Today I continued learning about children and worked on the pediatric ward. Interestingly, the ward only accepts patients up to five years old and any patient older than that goes to the adult ward, either male or female. This is because the way the room is set up only accommodates cribs and small cots. Similar to the NICU, there were over 30 children admitted. The medicine was very interesting as the predominant diagnoses include malaria, tuberculosis, and malnutrition- three things I have never seen in the United States. Rounds on the ward consist of each mother bringing the child to the doctor’s desk to discuss the child’s progress and treatment for the day. If they need labs they would then sit in another line to wait for the nurse. If they needed medication they would then gather their medication from the nurse station and administer it to their child themselves. Very few children had IVs. The mothers sleep on the concrete floor next to the cribs during the night. While visiting with every mother-child duo, I noticed almost all the babies less than 12 months old had a string of beads or thread tied around their waist. I asked the local doctor about this and he tells me it is usually for one or several of three reasons: 1) cosmetic to represent family/tribe colors, 2) spiritual protection for the child, and 3) to monitor the baby’s growth. So fascinating to me coming from a place where scales are readily available and babies return to the doctor frequently for well child checks.
Lugandan word of the day: okusaba (noun, prayer)
Medical learning point of the day: Complicated malaria is parasitemia with any of the following features: respiratory distress, pulmonary edema, coma, seizures, spontaneous bleeding, hemoglobinuria, anemia with Hgb <5, hypoglycemia with blood sugar <50, shock with systolic blood pressure <50 in children and <80 in adults, renal failure, or acidosis.
