T.I.A.

Every once in a while I have those moments where a situation takes me by surprise and I realize, This Is Africa.

Here are a few.

Working in the Casualty (ER) writing a note and the power goes off. Black out. Fortunately there is a backup generator that kicks on within 12 seconds. The ICU is grateful for that, especially when they have patients on the ventilator.

Here's a picture of the hydro where we get our power.

I'm used to traveling in the third world. The overcrowded matatu, near misses while passing 3 cars going up hill around a turn, sharing a seat with chickens on the bus, holding a baby on my lap for 3 hours (not quite sure where the mother was) etc. However, I witnessed a new sight. The hatchback was about 10 people over its capacity (not a new sight) but what I didn't expect was to see the cow in the back seat.

No anesthetist in the OR for an hour while our patient is under general anesthesia...

Six people on a piki piki (motor bike)...

Treating a patient who was gored by a buffalo.

Doing a below knee amputation with this...

The Emergency Department is called "Casualty"

Working in Casualty and realizing there is no blood pressure cuff, or normal saline, or gloves, or suture, or monitor...

No soap on the second floor of the hospital.

Being laughed at every time I call a patient's name.

Camping at the top of a 7,000ft peak 60 miles south of the equator with 20 African children in 50 degree weather and one 10 year old boy named Petunia saying, "This country I come from is very cold."

Washing my hands in brown water coming from the faucet.

Cleaning surgical equipment that is generally thrown away in the US.

In the middle of a rectal exam when the power goes off. (No picture for this one)

And treating patients who otherwise would have no access to quality medical care. These T.I.A. moments make life here exciting and interesting.