June 26th (Tuesday)

Today Nicole and I went up to hospital for the devotional at 7:15am and Fiona went with Dorothy to see her chronic patients around 8:00am. We began the day by going to outpatients to learn what they do there. We began by taking vitals for a patient and watching and RDT (rapid diagnostic test – it indicates malaria if positive) as well as observing what a clinical officer does when they assess people. He (the clinical officer) also quizzed us on what questions we should ask and got us to be involved by performing a chest exam. Tiffany then interrupted to ask if we wanted to see a hernia repair that Dr. Lipsi was going to do on a young boy. We both said yes and then followed her back to the theatre.

I scrubbed in a bit late but I became the third assistant. I was able to hold the retractors and clips while Dr. Lipsi worked. The next case was a young girl who had a burn to the elbow and they were going to perform a skin graft. It was kind of brutal and interesting to watch . Dr Lipsi used this tool that worked essentially like a potato peeler to get the skin from the leg. Kayumbo had to hold the girl down because even with dosing her several times with ketamine (conscious sedation) she was still wriggling against the pain. The case took a long while and we missed tea break and so we just took turns going to have a cookie and something to drink. When we were done and after the clean-up it was around 12:45 so Alison told us to just go ahead and have our lunch 15 minutes early. So we walked home and just quickly cooked some eggs and had naan bread. I also tried my quinoa packets, it was alright, it just wasn’t very fresh tasting and I didn’t want to have it again.

When we returned for the afternoon we didn’t get started right away as they were deciding whether to do the bowel obstruction surgery today or tomorrow, so they were reviewing the scan and assessing the patient who had arrived via ambulance. They decided to do it the next day so Nicole was scrubbed in and the patient that needed a LHR (left hernia repair) was next. They also did a MUA (move under anaesthesia) for a boy on the paediatric ward with a collar and cuff to adjust it to be more effective. Nicole was scrub nurse and I was the circulating nurse with Jack to perform the instrument counts.

The next patient I prepped and was able to put in an IV cannula myself! I was pretty happy about that. Also I watched Dr. Mwansa perform 2 cervical screens during the other surgery. Nicole also scrubbed for the last one as scrub nurse and I was again circulating nurse with Jack. The last surgery was a BTL (bilateral tubal ligation). Dr. Mwansa helped to get the patient prepped with LA (local anaesthetic) and accidentally got a needle stick so we looked at the patient’s ticket and there wasn’t a recent PTC (HIV test) done so she had to go find one to perform the test on the patient. This incident was a very good reminder that anyone can get a needle stick injury and we should be hyper-vigilant in not only protecting the patient but ourselves.

During the case Dr. Lipsi was teaching about John Huss and others from the protestant reformation. I know some of this topic but he had to give me a refresher. He seemed to be talking directly at me as he saw I was interested by the topic and information I suppose. It was fascinating stuff for sure. Later the finally found a PTC so Mwansa got the result for the patient and thankfully it was negative. After we finished the last case it was quite late (some time after 6:00pm and dark outside).

Nicole and I walked back to the house to start making supper and Fiona had not returned with Dorothy yet. We just made something simple -vegetable soup, ate the last of the naan bread and I boiled some sweet potatoes. Then we decided that we could make some peanut butter cookies. So Nicole made some and Fiona returned from her day trip and was able to have a meal of leftovers and we ate MANY of the peanut butter cookies, they were just SO good! It was like the brownie situation all over again but this time I joined in eating probably too many at once. We did leave a plate full for the next day. We then turned in for the night//

P.S. Fiona was very happy to have nshima 2 days in a row (she also was served a fresh big fish with it like Nicole had. I was the only one stuck with the small dried fish when going out with Dorothy).