Kibagabaga diary

Where do I begin? I guess I should talk abut how I ended up here.
A few years back, I watched an episode of Oprah featuring women with fistula. What is fistula?, you ask?
Obstetric fistula occurs in many developing countries. It is a hole between a woman’s birth passage and one or more of her internal organs. This hole develops over many days of obstructed labor, when the pressure of the baby’s head against the mother’s pelvis cuts off blood supply to delicate tissues in the region. The dead tissue falls away and the woman is left with a hole between her vagina and her bladder (called a vesicovaginal fistula or VVF) and sometimes between her vagina and rectum (rectovaginal fistula, RVF). This hole results in permanent incontinence of urine and/or feces. A majority of women who develop fistulas are abandoned by their husbands and ostracized by their communities because of their inability to have children and their foul smell

After watching this show, I knew I wanted to do something to help. Fast forward a few years later, a friend introduced me to the director of IOWD, and that’s how I ended up in Rwanda
After traveling from Houston via Washington DC and Brussels, I ended up in Kigali with the rest of my team on April 20th. On April 21st we went to check out Kibagabaga hospital. We found out we had a case scheduled, so we got busy and did our first surgery. It was a success!

The hospital is located in Kigali, Rwanda. The women come from all over Rwanda, mostly from rural areas. They come in large numbers, and have to be evaluated one by one by the IOWD surgeons ( the surgery team is made up of obstetricians and urogynecologists). Not all patients can have surgery, and this is very depressing. The surgery candidates undergo an exam under anesthesia (EUA) and cystoscopy (cysto) and the decision is made regarding what surgery the patient requires.

As far as our anesthesia team was concerned, we intended to give the best care to every patient regardless of the scarcity of resources. We had one working anesthesia machine, and halothane gas which most of us have never used. Talk of a steep learning curve! We did most of our cases with subarachnoid blocks (spinal)- where we inject local anesthesia in the patient’s spine and that numbs the body from the waist down. It was an interesting experience because the patients did not speak English, so we relied on the hospital staff to interpret what we were saying.

Doing anesthesia pre operative interviews was one of the highlights of my trip. It enabled me to learn more about the women, and relate with them. It was funny how most of them thought I was Rwandan ( think the East African forehead did me in) , and would speak to me in Kinyarwanda.

One of the most interesting things was that we used every resource we had to the maximum. We wasted nothing, and never complained when we had little to work with. It was an eye opening experience because we all realized we waste a lot in the US. We had one working autoclave machine, and therefore we used chemicals to sterilize equipment between cases. Everyone helped out, regardless of rank and title. It was not unusual to see one of the surgeons mopping the floor between cases. Did I mention we ran out of sterile gowns on our last day, and the hospital washing machine was broken?

We would arrive at the hospital around 8 am and work until around 5pm. By day 4, I was feeling emotionally and physically exhausted. I was more emotionally drained than I had prepared myself for. There was no time to sit and complains about being exhausted. The women needed us, and so we all soldiered on.

I got the opportunity to visit the women’s hospital at Muhima hospital. I was following the anesthetists at Muhima to learn how they do things. We had one urgent Caesarian section delivery for a baby in breech position. If I recall correctly, the baby was around 30 weeks gestation. When the baby was delivered, we heard a single cry, and noted that the baby was blue. Dr M, (one of the obgyn doctors on the IOWD team) and I took the baby to the NICU. When we arrived in the NICU, we didn’t have oxygen, so we decided to just help the baby breathe with room air. After a couple of minutes we ‘borrowed” oxygen from another baby in the NICU, we were also able to get some suction working, which helped quite a bit. I now know firsthand what they mean when they say God takes care of children and fools….. That was my first ever neonatal resuscitation. After what felt like hours, the baby was breathing on her own, and looked better. The memory of that resuscitation will stay with me forever

By the end of the trip we had operated on over 35 patents, and that was such a blessing. It was sad that we could not treat every patient with fistula. But one thing I know for sure, is that the women we helped will live a much better life than they did before.



This girl is on fire!

I recently rediscovered running. And for once I am enjoying it. I ran in the rain last week and felt so good at the end. Today I ran in the cold, and realized that I CAN do this! Running is my personal challenge of 2013. I can do this! I am running. 5k in march and April , and hope to run a half Mary before I turn 31.
Speaking of challenges, my challenge for Lent is to give up Facebook. Yes 40 days of zero updates , what am I going to do?
I think I will use the spare time to catch up on my reading and to write better posts on this blog. I need to get my writing inspiration back. I’ve been thinking of some posts when I run, so we shall see how this goes.
Yesterday affirmed why I don’t follow the news. I woke up and read CNN. First I find out that Oscar Pistorius is a murder suspect, and that North Korea is launching nuclear warfare. Let me just go sit in a corner and imagine that the world is a happy place. There is too much hate in the world and CNN does a good job of reminding me that. Case in point, this story- man slaps a two year old on a plane because the kid cried. It gets worse, he told the mom to shut the little ( insert racial epithet here) up. Really?
Have a hate- free weekend friends!


30 before 30 progress

I think I am doing pretty decent. I echo the words of Mrs Babes “without goals in life, you can get into the humdrum of life, the flow if I may say so and and one may do things because it is one is used to and is the norm. Having goals – some of which are DIFFERENT – make you think outside the box.’

  • Graduate from girl-pushups
  • Learn how to sew- Decided after a few attempts that sewing is not for me
  • Go three months without buying new shoes or clothes- two months and counting
  • Watch the color purple and the Sound of Music
  • Run a 10K  running a 5 k in March and May…hope to do 10 in June
  • Jump over a 30 inch box at crossfit
  • Learn German   Actively working on it
  • Go to Hawaai   loved it !
  • Go hiking
  • Lose four inches off my waistline  progress looking good
  • Get a Kenyan ID card     November 2012
  • Go on a medical mission trip- going to Rwanda April 19 2013
  • Attend my high school’s birthday service- will be there in Spirit- decided on Rwanda mission trip instead
  • Read 50 books- I am making decent progress. Doubt I will make 50. but its better than 0
  • Have a conversation with my family about my living will and what my medical wishes are-  I put it in writing, they will know if and when the time comes
  • Start a scholarship in my grandfather’s memory – working on this as soon as I am debt free
  • Save 10% of my salary- working on this and making good progress
  • Spend a week with my sister
  • Speak at a conference 
  • Visit Yosemite Park
  • Go without red meat for a month
  • Spend a day ” disconnected” from technology
  • Go camping
  • Start a photography/ travel blog- decided against a second blog- posting more of my photos on Kagori
  • Visit Alaska
  • Milk a cow
  • Serve a meal at a homeless shelter
  • See the Wildebeest migration Saw a bit of it in the Mara
  • Cut my hair. Done. May 2012
  • Learn how to dive/ snorkel   went snorkeling in Mombasa November 2012

I will take care of you

Today I took care of the cutest little old lady. When I met her, I just connected with her. She was so anxious, and she was having this surgery, worried about her hubby of 47 years. See he has some issue with balance and she is his only care giver. He fell on her last night, and her hip was hurting. In addition to the stress of surgery, she has to take care of him because they have no other family in the area. So we came up with a plan to keep him put until after he surgery in the waiting room, get her a private room, so he could spend the night, and then tomorrow she will drive home (scary, I know!). I really wanted to adopt this cute lady. She told me I had a beautiful smile and soul (Mhhh…maybe I just wanted to adopt her for constant flattery).
Anyway, tonight I’m saying a special prayer for her, because truly she loves her husband more than she loves herself. That, my friends, is the brand of marriage I would like to create one of these days 😉


The other side of the equation

So, today was day one at work after a week of no work- I could hardly wait to go home and do nothing. But…I was reminded to count my blessings and name them one by one.

The past month has been crazy! After a loved one had a cancer scare, I spent hours at my workplace – not working, but going from doctor to doctor and test after test. It was an interesting perspective, and by the grace of God, Friday we received the official “No cancer”. It was a great day!

Being on that side of the equation taught me alot, especially the worth of a smile, a hand-hold and a kind word. It made me proud to work with such an amazing group of people too. It also got me thinking about putting more effort into accomplishing the small goals I have set. Like getting better at photography, and learning German.

Speaking of photography, here are a few shots from Maui



This shot was from our Whale watching tour- which was INCREDIBLE!


One of the resident swans at our hotel



Week Recap

We are headed home after an amazing week in Maui, Hawaii. Beautiful and awesome place!
I can’t wait to share the photos I took in Maui.
We did the touristy stuff, like the Road to Hana and the Old Lahaina Luau. We also did the adventurous stuff like driving on the narrow roads along the cliffs with no guardrails. Maui was breathtaking!
Have a great week friends.

The last lecture


If you have never read or watched Randy Pausch’s “The last lecture“, please read or watch it NOW.
This is one of my favorite quotes from the Last Lecture
“The brick walls are not there to keep us out. The brick walls are there to give us a chance to show how badly we want something. Because the brick walls are there to stop the people who don’t want it badly enough.”-Randy Pausch