Hospital: Day 2
The info sheet for students says that work begins with rounds at 8am. Surprisingly, Clinton has already gotten used to “African time”, so I am anxiously urging him to get ready to go at 7:50. We finally begin the mile walk to the hospital, and I find the children’s ward (with a little help from my new friend Magagula) by a few minutes after 8. I expected the doctors would have started rounds without me, but so far, no one else has arrived. I pass the time waiting looking at the charts of the admitted patients. I look for the boy we admitted yesterday afternoon, but I cannot find his chart. I still don’t understand the system, so I figure I have missed it. I continue to wait. And wait. The first doctor arrives at 9, followed by the others shortly after. One suggests that since I am there for a few weeks they should arrive no later than 8:15. That is met by an emphatic—Oh no, How about 8:30 at least?… So, 8:30 it is.
We round on many of the same patients as yesterday. Some have showed some improvement, but many are the same. The mother of the 5 month old awaiting her CD4 results was still not able to obtain them. She is on oxygen, but is struggling to breath. The oxygen tube is only in one nostril because it is too big for her little nose. She has developed sores on her neck, possibly a disseminated infection. I finish seeing half of the patients with Dr. Getahun, and we still have not come across the boy admitted yesterday afternoon. Maybe Dr. Kinsala had him with his patients. I make a mental note to ask about him later.
After morning tea (which can last from 30min to 2hrs), we begin outpatient clinic again. It is not as busy as yesterday. The mothers carry their babies on their backs in large wraps, beach towels, or blankets. One woman brings in a 3 year old girl who is here for follow up of TB and HIV. She looks well. She is obviously cared for, and there is much warmth and affection between the woman and child. We discover that this is not the girls mother. Her mother, a girlfriend of the woman’s husband, had passed away months ago from HIV. The woman here today is positive as well. The husband, the girl’s father, still refuses to be tested. I admire this woman. This child could have been a constant reminder of betrayal and infidelity. Caring for her could have led to bitterness and anger. Instead, she has found the strength to love and value the child’s needs and well being above her hurt and pain. I thank God for such an example of faithfulness and silently pray for continued strength and good health for the two of them.
We break for lunch—the same chicken and rice that has been served every meal. It is very oily and I have a hard time eating it. The doctors return at 3, and we begin seeing patients again. I begin seeing patients alone this afternoon. The first patient is a 2 year old girl with infected sores brought by an older woman, a grandmother I suspect. I already need help. Dr. Bitchong explains that the sores are most likely from scabies. I have never seen them so severe. He also points out the lightened hair and distended belly that are signs of protein calorie malnutrition (kwashiorkor)—something else I have never seen at home. We discuss diet with the grandmother. She says the girl only eats soft corn meal because that is all they have. She is speaking through Magagula who is translating for us. She is obviously becoming frustrated. She says she cares for the girl because her mother has disappeared and her father refuses to provide support. She is the grandmother and she has no money, no income. She had to beg for money to bring her to the doctor today. No, she cannot afford eggs. No, she cannot even afford dry beans. Her frustration rises as the tears begin to stream down her cheeks. She is packing up and ready to leave. My fear is she feels we are blaming her. She is trying the best she can. We hurriedly give her medicine for the scabies and skin infection. I wish I had given her money. The price of a bag of beans is so insignificant to us. It is hard to see those who cannot afford even that. Why is there no one to support her? I’m sorry I complain about eating chicken and rice. What a luxury it must be to some.
We round on many of the same patients as yesterday. Some have showed some improvement, but many are the same. The mother of the 5 month old awaiting her CD4 results was still not able to obtain them. She is on oxygen, but is struggling to breath. The oxygen tube is only in one nostril because it is too big for her little nose. She has developed sores on her neck, possibly a disseminated infection. I finish seeing half of the patients with Dr. Getahun, and we still have not come across the boy admitted yesterday afternoon. Maybe Dr. Kinsala had him with his patients. I make a mental note to ask about him later.
After morning tea (which can last from 30min to 2hrs), we begin outpatient clinic again. It is not as busy as yesterday. The mothers carry their babies on their backs in large wraps, beach towels, or blankets. One woman brings in a 3 year old girl who is here for follow up of TB and HIV. She looks well. She is obviously cared for, and there is much warmth and affection between the woman and child. We discover that this is not the girls mother. Her mother, a girlfriend of the woman’s husband, had passed away months ago from HIV. The woman here today is positive as well. The husband, the girl’s father, still refuses to be tested. I admire this woman. This child could have been a constant reminder of betrayal and infidelity. Caring for her could have led to bitterness and anger. Instead, she has found the strength to love and value the child’s needs and well being above her hurt and pain. I thank God for such an example of faithfulness and silently pray for continued strength and good health for the two of them.
We break for lunch—the same chicken and rice that has been served every meal. It is very oily and I have a hard time eating it. The doctors return at 3, and we begin seeing patients again. I begin seeing patients alone this afternoon. The first patient is a 2 year old girl with infected sores brought by an older woman, a grandmother I suspect. I already need help. Dr. Bitchong explains that the sores are most likely from scabies. I have never seen them so severe. He also points out the lightened hair and distended belly that are signs of protein calorie malnutrition (kwashiorkor)—something else I have never seen at home. We discuss diet with the grandmother. She says the girl only eats soft corn meal because that is all they have. She is speaking through Magagula who is translating for us. She is obviously becoming frustrated. She says she cares for the girl because her mother has disappeared and her father refuses to provide support. She is the grandmother and she has no money, no income. She had to beg for money to bring her to the doctor today. No, she cannot afford eggs. No, she cannot even afford dry beans. Her frustration rises as the tears begin to stream down her cheeks. She is packing up and ready to leave. My fear is she feels we are blaming her. She is trying the best she can. We hurriedly give her medicine for the scabies and skin infection. I wish I had given her money. The price of a bag of beans is so insignificant to us. It is hard to see those who cannot afford even that. Why is there no one to support her? I’m sorry I complain about eating chicken and rice. What a luxury it must be to some.
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