in the business of saving lives..

I've only got one more week to finish my internship weeks in Paediatrics, and boy i'm i glad!
The other day, i was in our acute room... (that's like the Paediatric E.R. at this here district hospital) and i was thinking..

"hmm we must have gotten really good at this."

Gotten good at this, you see, since, it had been more than a week since a child passed away! A personal record, that i felt quite proud of. So there i was, happily remembering that i had only slightly more than a week b4 i was done with screaming babies and endless ward rounds every single morning!

I don't know if i imagine the headache, lakini, i suddenly felt like a pile of bricks had dropped squarely on my head. The nurse i was working with announced that "the child there in the corner doesn't look too good", and as i glanced at the said corner, i could see the mother sobbing and this one dedicated father holding the oxygen prongs on the child's nostrils.

"Oh dear!" My worst moments in the ward usually start this way. Well, actually they start something like... "Daktari, mgonjwa hapumui!" And right there, u've to jump on your feet and do something, anything... usually heroic, heroic-like or somewhere in between.

Back to the story. So this particular kid was gasping at every breathe it could muster, and after 11 weeks in that ward, you can almost tell how long one has to live. A very unnerving skill, and for this kid it wasn't very long. The child's dad didn't make it any better when he confided in me that this was his only kid, and only 1 year after he was born, it would be cruel for him to join his maker.

Time was of the essence, and i proceeded to fix a line. As expected, the kids veins could just not be seen. But we did not give up. Pricked and poked his arms, his hand, his scalp, his neck.. yet nothing. Things seemed to get frantic, the mothers sobbing only got louder, and everyone else held a deathly silence. (deathly, how apt!) .. strapped his leg to look for a vein there. Don't know if it was luck or 11 weeks of experience, but we got it. Felt like time for a war cry just there.

Victory was ours! Having given starting doses of some acute drugs to help the child breathe better i left, felt a bit like i was walking on air. Another young soul saved.

The evening was young and we had been invited for a dinner organised by a drug company to launch a new product.. (more like bribing us with food.. but that's a story for another day.) And we ate and made merry.

I wasn't on call that night, but i really wanted to know how the child i had left earlier in the acute room was doing. When they say life isn't fair, they really mean it. Being a resource poor setting, our 'mortuary' (prior to a body getting to the actual hospital mortuary), is an isolated bed,(or is it cot) placed near the door to the acute room, just as one gets in. And like a really bad movie, was the body of that kid, wrapped in a leso and labelled with his name, well in sight for me to read.

Uuuh!! It's a nasty feeling that. Yo' only consolation is that you did the best for the patient, and many others have survived, thanks in large part to yo' efforts. But ooh! it ain't consoling.. ..not one bit.

Laterz,
aNGuiShEd mEDiCinEmAn.

The mighty shilling..

Warren G's hit, "I want it all.." had it's chorus going like so

I want it all; money, fast cars
Diamond rings, gold chains and champagne
Shit, everydamn thing
I want it all; houses, expenses
My own business, a truck, hmm, and a couple o' Benz's..

I’ve never thought doctors earn enough. Ok, so almost every working Kenyan thinks they don’t get as much as they deserve, for all the nation building they are involved in, kaaaazi hio yote. (Well, MPs still want to earn more, despite not working at all.. Lakini that's a for another day.)

Caller No. 1: My doctor drives a Merc, he bought 2 months ago. And how does one sleep at night after charging you 2,000 shs to ask you a couple of questions and spend another 5 minutes listing a remarkable assortment of drugs worth another 3,000 shillings? Kwanza wakatwe mshahara! Shindwe kabisa!

Hehe… I think I already know which doctor this must be. The difference is this dude and myself is that he's a consultant, and a specialist in his field, and for sure, he’s gonna charge an arm and a leg for his years of hittin’ the books.

At the bottom of the food chain, however, is the eager, i-use-a-matatu-but-look-i’m-a-doctor, kind of chap, who, for the first few months at least, is excited and happy enough to have a new title and shiny badge to prove it.

That’s kinna us.. the medical interns. Enyewe, if there were ever misused persons, we would be them. My consultant visits the wards maybe 2wice a week and barely spends an hour or two, to review difficult cases, or just complain about this or the other. And for this, grosses around 150K from Sirikal every month. I wouldn’t want to imagine how much more she makes from her clinic and hospital consultations. My colleagues and I who slog away the whole day and night, weekends and public holidays, (did I say weekends?) earn 20K basic salo. Well, it’s not that bad, coz with my house and non-practice allowances it fikaz more than 30. Not bad for a recent campo graduate. So why am I complaining?

Caller No. 2: My doctor drives a Bima and lives in Runda. In fact, I want my son to do Medicine…

Me: wololo! Poor son.

Caller No. 2: I know he’ll be guaranteed a job once he finishes...

While I wouldn’t want to discourage any “neurosurgeon wannabe’s”, tread carefully. First, it’s confirmed that starting this year, interns finishing their internship are not guaranteed jobs with the govt. And just to make sure we don’t get any funny ideas in our minds, (u know, like a guaranteed job), they got us to sign contracts indicating that our 12 months employment was temporary with no bearing on future employment.

The other day, I was going through pay slips that had been carelessly dropped in the doctors’ room. I noticed something rather amusing. Most of the doctors were getting a non-practice allowance of 15,000 shillings. Amusing because, I can’t see how that amount will dissuade these doctors from not engaging in private work. Sample this, for part time work at a private institution, one can make that amount in less than a week, and that’s in one’s free time. So what makes the govt. think 15K will make these doctors focus their energies in the public hospitals? It’s not hard for one to rationalize on why he’s left work early to get to head off in search of more money.

Now if I was a neurosurgeon, I’d probably make 15K in a few minutes. And I can see why every top student in Kenya wants to be one. It’s challenging, And would certainly make for a captivating topic at those social events.

This-one-Thinks-Amefika: … so I had to call my agent in Dubai otherwise the cars were not going to be let thru’ the port. That’s when I realized that calling via satellite is so expensive. (laughter..) And what do you do..

Top-Student-Now-N’surgeon: I’m a brain surgeon. There are only 10 of us in Kenya you know. I was the ninth. So you were saying you import cars? From Dubai? Fascinating..

It’s interesting how many of these dreams slowly fade away during the first few weeks of 1^st year, and focus shifts to passing the next CAT…

Anyhow, since I’m not a neurosurgeon, and I don’t think 30K+ a month is enough for saving lives (and that includes nights and weekends) I concluded that I was some what short-changed and I’ve been thinking about several options I could have next year, now that I’m not even guaranteed a job! (Not that I would have taken it up, but that’s beside the point.)

Any ideas? Drop a comment.

5 years? I think i'm getting a headache...
Laterz,
tHE mEdiCinEmAn.

A Tale of 3 Companies

The other day, I was having a lively exchange on why Safaricom is the worst thing that happened to Kenyans.

“What? With 8 bob calls? How do you go calling them such ugly names?, ” you might wonder.

Well it wasn’t very clear to me either, but with 6+ million subscribers, Safaricom has such a powerful resource, you wouldn’t believe. And so much money, any competitors (media-speak for Celtel) can easily be priced out. Last year, they made 1 billion shillings in every month. That’s Kshs. 250 million in one week! And that is pure, clean profit! If any other company made this much in one year, they’d be considered to be doing pretty well…

Let’s talk about Celtel for a bit. Having launched their new Uhuru tariffs with a lots of flair to match, I expected a big switch from price conscious Kenyans. (I’ll tell you something about this later). It did happen, for a few days. I even got 2 Celtel lines for myself to take advantage of both the tariffs. Safaricom hit back with its 10 bob all-the-time calls and later, with the limited offer Saasa tariff, where for 12 hours a day, one can make calls @ 8 bob a minute, Safcom to Safcom of course. And as much as 52 bob per minute to call Celtel! (BTW what sort of name is Saasa? Don’t try to stretch the middle “aa” coz you’ll end up soundin real weird… or was that the idea?)

Anyway, what Safaricom had done was to effectively lock in their customers, all 6+ million of them. And charging Celtel an arm and a foot to allow calls to this pool. So during the discussion an interesting idea was floated. What if it cost you 7 or even 6 bob to call within the Celtel network? Won’t every other Kenyan have 073X sim cards in place most of the time? Besides, it hardly costs them anything to have calls routed thru’ their own network.

Sounds like a good idea, until you remember that it the reverse also applies. Wat if Safcom does the same and weka’s calls at 6 bob also? Subscribers with their other 6 million+ contacts, will stay on this network, coz it’s easier than to go around changing yo’ mobile contact etc, etc..

Effectively, there will be 6 million people calling at 6 bob on one end and only 3 million on the other, it’s easy to see who’ll be wearing the trousers in that relationship!

What about Telkom’s wireless fones? It costs only 5.50 to call another Telkom subscriber anywhere in the country, yet the uptake isn’t close to the millions that Safcom has been able to rack up. Surely people should be ready to call at these good rates!

Unfortunately for them, however, the entry costs are a bit too steep. Other than having to buy a line for 1,000 bob, one has to get a brand new handset, coz the technology can’t work with GSM fones. So a cool 5,000 bob+.. to get a fone that you’ll hardly use to call at the celebrated rate of Kshs 5.50 to another Telkom number! It only requires a basic knowledge of arithmetic and economics, to know that you’d rather bamba 50 and call a lot more people @ 8 bob!

So that round Telkom Wireless loses 10 – nil. Unfortunately, they still think in the old mindset of charging people to become your customers! That usually doesn’t work very well. I can get a Safaricom or Celtel line for as little as 40 bob. Why on earth would Telkom charge me 1,000 shillings for a piece of metal? Imagine if it still cost you 2,500 shillings for a Safaricom line? They never learn, I tell you!

So my conclusion? Even a new mobile company will not be able to nudge Safaricom out of their massive market numbers. Unless of course they have a brilliant product, that’s incredibly cheap, different, innovative, and did I say bloody cheap? It’s only in Kenya, where 99% if mobile users answering calls will have their thumbs squarely placed on the “Cancel” button to save that last few cents spent as the fone comes off my face for me to see wat I am doing. Curiously, the thumb-hovering is on calls that they are receiving and not paying for!

What do you think? Leave yo’ two cents worth of comment. Would love to here another perspective.

Should get to bed. Kesho I have a mortality meeting. We get to keep tabs on how many patients we got to kill during the month. More on that later.

Baadayez,
tHE mEdiCinEmAn.