I miss running

It may be a funny thing to say, but I really do miss running, even on a treadmill. It's been a week and a half since I logged any miles, and it's strange to go that long without it. But more about that later.

The day started in the typical fashion, with my standard unexciting breakfast (except for the fact that I've started drinking tea) and then walk to the hospital, where I headed over to the medicine wards for rounding again. It's quite difficult to manage any of these patients, given the resources available. There were a few women who were very, very anemic (hemoglobin of one was 2.2 g/dL; normal is between 12-16 g/dL), but they're still waiting on the blood to give her to arrive from Mombasa, which is where the regional blood bank is. And even after it does arrive, it can be diverted to an emergency patient, such as a trauma or Cesarean section. There was another patient with diabetes, who was transferred from the surgical service post-operation for diabetes management (at least that's one thing that's consistent across the board--surgeons will always transfer their difficult patients to the medical teams). Her blood sugars are all over the place and just about impossible to control. Before eating this morning, it was 194 (high), so she was given ten units of insulin. Three hours later, she started seizing. The intern didn't want to bother to check the blood sugar, because she knew it would be high (because it was high in the morning). I convinced her to check, since nobody had checked since her insulin was given, and it was 42 (very low). She was having seizures because of the hypoglycemia. If this were back home, she'd be on an insulin drip, titrated to keep her sugars even, which would be checked every hour. But there's no insulin drip, not enough testing strips, and not enough hands to make that happen. So she'll probably continue to have spikes of very high and very low.

After rounds was lunch, then working with Katana and Dr. Buni (the medical superintendent) on the waste incinerator issue. Except it isn't a waste incinerator, it's an autoclave (to sterilize the waste) and grinder (to put it into small pieces). There was previously an incinerator, built by the United States Marine Corps, but it wasn't located in the best place, according to the WHO guidelines; besides, vandals looted it for parts and scrap metal. So no more incinerator, and hopefully soon, and autoclave/grinder, which is a CDC prototype (they demonstrate it and let the hospital keep it). Before this happens, though, there's the standard rigmarole of finding a suitable site on the hospital campus, getting an Environmental Impact Assessment, building the shelter for it, and training people in operation. So this isn't a quick and easy project that'll be done before I leave.

Following all that excitement, I decided to try a gym across the street from the hospital, which is run by one of Metsanze's friends (he, like my driver, seems to have friends all around the city). It's not so much a gym as a place for aerobics. So I did an aerobics class, but like I said at the beginning, I miss running, and I don't want to pay for a month membership at a gym that doesn't let me run. It seems a little silly.

Anyway, that's my fun and exciting life. Tomorrow I'm going with Metsanze to a rural area (I forget the name) to see their clinic. There should be pictures with that one.