Liz and I have now been here for 10 days with another week to go. The list of diseases we've seen and experiences we've had are amazing both in and out of the hospital. Liz has been busy rounding on patients she has admitted from clinic as well as being on call every third night.....something she says she hasn't done in many years. We are both faithfully taking our Malarone, an anti-malarial and while I was scared about the potential for nightmares it's Liz whose sleep has been disrupted. I'm sleeping like a baby but she is awake multiple times during the night and says she has much more sympathy for folks with sleep issues than she did before. Despite sleep concerns well keep taking it as 2 folks on the compound have come down with Malaria but both were here during the rainy season.
Meals have required lots of creativity. Rice, lentils, quinoa, granola and yogurt make up much of our diet. When available we get to throw in bits of onion, garlic or vegetables. I actually bought a great papaya the other day that we add to yogurt. I will be eager for meat and spices by the time this trip is done. Barbecued ribs sound really good right now but the only meat I've seen here so far has been grilled on the side of the road and unless my histology is really rusty it's mostly organ meat (liver, kidney and lung seem to be favorites) but after hearing a story about being served fried lung and having maggots come out when cutting I'll stick to rice and lentils and let the folks eager for reality TV status eat off the street here. Today's market day so during rest our plan is to see what we can buy to add some interest or flavor.
While Liz has an interpreter with her almost all the time I haven't had that luxury which has limited greatly what I can do. In the medicine ward I spend at least part of every day checking IVs, making sure they are patent and that fluids are running as they should. There's no real sense of nursing practice here, it's just a job for a paycheck. When IVs are placed they aren't flushed so when fluids are hung and connected the "nurse" walks away.....job done.....with no care whether the fluids are actually flowing which is why I check. Since the needle system they use does not have safeguards to prevent backflow one has to be extra careful particularly given the incidence of HIV but I was shown 2 ways that seem to take care of the issue but neither one would I even consider using at home.
After feeling like I'd bugged the nurses enough yesterday about IVs and the importance of flushing them when they are first inserted I spent this morning in OB, making rounds with a German OB/GYN whose been here 30+ years and is very excited to teach. After rounds we headed to the OR for a C-section and tubal ligation (it was the woman's 9th pregnancy and she was severely anemic with malaria) She had been in labor 3 days before coming to the hospital. Thankfully her baby was born alive and is expected to do fine. That can't be said for many of the babies born even here in the hospital as 2kg seems to be large and are often26-30 weeks. One yesterday was 24 weeks and 800grams. It didn't make it through the night. Aside from low birthweight and premie babies there are an extraordinary number of molar pregnancies which have to be terminated.
At home I never leave for the hospital wondering if someone is still alive yet that's part of our daily conversation in the morning as we head up the dusty dirt road from the little cottage to the hospital. I wonder how some of these folks do this day after day for years. I envy their strength, endurance and faith
Enough for now,
Laurie
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