I don't have photos, again, sorry...my phone was taken with all the photos on it for this last month. So, I'm working on getting some more for this month's update.
Blessings,
Michelle
A week in the life of Michelle Doran
So, I’m an Ob/Gyn living in eastern DRC. I speak decent Congolese French and am
learning Swahili. I’ve been at Nyankunde
hospital for the last 3 years and have had some very interesting
experiences. Some weeks are calmer than
others, but I’m going to tell you a little bit about last week.
Malaria, it’s now the 3rd or 4th time
that I’ve had it. I woke up in the middle of the night with chills-teeth
chattering, searching my house for a second blanket—followed by sweating and
fevers. I throw off all the covers and
have to change my clothes because they are soaking wet. I know I have malaria, but it’s the middle of
the night and all the tests are negative.
So the next morning I go see my next-door neighbor Anna. We eventually find a rapid test for malaria,
but after poking my fingers 5 times with no blood coming out and only part of
the kit, we make the trek down to the health center. Fortunately it’s in a car, even though I could
do without all the bumps. The test is
negative there as well, but I start the treatment anyways. I make it through
the day, but it’s not pleasant. I feel
like I’m in a mini-labor having stomach cramps.
But, 12 hours after accidentally taking a double dose of the medicine, I
feel much better.
The next day I am outside my house after spending almost a
complete week in bed. And, 2 days later
I am back at work...consults, rounds and a C-section. The following 2 days I had every intention on
returning home early, but I ended up rounding early, having a surgery lasting
longer than expected, having an emergency surgery and then had to deal with the
aftereffects of a mom dying from anemia.
That was a tough moment.
We have moms who die here 3 or 4 times a year. It’s a lot better than some other places I’ve
been, but it was hard. She died because
she had a bad reaction to a blood transfusion where her lungs filled up with
fluid. What made it worse was that her
almost full term baby wasn’t taken out by c-section when they realized that she
had died. There have been 3 maternal
deaths this year all from problems with transfusions or bleeding.
With each one we sit down and go through what we could’ve
done differently. So much...a delay in
diagnosis, no ultrasound was done to confirm the age of the baby, a transfusion
was given but the patient was followed well and there was no post-mortem
c-section to save the baby. So, we
crammed 20 people into my 10’x10’ office and discussed this until people
started blaming each other for what went wrong.
That’s when I just lost it. I
don’t cry often, but it’s just awful to have something like this happen and
then everyone try to blame someone else for what went wrong. In the end, the responsibility lies with me
to teach, to train, to help people understand what to do better next time. And, helping people understand the importance
of taking responsibility for their mistakes in order to improve.
Well, because of this 2 hour meeting, I had to cancel a
surgery and then try to deal with all the different pregnancy complications
that come with malaria season...anemia, blood transfusions, low amniotic fluid
levels, fetal distress, etc. It was
turning into a long day. We had over 30
patients in the department with their babies with some of the beds having 2 people
in it. The lab wasn’t getting out
results. And, we had 2 emergency
c-sections and a D&C on a lady who was bleeding significantly.
This, of course, was the day that I got back the money I was
asked to exchange in the US. I was asked
to take a large sum of money back to the US to change the money into new
bills. In the DRC, if a bill is older
than 2008, has even the tiniest tear or doesn’t look pretty enough, it won’t be
accepted, not even by the bank. So, I
took the money with me when I left in May 2017, I gave it to someone in
Samaritan’s Purse, they sent it back to the DRC where is preceeded to sit in
someone’s office drawer. The person who
brought it back no longer worked for SP, so it took 4 months to track down the
person and figure out where the money was at.
Finally, after all of this, the envelope with the new money
arrived when I was working. I was so
happy, so I put it in my pocket. Well, I
didn’t keep close enough track because I eventually took off my jacket in one
of our working areas and it disappeared...money, my phone and my house keys in
the only jacket I’ve worn for the last 2 years.
It was devestating. Losing
someone’s money after all that time and energy and knowing that I’d have to pay
it back out of money of my own. Not cool,
especially because it’s really hard to get money in the DRC.
I searched every department twice, but wasn’t able to find
anything. So, after a pretty awful day, I went home, had dinner and went to
bed. I had hoped that my jacket and my
phone would turn up, but it didn’t.
Everyone was really concerned at the hospital, but I had to accept that
I wasn’t getting anything back. I think
worse than the money was that all my information was on my phone. It has a code, but it takes forever to
download apps on a phone. And, a week
later, I’ve not been able to replace the SIM card because the person at the
5’x5’ phone “store” can’t figure out how to register a SIM card with an
existing number.
Well, the week continued.
The next day was just as busy. It
was better because I had moved past my stuff getting stolen and could focus on
life again. We did surgery, we helped
people and we worked until late in the day to get everything done. It was great to work with Dr. Deborah and the
resident was finally getting the picture that if he rounds early in the
morning, then he gets to operate.
So, I got up the next day to go down to our weekly doctor’s
meeting. It lasts about 2 hours and
includes a devotional, praying, talking about difficult cases and education. There are so many things going on at the
hospital that we didn’t have time to have the educational portion….water not
running at the hospital, the 5 or 6 deaths at the hospital because of late care
or anemia, not having a blood bank, how to improve things at the hospital
without having the resources to do so.
And, a discussion about a difficult case at the maternity.
There was a woman who came to have an operation from a town
far south of us. When she came she had a
catheter in her bladder and a note saying she had a mass in her pelvis. Well, she had some problems with parasites in
her intestines, some weird polyps coming out of her uterus and belly pain. I opted to treat her medically. A few days later one of her relatives found
me walking down the road and says that the patient actually went to the
hospital in Beni (the town south) because she was unconscious and not making
any urine. Well, I tucked that
information away to talk to the patient the next day. Well, that’s when I got
sick and the patient had to wait. When I
finally got back, we then had the meeting about the maternal death. Then she had a reaction to her
transfusion. Finally, almost 3 weeks
after she arrived, we decided to operate on this pelvic mass the next day.
Well, after rounding and seeing a few patients, I decided I
should probably catch up on the 30 emails I’ve ignored over the last week. So, I walked down the hill towards MAF (the
pilots and airstrip). I go down there
because they’re kind enough to let us use their really good internet. So, I grab a key to an empty house and sit on
the floor in order to respond to the wide variety of emails in French and
English. 4 hours later, I decide that I
can’t do any more, so I head back up the hill about a ¾ mile home. I’ve figured out what I’m going to do for
vacation, I try to see what’s going on with the travel plans for the visitors,
I e-mail about getting a health evaluation for myself, I start working on the
contract between Serge (my organization) and CME (the hospital) in French, I check
to make sure no one’s used my credit card information from stealing my phone,
which I assume they figured out the code because they called one of the doctors, and I replied to multiple personal emails.
I can’t quite remember what I did once I got home, but I think it
involved making dinner, working in the garden, trying to clean up my desk which
is a disaster and then getting to bed.
And, trying to reply to all the emails I got in return to the ones I sent out earlier in the day.
Well, Friday was looking up.
I’d caught up on a lot of correspondence and we were finally going to
operate on this lady who had been waiting for 3 weeks.
I looked through the clear window of the OR door. They were just putting in the medication into
her back (spinal). I walked towards the
changing area when one of the interns found me and said there was an emergency
in the operating room. I was there less
than 30 seconds ago, what could be the problem? I walked back the way I’d come
and see multiple people standing around the OR table with the patient laying on
the bed which was tilted at 30 degrees.
The new anesthesiologist in running around at the head of the bed
looking for something. So, I ask what’s
going on as I examine the patient. She
stopped breathing and her heart wasn’t beating.
It was one of those moments that I was glad I’m bossy and
that I’ve dealt with a lot of emergencies before. So, I tell them to put the bed flat and started pressing on her chest to
circulate blood while bossing around all the people that had no idea how to
resuscitate a person. Put a tube down
her throat to breath for her. Try to get
a bigger IV. Go get Dr. Patrick to
help. Look for the medication called
epinephrine. Give her 1mg. Go get more
IV fluids. No, you have to empty the air
out of the IV line. Change positions with me.
You have to press harder than that for compressions. What’s her pulse? Is she breathing? Thanks
Patrick for getting the defibrilator.
What’s her heart rhythm. Stop
touching the patient. She has a heart
rate again. Doesn’t look good. Keep
giving fluids. Stop compressions. Is she
breathing on her own now? Leave the tube
in place until she can pull it out on her own.
She’s having an MI (myocardial infarction/heart attack). Keep the oxygen going...etc. Then I had to
run, down to the health center and back to get aspirin because there wasn’t any
at the hospital. And, the patient could never figure out that she was supposed
to chew it instead of swallowing it. But, she lived, and I was convinced that I
wasn’t going to do surgery on her. The
poor lady waited 3 weeks for a surgery she will never get. Thankfully, her family understood. Disaster
averted.
Thank God for the weekend.
Saturdays are half days. So, I
show up with the thought that maybe today will be a little different. Well, I did end up going to the local,
open-air market where I bought cabbage, beans, tomatoes, onions, and some other
things, I got to finally talk to the lady to whom I’m giving money to help
build her roof (her husband left her with 9 people to care for and she makes
less than $100 a month), I help celebrate Luke’s (my 6 year-old neighbor)
birthday, I went to the church to encourage people to donate blood for free for
all the people dying and I paid back Katsiko the money that had been stolen from me.... This was intermixed in with 2 c-sections, rounds
and a few consultations. One of the
c-section was on a lady who was newly diagnosed with HIV just before the c-section.
Sunday is my day off.
Well, it seems like it’s the day to get things done. I woke up late with a sore throat. It was raining for the 7th day in
a row. The solar electricity hasn’t been
running well because there’s been no sun.
So I get up an switch on my fridge, which has been off all week because
the solar batteries don’t last through the night. I get dressed and I head to church. I’m thankful I’m late because today the
generator has gasoline and they are using the microphones and the
amplification is highpitched with whining—a sound that only dogs should hear.
I sneak in the back and listen to what’s going on. The lady behind me needs me to unzip her
shirt in back so she can breast feed. The new
missionary family’s son keeps walking back towards me to smile and wave. I can hear what the pastor is saying because
there is a microphone and it ends up being a really good talk. I think it’s the first time I take notes and
actually have paper and pen with me.
Church ends and I walk through the mud in my flip-flops back home. I need to find bananas so I can make banana
muffins for breakfast throughout the week, but no-one’s been able to find
them. Well, I catch a ride with my
neighbors who are heading down the hill so I can go to the market, but then I
realize that the guy from MAF is heading up the hill to help me with some
projects at home. I jump out of the car
and head back up the hill.
I finally got the door latch put on, the soap dish hung on
the wall, the hinges on my cupboards tightened down. I helped some, but I was working on making
beans. I had soaked them and cooked them
and now I just had to heat them in oil with some spice. I also was able to make passion fruit
juice. You cut them in half, dump them
into a fine strainer, put water over top and grind the seeds against the
strainer with a spoon to press the juice through. And, I worked on some other
things in the kitchen while getting help with all those other projects. So, after this I thought about sitting
down. Sunday is a day to rest, or so I’m
told.
Well, that changed.
One of the nursing students that works in the yard told me that the
youth meeting was at 2pm instead of 3pm.
Funny how they failed to mention the time change since I was the one
talking. So, since it was already
2:15pm, I thought I’d head back towards the church. Well, I was the only one there even though I
was late. Thankfully, people started showing up.
It was the first time I had talked with the youth
group. My voice was holding up, despite
me sounding like a chain smoker (laryngitis).
And, we talked through the very taboo subject of sex. There ended up being close to 100 people
there. And, there were people with some
very specific and detailed questions.
But it was great because they were talking. Somehow I got volunteered to talk about
normal anatomy next month.
Heading home, I thought about the last week. It was a tough week. I don’t typically have things stolen, but the
rest of it seems status quo. I thanked
God for my returning health, that the lady we tried to operate didn’t die, that
I could converse in French, that I have the resources to repay that money that
I had stolen, that it’s warm enough here that I don’t really need a coat, that
I have friends who look out for me and I have a good home where I am safe.
It ended up being even better when I got home because I had
bean burritos for dinner and I got to eat some cake and ice cream that someone
had made for Luke’s birthday. And, I got
to see some missionaries that had spent a few years in Nyankunde but are now
working in an even more rural hospital.
I went to bed wondering what the next day would
bring...today. Well, it seems like maybe
it will be a little less intense this week.
