Where do I even begin with today! We started our day with a tour of the hospital in Voi. Then a group of 5 of us went on home visites in the rural parts of Voi. We visited 3 homes. The first home was make out of clay walls with a dirt floor and was about 7 feet by 7 feet. The patient pulled out chairs for us to sit as we entered her one room home. Mary is 38 years old and is HIV+. We were visiting her to confirm that she was taking her HIV medications properly ans was not skipping any days. HIV medication is not effective if the patient is not eating and Mary has very little to no food each day. We spent about 15 minutes in her home and then provided her with $5 for food and water.

Our next home visit was with an older man that was 84 years old. He lived in a similar home with a dirt floor and the clay bricks. The home was 6 feet by 6 feet. It included one tiny twin size bed, a night stand table and an open chimney. Paul was blind due to his hypertension and he is also HIV+. He contracted HIV because he was a night guard that worked at a truck stop. Women would sell themselves for food and money which led to him contracting HIV. While we were in Paul's home a chicken and 3 chicks came out from under the bed. So crazy! We finished our work up at Paul's home and headed down the road to visit another patient.

       Our last home visit was with Dorothy. As we walked up to her house, there was a 2 year old child laying on the ground sleeping covered in flies. The patient was a 33 year old woman with 2 children. Dorothy was diagnosed with HIV and had a new diagnosis of TB. We sat in her home mwhich was a little bigger than the last two houses. She also had many skin lesions that she was told is melanoma. The growth of her skin lesions and blisters has grown 3x their size in the past 2 months. Along with all of her other health issues she was very jaundiced. We left her with water and $5 and went on our way.

        The group was split into four groups in the clinic where we got to spend 4 hours with various healthcare workers. I  (Ali) was one of the students to spend time in triage with a nurse. We met all patients before they met with the doctor for their appointment. We obtained vitals, height, weight, pill counts and asked various questions pertaining to their visit. In 4 hours we saw 48 patients of all ages. It was amazing experience to be a part of their clinic visit and get some time provide education. BMI is monitored closely. All patients had a blue or yellow card with their HIV status and recent weights from previous visits. It was important to provide education and address concerns with the many low BMIs. Something to take away from this expirince is how appreciative clients are and eager to learn about health. Many of the diseases such as HIV and tuberculosis we do not address much in the U.S. It was an amazing learning experience culturally and about various diseases.

One doctor we worked with put on different hats. Some of the other things we accomplished today was going over a cervical cancer screening. It is different than how we do screening in the United States. Some women get the than women in the United States do. Another thing we did today was take vital signs and give assessments of babies and their mothers.

       At about 5pm the hospital received a call that they had an emergency cesarean section on their way. The woman was about 30 minutes away so we spent those 30 minutes prepping the surgical room. About 2 men were in and out of the room in their sterile gear throughout the 30 minutes. We also were all able to be in the surgical room so about 18 people were in the room not including the patient. We all wore sterile gowns, scrub caps, and masks, but there were not any gloves provided. We were able to take pictures and video tape the entire surcery. From when the mother got the epidural to when the baby came out it took less than 10 minutes. It was AWESOME! The majority of us have never seen a cesarean section before so for us to be able to say we saw our first in Africa is pretty amazing! The mom and baby girl are both doing great and the baby arrived at 39 weeks and weighed 6lbs 2 oz.