Day 7

Hello friends, family, and newcomers. Welcome to or welcome back to my blog where I am documenting the process leading up to and during my first humanitarian mission to Eldoret, Kenya.

Breakfat :)

Today is Saturday April 5th, 2025. Today marks day two of our mission work. We are starting the day with 37 cases completed.

I was terrified of getting my period during this trip, as many of you know I have endometriosis, which can be debilitating. This morning, I woke up at 3 AM with cramps and spent nearly two hours in the bathroom feeling nauseous. I eventually managed to return to bed and fall asleep. Our alarm went off at 6, and I seriously considered taking the day to rest. However, I got up, prepared myself, and pushed through the day. I refused to let endo ruin this trip for me. I wasn't sure what the day would bring, but I knew there were people who needed me, and that was enough motivation to get out of bed, dress, eat, and join everyone else in the van.

The team in front of Gynocare on day two !

I took my medication, reviewed the day's assignments, and got started. Based on yesterday's work, I knew there were at least three patients who needed attention. Two required their stomas to be examined, and one needed to be marked for a colostomy creation. For those unfamiliar with the terms, a colostomy (stoma) involves bringing a loop of the bowel to the skin's surface and fitting it with a pouch, allowing the patient to go to the bathroom. This means they no longer pass stool through the anus.

In the late morning, after attending to patients who required attention outside of the usual rounds, I visited the Beyond Fistula store. This store is home to several seamstresses who have mastered their craft and create beautiful items. From book bags to toiletry items, bracelets, and more, their creations are exquisite. I placed an order for some items I desired, allowing them time to craft them. These will make wonderful gifts, and I'm excited to support such an incredible initiative. After visiting the store, I took some time to sit outside, observe, and take it all in. Near their homes are beautiful and fruitful avocado trees. Some avocados had fallen to the ground, and it was very tempting to pick one up to use in my meals. I also had the chance to watch them making hospital bed sheets. This was a remarkable sight. They lay all the blank bed sheets across a picnic table, place a screen with the hospital logo over the sheet, and use blue paint to screen print each sheet individually.

The hospital plaque!

After spending time outside, I was called to the operating room for a laparoscopic colostomy creation. This procedure involves making small incisions in the abdomen to insert a camera and instruments, avoiding the need for a full abdominal opening. I had the opportunity to place a pouch on the patient after their surgery, which was a surreal experience for me as it was my first time doing so. In the operating room, I prepared by getting sterile, sizing the patient's stoma, cutting the appliance to fit, and applying it. I also educated the OR team and nurses on colostomy care, emphasizing the importance of education to ensure everyone is informed. Here, education is limited, and the staff lacks familiarity with various stoma products and their suitability for patients. Providing them with basic knowledge will benefit both the staff and the patients. However, not being a certified WOCN made me feel somewhat like an imposter, as those professionals work hard to earn their certification and expertise. I relied on the skills I had acquired from observing them over the years. Nevertheless, it was an incredibly rewarding experience, and I felt grateful to be in that position.

I had the opportunity to collaborate with one of the urologists on our team. The exciting aspect of working with a diverse group of surgeons from various specialties is that everyone combines their expertise to ensure patients receive the best treatment and their care plans are coherent. There was a patient with a urostomy scheduled for a major operation. After discussing the case with my colleague, Dr. Ali proposed that we pouch the intubated urostomy, allowing the patient to be free from the urine Foley bag. I had the chance to pouch my first intubated urostomy, and the patient is doing well. She will no longer require a major operation unless she chooses to have one.

Apart from going to the operating room to place a pouch after the lap colostomy, I had the opportunity to observe several surgeries. I witnessed a c-section, which was incredibly moving, and I found myself in tears as the baby was delivered. It was indescribably beautiful to see life entering the world in such a way. Interestingly, after the baby was delivered, the uterus was temporarily outside the body, and in a strange way, it was quite beautiful. I listened intently to the OB as he discussed the presence of endometriosis on the patient's uterus, tubes, and ovaries. Seeing endometriosis on an organ firsthand was surreal. I felt a deep empathy for the patient, knowing she likely faced challenges because of it, yet I also felt joy and happiness that she was able to carry to term and deliver a beautiful baby boy. Becci, my new best friend, assisted in this case by cutting the cord and sutures. She is a second-year medical student about to start her clinical rotations and is incredibly talented. I am extremely grateful to have shared this experience with her. The final case I observed for the day was a transvaginal hysterectomy, where the uterus is removed through the vagina. This procedure was necessary due to the patient's uterine prolapse, where her uterus was descending into her vagina. It was an honor to be in the theater today, watching my colleagues demonstrate their exceptional skills.

It was another long day, yet so beautiful, filled with numerous life-changing experiences. Once we returned to the hotel, we dropped off our belongings and decided to visit an Indian restaurant. We walked there from our hotel, which might have been a questionable decision, but it turned out fine. There were seven of us in total, and the food was excellent. It's nice to unwind and spend time with some of the group after our busy days. Another surprising aspect for me is how affordable the food is. Our bill for all seven of us was $65. Often in these situations, one person pays, and then the rest of the group reimburses them, so we don't have to split the bill. After dinner, we walked back to the hotel, and I got ready for bed. I'm noticing that I become more tired as each day passes, but I've never felt more alive or happy. These women, my colleagues, and the hospital are what keep me going.

71 total cases !! WOOHOO

Today was a day full of firsts for me. Having been in medicine for 6 years, I'm continually amazed by the capabilities of the human body and what we can do to support it. Despite feeling tired, my body being uncooperative, and in pain, it was an incredibly rewarding day—one of the best. We have completed 71 total cases and have 5 more days to go. The team is working tirelessly to help as many women as possible. I cannot express enough how honored I am to be here. This experience has forever changed me, and I am deeply grateful for everything it has taught me and for the incredible people I've met and connected with. I experienced a whirlwind of emotions today, and I doubt I'll ever find the words to fully describe them. Each day comes with its own highs and lows, its own rhythm. Until tomorrow :)

All Love,

Meg