of different sounds. My favorite bird call that I have never heard before I call the harmonica bird. It plays 3 scales sounding like a harmonica decreasing in pitch. There are roosters in the distance but they are not dominant. Actually the sound that is most dominant even over the birds are the goats baaaing.

Man there are goats everywhere. They pretty much replace dogs and cats. I have only seen one dog here my entire time. But everyone has goats roaming around their yard. Some are on leashes. Some are big some are small. There are white, brown, and black. Kids lead them around on a leash and the goats also play with each other. Sometimes I do a double take because I think it is a dog but it is actually a goat. For some reason though people here don’t drink goats milk. It would be a useful source of milk though.

So Monday a week ago on the wards a really sick looking patient rolled in. His pulse was 140, his blood pressure was 65 and he was breathing 50 breaths per minute. His oxygen saturation was 65%. His lungs had crackles everywhere. In the States we would have intubated him immediately. Here we don't have that option. So I got an IV line and started giving him some fluids to raise his blood pressure. Our differential diagnosis was PCP from AIDS, advanced TB, or severe pneumonia or sepsis with ARDS. Since we didn't really have a way of knowing we treated him for everything. We also really wanted to at least give him some supplemental oxygen. Again we were told the only place with oxygen is the maternity ward and we are not allowed to take it from there. We went to check that out and got the hospital superintendent to give us permission to move it for the night. I got a 100% non-rebreather mask that I had brought from the states and we put the oxygen on him. His blood pressure came up with fluids and he was still breathing really fast. I was watching the machine making oxygen and I noticed there was a light that said oxygen concentration. And it had 3 color lights. Red yellow and green. Most of the time the light was red. THen for a few seconds it would change to yellow then go back to red. it never made it to green. So I don;t think the oxygen was that much greater than room air anyway. Then next morning the oxygen machine was off and I wondered why. I guess because it was noisy and the nurse turned it off. They just didn't get it was keeping him alive. Later that day it was off again. I tried to turn it back on then I realized the power had gone out. A few hours later the machine was taken back to the female ward. His oxygen saturation was still 65% and he was still breathing like 35 but he looked much more comfortable. Over the next few days he improved even more and now he wants to leave the hospital. His oxygen is still 75% but he is living like that. Crazy times here.


1 comment:

Abba said...

I love your descriptions of the sounds of frogs, birds, and goats to say nothing of your medical experiences and descriptions of the beauty surrounding you on your explorations.

Kol hakavod!
Love, Abba