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| All day case on Wednesday |
I see the last time I blogged was Monday. I Think I have been working endlessly since that time. It seems word got out that I was leaving and there has been a line of patients who have money to pay their deposits and have surgery. At Tenwek, even though it is a mission hospital there is a small deposit needed to schedule surgery and the balance is paid at discharge. For a short major OR case the deposit runs about 20,000 shillings (200 dollars). The balance is paid at discharge. It is rare to find a patient who has the deposit available to schedule surgery at their clinic visit. Insurance is rare and only about 20% of the population is insured. Insurance does not cover outpatient surgery or Ct scans. Even with insurance there is a 15,000 shilling deposit needed. Most patients will say they do not have the money and will need to "go look for money". this usually entails seeking relatives, selling cattle, etc. I have had a line of patients returning this week with their deposits for surgery! After surgery, patients are not discharged until their bill is paid. I have seen some that are sitting in the wards, taking up bed space for up to 5-7days. This is a real problem as the hospital is often beyond capacity. Last night I had a family with a 3 month old patient and family who spent the night in the Casualty ward on a bench because there were no pediatric beds.
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| Joseph being prepared for surgery |
Joseph is a 50 some year old male with 1 year history of hoarseness. He has been seeing a local healer for treatments. If you look closely you can see multiple slash marks where the healer has cut him. Usually the cuts are in the distribution of the pain or problem. He had multiple marks on his neck near the sternal notch. Needless to say, his hoarseness persisted and he came to see me. His exam revealed a large laryngeal tumor. He was admitted to the hospital that day, spent the night on a bench as there were no beds, and underwent a laryngectomy (removal of the voice box) the next day. This was a long, 8 hour case but all went well. I am grateful he got to me while the tumor was still treatable.
Please continue to pray for all the patients I have been treating. There are some loose ends and one patient with a remaining complication not resolved. Tomorrow is my last day which will be spent winding down, no OR cases.
God bless,
Chase Miller
