Tuesday, August 7, 2012

In which I can't even remember every thing I did

It was one of those days where so much was crammed into it that you get to the end of the day and something reminds you of one of the things you did much earlier and you find yourself asking if that was really the same day? You know what I’m talking about? That was Monday for me.
I started to write this day in narrative but it will take me whole other day to do that so here was my schedule:
6:30 Run with Ronnie
7:30 Shower, breakfast, pack med bag and supplies for clinic.
7:50 Call from CLIDE staff “could I please bring by a few medications for them?” They are doing their big Timothy Retreat this week where all of their sponsored children from all over Karamoja come down to Soroti for a week that resembles camp. I had already treated several of the kids the day before for various aliments but I know that most of these kids are from the poorest families in Uganda and never receive medical treatment (or even enough food but that is for a different post) so have everything from chronic cough (TB?) and malaria to tropical ulcers and parasites of every  make and model.
7:55 Pack another bag of meds and supplies.
8:00 Pick up Betty and Abella who are on school holiday this month and wanted to come with me out to the clinic. As they both do really well translating for me I agreed to let them come.
8:10 Arrive at the school where the 400+ students are staying. I found the director and gave him the meds and he asked me to please see one or two.
8:45 After three positive and one negative malaria tests, two nasty  wound dressings, and one with what I suspect is TB I was getting panicked that the patients out in Obule would be piling up so begged to come back after clinic and see anyone else who needs treatment.
9:20 Arrive in Obule to find 6 prenatals waiting and 5 others.
10:00 20 minutes of pregnancy teaching and answering questions. I’ve managed to do only 3 of the prenatals before the teaching because all three were prima gravida .  But 3 more have arrived so I taught everyone and let the finished ones go home. I’ve also begun sharing the basic gospel presentation with the 5 minutes at the end. Up to this point I’ve gotten very little response but at least they know where I stand and that they can ask questions if they want.
10:30 Lucy (the actual nurse) took over antenatal clinic.   I took a few minutes to go visit a girl who was a patient back in Feb. (Remember the Uvulaectomy?) I had heard she was pregnant so really wanted find out the whole story as she is only 14 years old.  Turns out she is 6 or 7 months along but I didn’t get to see her as she was sent to live with her “husband” (which is just how they refer to the man who knocked her up. They are in no way married.) But she was sent almost a day’s travel away. I know she was going to school here in Obule so I was trying to ask how this man made her pregnant from so far away. I got some very confusing answers about how she is accusing a man from here of impregnating her (which makes a lot more sense!) but he is old and already married.  I’m still  very confused (and saddened) that she was sent away and have no idea how to get the real story. But on a more positive note the other pregnant girl I’ve been writing about- Esther- found me as I was headed back to the clinic. She wanted to give me 10 pounds of corn and 5 pounds of millet to say thank you for helping her.  She said she was feeling really good, feeling the baby move, taking her medicine and then promised to come next antenatal day.
11:00 Back at the clinic and began with all the other patients- of which there were many more now.
Sometime early afternoon a two year old with a 3rd degree burn on his chest and left arm arrived. It had just happened and it was possibly one of the worst burns I’d ever seen. He had pulled a pot of thick hot portage onto himself.  I debated starting a line but I knew the mother would be taking him home and when she was trying to comfort him she kept putting him to her breast. It isn’t very common to let a baby that old still nurse but mostly because most mothers already have another baby. It was translated for me that this mother had still born a few months back and had gone back to breast feeding the toddler. I encouraged her to drink a lot of water and let him nurse often and we could possibly avoid putting in a line. She agreed. I also started abx right away. I don’t know what the correct protocol is but here it seems the risk for infection is just too great to not give.
Then just a little bit later a 70+ old man came in with scrapes and abrasions all over but worse, what I’m pretty sure was a broken clavicle. He was surprisingly calm when I recommended he stop riding his bike.  He also said the sling really helped his pain which I’m happy about but I still sent him home with some Tylenol.
3:00 Finally wrapping up in the clinic. Had sent Betty and Abella to the home of one of the girls that they go to church with while we were out visiting and it was obvious that I was going to be at the clinic quite a while longer. When I stopped by to pick them up they said they and their friend “had made lunch couldn’t we please stay a bit longer?” Feeling like I was making the wrong decision but also feeling like no was the wrong answer I agreed. The good news was the meat was already killed and cleaned and even cooking. The atap was not yet mingled though. But they worked pretty fast.
3:45 Lunch was served. We ate, loaded back in the truck and headed back to Soroti. I dropped off the girls at their home and headed over to the school where the CLIDE kids are staying.
4:15. Find my truck surrounded by kids in a matter of minutes after arriving. Throw down the tailgate which is about table height and begin doing assessments.
6:45 I can’t even really think clearly anymore. I’m sure I have treated more people in this one day than any other day up to this point. Somehow, I still have the meds I need in the back of my truck and I just keep treating kids. At the end of the day I counted 52 administered malaria tests, of which 40 were positive. I also have one very full sharps box. But I haven’t charted or documented much of anything so I don’t really know how many I treated.
6:50 Race home, wash my hands and face, grab my books and head back out the door for bible study at Karen’s home.
9:30 Home, shower, dinner and bed.

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