First Impressions of Tenwek

We have being experiencing so many new things as we begin to discover this amazing country and culture. The following are some first impressions and experiences of Tenwek hospital...

Dad
We had a tour of the hospital complex the first day we arrived. Knowing the humble beginnings of the hospital in 1959 (through reading the “Miracle at Tenwek) contributed to my amazement at the extent of the current 300 bed facility. It has become a referral centre only by virtue of its reputation. My first day was spent in the emergency room. Hundreds of people present to the hospital every day. Many of them have been told to come on a specific day for one of the various outpatient clinics (HIV, TB, Maternal/Child Health, Orthopaedics, Dental, Outpatient and Chronic Disease). These are mostly staffed by national Nurse Practitioners with a couple of national MD’s. The rest just show up and are triaged to one of the above clinics or to the ER – these are the sickest of the sick and more often than not require admission. Common medical admission diagnoses are severe pneumonia, meningitis, typhoid (current epidemic), malaria, sepsis, heart failure, diabetic ketoacidosis and dehydration. Common surgical diagnoses are fractures, surgical abdomen (recently often a perforated typhoid ulcer), esophageal cancer and acute urinary retention. About 40% of admitted patients are HIV positive (7% in the general population in Kenya). My second day (today) I spent the morning on the medical floor – the complexity and acuity of illnesses is staggering. An incredible amount is accomplished with the limited diagnostic and therapeutic resources available. The afternoon was spent in ER where we had status epilepticus, suspected meningitis, severe pneumonia with liver failure, periodontal abscess and a comatose young man who attempted suicide by ingesting poison (an increasing problem). I will have a very steep learning curve for the next couple of weeks. Fortunately my first night of call will not be for another week – they say it can be quite brutal (covering all the medical wards, the ER, medical problems arising on the surgical and OB wards, and a 6 bed ICU with 2 patients on ventilators). I am grateful for the mentoring of the long term missionary doctors, my PDA (containing all the Up to Date information I need!) and the many prayers of our supporters. Already this had been an incredible learning and stretching experience!