August 26th, 2017 by jenniferolmstead

I did not do much today, removed a couple IV lines for discharging patient, but I learned a lot. Much of which clarified previous information. I am learning most importantly to question much of what I here as the accent and pronunciation of words often sounds like something entirely different. Also, if they do not fully understand my question they just answer what they think I asked, not exactly accurate.
Where to begin. First, I’ll start with scheduling. The hospital wards are all staffed round the clock with nurses and one doctor is on call all hours, this rotates mostly among visiting doctors when available. There are a few countries with programs specifically in international health. The students are required to spend at least 6 months, usually the last six, working in a rural setting such as Makunda. These doctors are already certified as physicians and this rotation is for international health specifically so they usually take turns being on call. The nurse schedule is quite interesting. A few have a set schedule of working six eight hour shifts and having Sunday off. Most rotate. They work a day shift, an evening shift, a night shift, then a day off before repeating the cycle. This ensures coverage of all wards at all times. There is some variance, but that is the general routine.
The pediatric ward has 15 beds. This ward has opened within the past year. They are working on opening a new neonatal unit as well. The current one has 5 beds and often has 2-3 babied in each warmer. They have the ward built and the incubators, they are waiting for funding to get oxygen supplied to the ward before it can be used. The hospital has really grown in the last couple years thanks to outside donations. They have plaques placed everywhere this has happened. It is very encouraging to know that people realize the importance of this hospital.
To help everyone see how important this hospital is I’ll fill you in where I got more information and corrections on the two-year-old with febrile seizures for 1 month. The child was taken to a local hospital, possibly government, with no or little funding. The hospital has a limited medication supply and IV fluids at best, this is the general condition of all local hospitals. The parents were told the child just had a fever. The child was given fever medication, similar to Tylenol, and Iv fluids only for one month. After one month when the parents could not pay the hospital stated they could do nothing more and referred them to the Makunda hospital. This is quite common, though very sad. This child has significant contractures of his left hand, arm and leg as well as possible brain damage. The encouraging note is that the nurse I was speaking with has seen this many times and occasionally the children will walk out of the hospital after a couple of months. I can just imagine how difficult this is for the parents. I feel my one contribution today was educating the nurses on the importance of raising the head of the bed when feeding through an NG tube to prevent aspiration and pneumonia.
A patient was discharged today, a baby born prematurely and proudly catholic, Christian in their understanding. It is a little boy and as of yet was unnamed. They asked me for some Christian name ideas and then stated that since he was born on a saint’s day, I could not understand the name as I am not familiar with the catholic saints, and I told them that was a wonderful name. They asked me to pose for pictures with the baby and family members before leaving. It was a very nice family and I told them I would keep they baby in my prayers as he is still very small and weak.
We had another young child, 11 months who was admitted yesterday. Parents decided they wanted to leave today and the mother argued with the doctor who told them the child was still very ill with a lung infection. Shortly after the doctor left the mother went and got the father who came in and yelled at the nurses that they were leaving. After telling them the risks they were told they would be discharged but it would take a little time. While giving meds to the patients it was noticed that the family had left, the child still had an IV line. Someone went and found them in the hospital, the concerned parent of another child, and the came back to have IV removed and in dot what medications were needed from the pharmacy. Part of the discharge process is the family must go get the medications and bring them back so the nurse one knows they actually have it and two can explain how it is to be taken.