July 20th, 2017 by mihiretbelihu

Soddo is located in South Central part of Ethiopia, East Africa and has a population close to 90,000. There are many languages spoken at Soddo, most common is Wolaytigna.

While making bedside rounds on patients in the Gyn ward on my first work day at Soddo Christian Hospital I came across a pale young woman in her early 20s who was admitted the previous day for incomplete spontaneous abortion. Her Hgb at admission was 6 and therefore was given a unit of blood and IV fluids and because she did not have active bleeding was scheduled for a D and C the following morning in the OR, the patient was counseled by a surgical resident and a GP in the Gyn ward using an interpreter since she does not speak the most common dialect in the area. On rounds we discussed the same plan and went to get ready in the OR while she was brought, as they were prepping her and having her sign a consent the patient refused and we were told she would not get up on the OR table and left the room. The patient apparently did not know that she was being taken to the OR, and she knew she did not want an operation and therefore did not see the need to be in the operating theater.

After much convincing she finally have the D and C but instead of the OR wanted to be on the delivery couch and the procedure was an eventful.

Informed consent is a very crucial part of health care especially in developed countries patients want to know about what you are doing, why you are doing it, when you are doing it and if there are other alternatives and we as physicians are trained to give that information at all times. The trickier part here is the patients education level and mistrust towards the health care system and most importantly the language barrier. Later a relative told us that she thought we were going to do surgery on her and that’s why we told her to sign the consent on the OR table and she was not going to fall for it.