Have you ever seen Grey’s Anatomy? Many of the episodes begin with a patient being rushed to the hospital in an ambulance and wheeled into the ER while all of the doctors are doing assessments and shouting orders to each other and trying to figure out how to save the patient’s life. As a devoted Grey’s Anatomy fan, I have seen so many of these scenes and it gets my adrenaline going every time. The stress, the tension, and the unknown that surrounds the patient’s situation makes me so intrigued that I can’t stop watching until I find out what happens.

That is the kind of scene that occurs every day in the Mt. Meru ER, or as they call it here, Casualty. After a slower pace last week in the Pediatrics ward, I decided to jump over to Casualty this week to see how I liked it. I’ve only spent one day in an ER in the U.S. during nursing clinicals and I remember being a little overwhelmed by the continuous flow of patients walking through the door and the mystery illnesses they brought with them. This past experience made me hesitate to request a placement in the ER for this trip, but I can tell you now that I deeply regret it.

Casualty is best described as unpredictable chaos. It can be extremely quiet and empty one minute, and the next thing we know there are 4 different patients being wheeled in with serious injuries. The part of the ward we work on is the main Casualty room where the most emergent cases are brought. It’s comprised of a single room with 3 beds available for incoming patients, two cabinets for medications and supplies, and a small desk where the doctor can sit. The more severe cases are taken straight to a bed, and the less severe patients are seated at the doctor’s desk to be evaluated.

I’m not exaggerating when I say that literally anything can (and does) walk through that door. In just the past two days we’ve seen gruesome wounds from car accidents, broken and dislocated bones, head lacerations, continuous seizures, miscarriages, HIV complications, heart failure, knife attacks, and lifeless bodies. There have been unconscious patients wheeled in with absolutely no clues as to what happened, and all we can do is assess and stabilize them and hope that we can get a solid diagnosis later. Today there was a woman who came in as a victim of a motor accident with a leg swelled up to at least twice the size it should be, the result of a hemorrhage secondary to a broken femur. We are usually the first to get to a new patient, and we are left with hand gestures and our broken Swahili to try to figure out what happened until the doctor has enough time to come over.

The biggest challenge in this ward is the language barrier. When I’m standing beside a patient who has just woken up from a fainting episode and has no idea where she is, I so badly wish that I could tell her that she’s been taken to the hospital and everything’s going to be alright. When a woman comes walking in vomiting blood and clutching her stomach, I wish that I could ask her how many times she’s vomited and when it started. But of course it’s in those crucial moments that my basic Swahili words go out the window and all I can think to say is ‘pole sana’ – I’m so sorry. It’s in these moments when all I can do is hope that they can understand an affectionate smile and warm touch, and pray that they see Jesus more than they see me.

I’ve only been on the Casualty ward for 2 days and I have already fallen in love with it. The fast pace and the unknown that surrounds each patient is exhilarating and addicting. It is not easy to see the state that some of these people are in when we first see them, and sometimes my lack of Swahili and position as a nursing student makes me feel pretty helpless. But it has allowed me to learn so much and have more hands-on experience than any other ward has offered. I’ll try to spare you the gory details, but it’s safe to say that what I’ve seen here is nothing like what I’ve ever seen in the U.S.

If you feel compelled to, prayers for these Casualty patients is so needed. The lack of resources, medications, and life-saving measures makes even the most minor injuries life-threatening if they’re not treated quickly and correctly. Sometimes in the most helpless situations, all I can rely on is the sovereign and healing hand of God. I hope that even in the smallest ways, He is using us to take care of these patients and hopefully save their lives.

 

– Allie