A Kitty In Kenya: Annual Report

As I am celebrating the end of my first year on the field, I am excited to say that I feel like it has been a productive one. The learning curve has been incredibly steep, but the OB team has grown and improved in many ways.

I am so thankful for the way that I have been embraced and welcomed into the OB department. I am much indebted to the many people who have helped make this year possible: nurses, visiting doctors and students, donors, prayer partners - so many that I cannot even name you all, but your assistance and support has meant more than I can ever say.

Resources
Finding and keeping resources is a challenge at any mission hospital. One of our challenges this past year has been supplies: vacuums, protective eyewear and masks, nitrazine paper, a fetal heart doppler and other useful tools that tend to "walk" off.

Thanks to our nursing supervisor, we were able to secure a locker outside the OB theatre and stock it with supplies brought by our very generous visitors. Now, we are better able to alocate and locate our supplies. The interns share a doppler and have been very responsible with its upkeep (of course, I did threaten to disembowel them if it got lost!). They also now have access to protective eyewear for surgery (very important in our high HIV population).

For those of you who have generously donated to my Project Fund - I have used some of those funds to restock equipment for the nurses and interns: new blood pressure cuffs, stethoscopes and batteries for equipment, cytotec for inductions of labor, personal hand sanitizers (great when doing wound dressing changes as soap is not always readily available).

Protocol
When I first arrived at Tenwek, I was often told to refer to the "OB Protocol" Book. It took me a few weeks to find this epic book and when I did find it, I was vastly underwhelmed. It was a softback book, bound in old newspaper, with mainly information, but few actual guidelines inside. In order to standardize care, and decrease maternal morbidity and mortality, a effort was begun to update - and create - hospital protocols.

We now have standard protocols for: Preterm Labor, Rh isoimmunization, Pre- and Post-Op Antibiotics, Miscarriages, Vaginal Delivery after C Section and Operative Delivery. The protocols were a joint effort between OB doctors and OB nurses. Several more are currently under way, but this endeavor has greatly improved communication among caregivers and has hopefully helped to decrease our wound infection rates.

Our OB clinic - MCH - has also asked for practice guidelines regarding common occurences just to ensure that practice is consistent among all the providers/interns.

Education
Education has become a huge part of my ministry here at Tenwek. In August, I purchased pocket textbooks for the interns; the books became so popular several interns have asked to buy their own copy.

In addition to teaching/group rounds, I have tried to implement quizzes during the OB rotation. Each rotation also now holds the tradition of having a "suture party," where interns - past and present, gather at my house for a tutorial on proper knot tying technique and instrument handling. Afterwards, we have dessert and tea!

A few fond memories from the past year: