Matthew Weighs In...

4.10.2011

After several days of travel, we can finally say that we reached our destination. We actually reached it on Friday, but this is the first access we have had to the internet since leaving Chicago. It was a fairly uneventful trip although a little exausting. I still feel I am having trouble adjusting to the time change and try to take naps whenever I can.

We had the opportunity to take a brief tour of Tumutumu hospital this weekend and learn more about where we are spending the next few weeks. Tumutumu has approximately 100 inpatients and is housing medical, surgical, gynecological, pediatric, and maternity patients. There is a surgical theater (OR), xray, and ultrasound services that are available on the weekdays. The hospital has no ICU beds and all critically ill patients are transported to the nearby hospital in Nyerie- approximately 30km away. Still, Tumutumu is a referal center for the nearby area of Karatina and cares for the "sicker" patients.

There are only 2 nurses staffed at any time, but Tumutumu houses a nursing school on the hospital grounds and the nursing students do the brunt of the patient care. In addition the hospital hosts a variety of medical students for one month rotations (currently there are 9 Chinese medical students staying in the guest house next door.) The hospital is staffed by 3 physicians- an internist, a surgeon, and a gynecologist. The remainder of services needed a done on a consultant basis with the consultants visiting during the weekdays.

There is minimal staffing at Tumutumu Hospital on the weekend, so my first day at work is not until Monday. I'm not exactly sure what my capacity will be, but  I assume that I will work with the  Comprehensive Care Clinic, an outpatient clinic to treat the large population of TB and HIV patients. I asked one of the nurses to give rough numbers on how many people they see a day and the only estimate that I got was "a lot."

Currently, I am struggling with my role as a physician and "missionary" here. I know this has a lot to do with the fact that I have not started work yet, but it still is a source of some anxiety for me. One of the joys of emergency medicine is that EM physicians are highly adaptable to most situations. While there is no formal emergency room here, I feel that my training will allow me to help out in a variety of areas here. And while I have had experience in treating both HIV and tuberculosis, I feel that there will definitely be a learning curve as to how best to diagnose and treat with the resources avialable. There are also a variety of disease that I have no experience treating (I honestly can't say I've ever seen a case of yellow fever or African sleeping sickness in South Carolina!).  I expect to learn much from Dr Kariithi and the rest of the Tumutumu staff.

My wife and I are currently reading a book by Henri J.M. Nouwen entitled Gracias! A Latin American Journal reccommend by our friend Sarah Cooper Searight. Nouwen is a Catholic priest who travels to South America to minister to the poor through the church in the 1970s.  In Gracias! Nouwen describes the changing face of mission work.  This passage spoke to Christina and I:

"It is hard for me to accept that the best I can do is probably not to give but to recieve. By receiving in a true and open way, those who give to me can become aware of their own gifts. After all, we come to recognize our own gifts in the eyes of those who recieve them gratfully. Gratitude thus becomes the central virtue of a missionary."

I hope that through this time I can help as I'm able and most of all be grateful for those that teach me through our fellowship.