The unscreened windows were wide open, letting in both the breeze and buzzing flies. A chicken roamed about freely, unaware that it was in a surgical area. Off to the side sat a drying rack half-filled with "sterile" gloves, standing at attention like soldiers ready for inspection. In the center of the room lay a woman on the operating table, her feet in stirrups and her dress hiked up to her waist. She had delivered a baby at home a few days before and now was bleeding heavily. In desperation, she had walked by herself, in the heat, on dirt roads, from her hut to the hospital.
The doctor planned to do a D&C to look for for the source of the bleeding. He wrestled with a canister of gas, hoping to give the patient some sedation, but the canister appeared to be empty. Left with no other choice, he proceeded without anesthesia. I stood back, aghast. I was a fourth-year medical student spending a month in Kenya--one week of that time at this remote, bush hospital near the Ugandan border. My backpack of donated medical supplies paled next to the region's needs.
As I watched from behind him, the doctor, wearing rubber boots and “sterile” gloves, began scraping the lining of the patient's uterus. I looked at her, expecting to see a grimace or some sign of pain, but she bore no expression on her face; it was as if she wasn't even there. Within minutes, the doctor pulled out some tissue, probably remnants of the placenta that hadn't come out during the delivery. The bleeding slowed to a trickle.
After the doctor was done, he left the room while the patient dressed. He went into his "pharmacy," a room sparsely stocked with outdated medications, and found some antibiotics. He handed them to the patient before she started her journey home, walking alone back to her baby.
By the end of my week there, I was thoroughly impressed with this doctor, serving the community the best he could with limited resources. I was equally impressed with the courage of the patients as they endured procedures and treatments we would deem unacceptable in the United States.