Kijabe Living

So while M is spending his time in the OR, I needed to find something to occupy my time. Per usual, it was impossible to set something up prior to arriving in Kijabe so I set about doing what I always do in Kenya: make it up as I go along.

The first order of business on Monday was keeping the doctor fed and watered. This is the first time in Kenya that we've lived in a town without a large food store. Although there are some small shops and a vegetable market, food shopping leaves much to be desired. The small shops carry about as much stuff as a mid-sized gas station so I've been having fun thinking up meals. The veggies are amazing though because of the constant growing season up here so we're definitely taking advantage of all of it. In addition to the food, we still need to purchase or boil/strain all of our water so I walked home with a 5 liter jug of water on my head. I still have to steady it with my hand but I've been practicing and my neck is getting stronger. Honestly, it's not that much easier than carrying things in your hands but the looks I get are priceless.

Tuesday dawned and M headed to the hospital (100 yards away). I had heard a tip that sometimes they needed volunteers to help prep the surgical kits so I headed down to the OR to see what I could find. I think they thought I was really weird but they gave me a gown, shoe covers, gloves, and a fancy hairnet and led me into the room where they prep the kits.

So as we've previously mentioned, very little in a Kenyan hospital is disposable and nothing is bought in a pre-packaged kit. So, if you've ever seen anyone tear open a packet of neatly folded and sterilized gauze, those have to be assembled by hand in Kenya. First, you take a giant 5-ft roll of gauze and cut a 6-inch square, then you fold it in thirds, and then in halves to make a neat little gauze towel. Now repeat for 2 hours. Then we prepared cotton balls and no, they don't buy the pre-packaged ones from CVS. They have a giant ball of cotton batting so you tear it off, ball it up in your hand, and make a cotton ball. Once we had prepped enough gauze and cotton balls, we began preparing kits.

Gauze piles:


When a surgeon enters the OR for a case, there are usually one or more specialized kits available with all the necessary tools for the procedure. So for example, the kit contains different instruments for a c-section vs. an ACL repair.

You can see pediatric instruments to the left in this photo as well as the bowls for gauze/cotton balls:


So with a really loud noise, several men entered and dumped all of the instruments used in the previous day's surgeries on the table. These instruments had already been washed at least once and now were ready to be re-packed. Everything was in a giant jumble: forceps, rods, basins, bowls, speculums, scalpels, etc.

They taught me to put together some of the basic kits and we began to assemble the instruments and the appropriate amount of gauze and cotton balls. When complete, these were wrapped in surgical material (the same material the surgical scrubs are made of) and taped closed. This entire packet goes into the auto-clave to be sterilized and then can be used in surgery. It had never occurred to me that they have to sterilize the gauze and cotton balls used in Kenya because they can't buy them sterile. It was amazing.

Another interesting thing was this sewing machine. They sew and repair all the sheets, surgical clothes, and scrubs onsite. Nothing is thrown away. I saw them piece together scraps in a sort of madras style surgical towel (I guarantee that sentence has never been written before now) so as not to waste anything.



Anyway, tomorrow I'm going to do something new since one can only fold gauze for a few hours before dying of boredom (well, if you're a spoiled American). It was really interesting though to see the functional pieces of the OR kits that the doctors use everyday so I'm glad I did it.