Thursday, March 27, 2008

A Day at Our Clinic

~ by Michelle Kiprop
ELI Family Nurse Practitioner

While studying to become a nurse practitioner, I chose to specialize in Family Practice because I figured in this setting I would see just about everything. And boy was I right! I’d love to write about our typical day but I’m not sure we really have one...

I’m the only American at the clinic; the rest of our staff are amazing Kenyans with a boatload of experiences. We have two highly trained RN’s, a Clinical Officer (very similar to a physician’s assistant), a dental technician and a laboratory technician.

On Tuesdays and Thursdays we provide antenatal care and do well child immunizations. We typically have many malaria cases throughout the year. The clinic staff cares for patients from all walks of life and with many different types of problems. We may see a 2-month-old baby and then treat the grandmother who brought her in the same visit. One of my recent weekend clinic adventures was suturing up machete wounds from a domestic dispute.

Our clinic theme is “We treat, God heals”.

One of my favorite aspects of working in the clinic is helping the mama’s deliver babies. Last night was one of those special nights. A little after midnight I got the phone call “She is fully dilated and getting ready to push, you better come now.” William, my husband, got up with me to go to the clinic. We put on our gumboots (rain boots) and tromped through the mud using our flashlights to get to the clinic.

The patient was a 16-year-old I had been following in antenatal clinic. When I walked in the room the mama broke out in a huge smile and thanked me for coming. That moment alone was worth the midnight trek through the mud. If my presence could induce a smile like that at full dilation, the trip was most definitely worthwhile. Bernard, the nurse on call, declared that as I had followed her all the way through, I should be the one to deliver the baby. Thus far I’ve only assisted but haven’t actually taken the lead. Bernard coached me through step by step. I couldn’t have done it without him. And by the way, I still consider myself to have assisted in the delivery. I don’t think we medical professionals should get the credit for delivering the baby when it is the mom who does all the hard work!

Somewhere between 1:30 and 2:00 Karen Jemutai made her grand entrance. It was a difficult delivery with some minor complications. But I’m pleased to announce that both mom and baby are doing great this morning. What a joy it is to watch a new baby take her first breath and scream out her protest as she enters this world. Then those little eyes start blinking and taking it all in. Those first minutes are so precious. Mom and gogo (grandma) thought that I should name the baby. They asked me if I wanted to name her Michelle after myself. I told them that I was honored but I thought the mom should choose. Mama and baby Karen stayed overnight and are getting ready to walk home as I type. That’s right! Just eight hours after delivery mom wraps up the baby and walks her home.

Life in rural Africa is very, very different from life in the US!

Services offered at the Chebaiywo Clinic includes the following:
1. Curative (The treatment of injury or illness of just about any type i.e. from sprained ankles to malaria)
2. Laboratory Services (including HIV testing and counseling)
3. Maternal Health, Infant/Child Health, and Family Planning
4. Basic Dental Services (Usually resulting in tooth extraction)
5. Preventative Services: Sale of Mosquito nets and Water Guard (kills parasites and bacteria from well water to make it safe for drinking)
6. Outreach Services: Mobile Clinic (We literally take the clinic on the road to a remote location)
7. Reproductive Health Training Sessions (focused for local midwives)
8. Pharmaceutical Services
9. Maternity/Deliveries

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