Thursday, July 15, 2010

Soroti Regional Referral Hospital

Spent a little time in Soroti hospital again today. I would have thought by now it wouldn't shock me so much but somehow it still does. The purpose of my visit was to check on a few kids that possibly would need follow up after they left the hospital. Amecet knew of a couple there now that are high risk for being neglected again so asked if I would watch them. I wanted to meet them and see if I could make a guess at a discharge date. As always, we bring food with us because rarely does the feeding program have food to provide. (There is no food provided in any ward of the hospital- when people are admitted they have to bring someone with them who will get and prepare meals so why should it be any different in the malnourishment ward?!) Anyway, there were 6 little ones there, but none terribly emaciated so we talked with the mothers and passed out the food and prayed over them and prepared to go. But the ones that Amecet wanted me to see were not there so we headed out into the rest of the hospital to find them. We went into the pediatric ward first. It was packed today. (I'm not allowed to take pictures there so I'll try to describe it). Picture a big open room, bare cement walls and floor. About 30 old steel frame beds and 10 more old steel cribs (that look more like cages) in rows. Every bed with at least one child in them, some with two if the kids are smaller. Most beds have IV fluids hanging, often held up with sticks wired to the bed frame. There is a blanket spread under most beds because that is where the child's caretaker sleeps- this is the person who essentially provides any “nursing” care. One child even had blood hanging which both frightens me and makes me happy because often this intervention isn't available. In the dark hall leading to the treatment room the walls are lined with parents holding kids. I don't know if these ones are just here for the day and waiting to see the doctor of if there just are not enough beds (most likely both.)
As we stood in the middle of the room scanning the kids looking for the ones I need to meet many parents call out to us to get us to come over to look at their child. They want help paying for needed medicines because their child will not get treatment until they pay. It is noisy, crowed and stinks of sick, unclean bodies. Even for someone comfortable in hospitals this place is frightening. I can't imagine being a sick child in this unit. We don't find the children we are looking for so head back outside. (Each unit is a separate building connected by dirt paths wide enough for gurneys to pass.) As we walk past the surgical ward (you can identify it by the clothes lines outside covered with the dark blue and green cloth surgical drapes, caps, shoe covers, aprons and sponges drying in the sun.) I look in the windows and can see that surgery is clearly going on. There are no screens in these open windows. We walk from ward to ward and finally find them. They have been moved to the TB ward because the have both had positive chest x-rays. Good that it was caught and treatment started and also good because this will get them two more weeks in the hospital. Well, good I think. At least I know they are getting food there because Amecet is providing. The TB ward is not as crowded at the other but just as open, dirty and the people clearly just as sick. I can tell just by looking that many would be on an ICU in the states (and some intubated). But there is no such thing here. The head nurse on the TB ward was telling me about the kids treatment then went on to tell me that a year or so ago they opened a new TB ward with separate rooms. The tone of her voice was telling me that she thought this was a ridiculous idea so I asked why they moved back into the old unit. She explained that frequently when someone is diagnosed with TB the caretaker won't stay so when they were in private rooms the person could die and no one would know for hours because they were alone. As I looked around I guessed there were about 15 patients and two nurses (only one for night duty). There is such a difference in “nursing” here and “nursing” in the states. Today I really missed my 12 hour shifts on IIU with a nice 4 patient assignment and one in respiratory isolation...
 
*a picture is worth a thousand words so I'm going to someday figure out a way to sneak my camera into the hospital to get some pictures. There has to be a way to hide it in my bag....

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