I worked in a hospital once.
Mbagathi Hospital, the little government hospital on Mbagathi Way. The one that you should thank God you have never been to, or will never have to go to. During my time there, it was a sad place and I genuinely hope the government fixed it, too many sick people, not enough doctors, or nurses..and that how I worked there.
I did a paramedic programme at the Kenya Red Cross, and as part of my internship, I was assigned six weeks at the hospital. I was 20, fresh-faced, and a little too eager to make a difference.
My first day working there was memorable, I had heard bad stories of a strain of tuberculosis that was drug-resistant, and consequently, (and naively), I wore gloves and mask from check-in to clock-out. A few hours into the internship, I met this matron, stern faced, stocky and with a perfume that only nurses have, strong enough for you to take notice, and subtle enough for the scent to hit you on the third sniff. She asked me why I had my mask on.
I thought it was rather obvious why I had it on, but I had to say it anyway, “Eeeer, because I don’t want to get t.b”, I answered.
She looked at me, and she had a look of utter disgust on her face, then she breathed in, and told me, with clenched teeth, that I was being insensitive to the sick people. Then she walked away, ending the conversation with a finality that said me and my mask could shove it. That was tough, disposing of the mask and gloves, my only remaining defence against tubercle bacillus according to my 20 year old self. I did it anyway, largely because the nurse looked like she wasn’t afraid of causing a scene to put me in my place.
A few weeks later, (and gladly still tuberculosis-free), I was stuck in the burns unit for my wounds and dressing practicals, and the nurse, as always because of being under-staffed, left me alone. This guy, I think he had diabetes, and his feet had those festering wounds that never heal. I was bent over, hard at work, washing them, and the smell was killing me. I didn’t want to wear a mask though, because I didn’t want the matron to walk in and dress me down in front of a patient. So I suffered in silence, because sometimes the patients are too poor to afford the fare to come to hospital,, the dressings aren’t changed daily as recommended, and the wounds can get your eyes watery once you unwrap the bandages. I took it all in, until another matron came in, looked at me, walked out and came back with a mask. That little scenario taught me although I needed to be humane, I should always let common sense prevail.
DESPAIR AND VALIANT, NOBLE NURSES
For me, the saddest thing in Mbagathi was the fact that people never seemed to get better. In a later stint at Kenyatta, I’d see people make recoveries in days, and head on home. But in Mbagathi, people seemed to get worse, thinner, the coughs more raspy and productive, the beds more squeezed, the only thing that seemed to improve, *sic*, was the figures on their bills. That was hard to take, because there were literally kids who’d spent a whole year at the wards, and they knew nothing but hospital gruel and white rice, whose grains were fatter than their bodies had ever been. Then there are those that just wait for death, no family, no money for surgery or for treatment, no nothing. Nurses are amazing people I tell you, during ward rounds they have to treat everyone the same, regardless of how rude, dirty, poor, smelly or hopeless they are. I respect doctors, it’s the noblest profession for me, but it’s the nurses that are left behind to give the dosage prescribed by the doctor. Sometimes the patients are in so much pain already, especially the kids, you have to fight them to get them to get injections/drugs, it’s worse even when they don’t have relatives, because you have to hold them and administer drugs by yourself. Also, because of the cold, they close the ward doors at Mbagathi at night, so if there is a ward round at say, 4 a.m, the stench that hits you when you open the door..all I’m saying is there should be a special place in heaven for nurses.
THEY CALLED ME DOCTOR.
During first week, because they couldn’t throw us into the deep end, all we did was take down patient details. I was stationed in paediatrics, and since babies don’t know a lot about themselves, I asked their parents questions on their behalf. Most babies only had their mothers with them, (another reason why everyday should be mother’s day for your mum), because the father was busy working, drinking or being an absentee father. It really made me sad to hear unemployed families with five kids onwards, or 24 year-old women with three kids with no steady source of income. It breaks your heart to see someone struggle to pay Ksh 20 consultation fee, while they have four kids, makes you wonder how/what they feed their kids on. I’d wear a blue shirt with a logo, and black pants, meaning I was not even a nurse but a basic paramedic, but sometimes people on the queue would get so desperate, they’d ask me to check their kids for them. Thank God that most times it was just heightened temperature, or irritation, and I’d give a spoonful of paracetamol and smile and tell them the doctor would soon be with them. The worst thing for me was that, I was light years away from a doctor, (we studied anatomy for a week, doctors study anatomy for a year), and they were so desperate they trusted anything I said. Something needs to change in regards our healthcare, a major paradigm shift.
One time, late at night, I was walking down a hall, with my stethoscope, looking all doctor-ish and whatever, (I was a foolish, vain 20-year-old) and a lady came screaming at me, she grabbed me and I followed her to the paediatric section. The room was empty, except for a baby that was convulsing on a baby cot. It’s easy to write convulsing, but when you actually see it for yourself, the eyes roll back, the arms shake like a rag doll under the control of a toddler, then the choking sounds the patient makes, you can’t put that in words, you cannot. My mind went blank, I didn’t know what to do, so I told the lady to wait then I run out and came back with a nurse, I was so scared and confused that I was swallowing words. The nurse was so chilled when she was administering whatever drug treats convulsions, that all me and the baby’s mother could do was look at her in horror. The baby came back to normal, for a few hours, and then he suddenly stopped breathing. Resuscitation didn’t work and seeing the mother, she looked like she was in her early twenties, in denial was just the worst. I saw a couple of people die when I was there, but that baby’s death was the saddest. The mother cried till her voice got lost, wailing for hours on end, talking to the dead baby, asking questions like she genuinely wanted a reply. The lone ambulance was away, so we couldn’t even pretend to rush her to Kenyatta, so she had to stay there and watch the baby she had sacrificed so much for get rigor mortis. The worst thing though, was that apart from a few “I am sorry” statements, she didn’t have anyone to comfort her, let her cry and let all that hurt out.
I saw lots of things at Mbagathi, ill-equipped ambulances, crammed beds in maternity, (a crammed bed doesn’t sound too bad until you’re 38 weeks pregnant, your feet are swollen and you have to share a tiny bed with a stranger whose level of hygiene you don’t know). I saw people lose fingers, feet, organs, children, relatives. I heard voices, screams of mothers delivering, I heard boys screaming as broken bones were re-aligned, I heard the unmistakable screams of someone mourning someone who just died.
The matron was right, no mask or gloves can save you from witnessing all that is wrong with our healthcare system. What is even sadder is that there are people, and a large majority, who came from far-flung areas, because Mbagathi was way better than what they had back home.
I hope the government changed things, because nobody deserves to share beds with a stranger of indeterminate hygienic standards. Also, I dislike politics as much as the next guy, but the truth is, except for a select few, it affects how we live our lives. A lot of people I saw in Mbagathi are people that are easy to sway, with a hundred bob here, an umbrella and t shirt there, so if you feel helpless just remember that in the next elections, you can put someone who actually cares about people in power. Someone who will talk to people about family planning, provide preventive measures, pay our doctors and nurses better. Someone who will ensure that interns don’t have to worry about masks and gloves when they are posted to Mbagathi.