Remera-Rukoma HospitalSome things are just hard. It was hard watching tiny kids on the streets in Phnom Penh begging or selling trinkets on the same corners every night, seeing poverty and sickness and social injustice, leaving Sandeep in India wishing we could adopt him as a little brother, hearing stories of where the kids we loved in Rwanda had come from and what they were up against in the future, and it was hard for me to volunteer at the hospital, some days more than others. But I still loved doing it. The highs outweighed the lows.
My daily drive to the hospital
The weekend after a genocide memorial for the Kamonyi District, more than a dozen new patients were admitted for post-traumatic stress crises, and hundreds more filtered through the outpatient mental health department. Some were mute, refused to eat, or still thought someone was hunting them, and others had spent more than a decade in prison for their part in the killings. I sat next to Jeanne, the mental health nurse I occassionally shadowed, and transferred their histories into new patient charts while she evaluated them.
The next Monday after the daily staff meeting I found Dr. Kakule and asked him about the intestinal perforation patient. He said, "She has died. Septicemia."
She was on my mind as I followed Dr. Kakule to the maternity ward and watched as he checked on his first patient of the day. Something seemed amiss so he took her to the ultrasound room, and after looking at the baby's heart took her immediately into surgery. I dreaded putting my scrubs on that day.
After making the first cuts, the baby's head didn't immediately appear as it had in the other C-sections I watched. Dr. Kakule seemed to have trouble finding it. He pulled out a tiny hand first, then the legs, and then he pulled the little boy out backwards. The baby didn't move. Dr. Kakule handed him to the nurse, who began suctioning out his mouth and nose, and pushing air into him through a mask. Fifteen minutes later, Dr. Kakule had finished stitching the cut from the C-section and came over to check on the baby. He was still pale and motionless. Dr. Kakule said something to the nurse, who wrapped the baby up and took him away.
As I helped Dr. Kakule untie the back of his surgical garb I saw a frustrated look on his normally calm face. "That baby has suffered," he said. "Because we have no oxygen. Maybe even now he is dead." He told me the nurse had taken him to the maternity ward where there were oxygen tanks, so I followed them there and found him wrapped in blankets lying on an inverted table under a heating lamp. The nurse put a nasal cannula in his nostrils and went to check on other patients.
I sat down next to him because it didn't seem like there was much hope, and I didn't want him to die alone. But when I slid my hand under the blanket I could feel his heart beating, even though his skin was cold. I watched him for two hours, and when I left for the day I was excited to tell the doctor that he was breathing every ten seconds or so instead of once or twice a minute, he was slightly warmer and he was starting to move his mouth as if he wanted to cry, but I knew he was not out of harm's way.
I went home feeling demoralized.
My daily drive to the hospitalThe weekend after a genocide memorial for the Kamonyi District, more than a dozen new patients were admitted for post-traumatic stress crises, and hundreds more filtered through the outpatient mental health department. Some were mute, refused to eat, or still thought someone was hunting them, and others had spent more than a decade in prison for their part in the killings. I sat next to Jeanne, the mental health nurse I occassionally shadowed, and transferred their histories into new patient charts while she evaluated them.
The next Monday after the daily staff meeting I found Dr. Kakule and asked him about the intestinal perforation patient. He said, "She has died. Septicemia."
She was on my mind as I followed Dr. Kakule to the maternity ward and watched as he checked on his first patient of the day. Something seemed amiss so he took her to the ultrasound room, and after looking at the baby's heart took her immediately into surgery. I dreaded putting my scrubs on that day.
After making the first cuts, the baby's head didn't immediately appear as it had in the other C-sections I watched. Dr. Kakule seemed to have trouble finding it. He pulled out a tiny hand first, then the legs, and then he pulled the little boy out backwards. The baby didn't move. Dr. Kakule handed him to the nurse, who began suctioning out his mouth and nose, and pushing air into him through a mask. Fifteen minutes later, Dr. Kakule had finished stitching the cut from the C-section and came over to check on the baby. He was still pale and motionless. Dr. Kakule said something to the nurse, who wrapped the baby up and took him away.
As I helped Dr. Kakule untie the back of his surgical garb I saw a frustrated look on his normally calm face. "That baby has suffered," he said. "Because we have no oxygen. Maybe even now he is dead." He told me the nurse had taken him to the maternity ward where there were oxygen tanks, so I followed them there and found him wrapped in blankets lying on an inverted table under a heating lamp. The nurse put a nasal cannula in his nostrils and went to check on other patients.
I sat down next to him because it didn't seem like there was much hope, and I didn't want him to die alone. But when I slid my hand under the blanket I could feel his heart beating, even though his skin was cold. I watched him for two hours, and when I left for the day I was excited to tell the doctor that he was breathing every ten seconds or so instead of once or twice a minute, he was slightly warmer and he was starting to move his mouth as if he wanted to cry, but I knew he was not out of harm's way.
I went home feeling demoralized.
Doctors after the morning staff meetingHe took me to the maternity clinic where the baby was wiggling and crying and bright pink on a bed next to his mother. Dr. Kakule picked him up in one hand and flipped him onto his tummy and watched him for a minute before picking him up again and examining him all over. He told me that on the day he was born, he was only a 2 on the Apgar scale, but now he was a perfect 10. I had to try very hard not to giggle as I watched the poor little guy struggle until he was safely back in the arms of his mother. It was the perfect end to an affecting volunteer experience.
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