Tuesday, November 27, 2012

A little glimpse of the system that is IHK (International Hospital Kampala)

I’m at what I consider the best hospital in Kampala (this trip has not yet changed this opinion) and a few things still knock my socks off. AS we were looking for a place to park, a portion of the lot was unusable because apparently the hospital’s septic system was having some problems. As we passed they were prying the lids off and you cannot imagine the number of cockroaches that ran out. Sick!
We walked up to reception, registered and paid a registration fee. They then determined what kind of service we needed. For example, this time I wanted a pediatrician but was willing to settle for a GP. They said the pediatrician wasn’t too busy so we could do that. Then we went over to the peds office and filled out more paperwork and did an ultra brief triage with the nurse. She then sent me over to the cashier’s office (back down on the first floor) so I waited in line to pay and get a receipt. Then back upstairs because now we could wait in line to see the doctor. Eventually we got in to see her and got orders for labs and radiology. We took the lab requisition slips over to the lab (which is both inpatient and outpatient) where we waited while they filled out the bill which I then took to the cashiers to get that receipt. (I tried to pay the bill for radiology at that time also but, silly me, was told I had to go to radiology first).  While waiting in line there I realized that I wanted to add several labs to what the doctor ordered because I don’t want to be doing all of this again in a couple of days. So, back to the lab to ask them to add CBC and CMP.  They didn’t even hesitate. The doctor had already ordered a Hb electrophoresis, blood smear, and a few other very specific things but I wanted a broader general picture. Back to the cashier with an updated bill, then finally got in line again to have the blood drawn. We were given a card with a # and a date to know when to come back to collect the results to bring to the doctor. Then over to radiology to get in line for another bill with that requisition slip. Then back over to the line at the cashier’s office (seeing a pattern here?!) to get a receipt and back into the radiology line to finally get the scan.
The astounding part of all of this is that if you don’t bring someone with you to do all of this (like I’m doing for Abraham and Emma) then you have to do the back and forth and up and down yourself (it isn’t a huge hospital but it is still a lot of moving around!) like the poor guy who was bleeding from his head behind me in one of the many lines I was in. I’m not a doctor but I still think he shouldn’t have spent hours standing in lines today while losing blood like that.  One other mildly entertaining thing was how often at the cashier’s they couldn’t make change for me. Both of the times that they didn’t have my balance I knew I was coming back so I was OK with it when they just scribbled a note on the top of my receipt that they owed me 20,000/= or whatever.  But it seems a little strange that they really only have one job…
But enough of all that. Back to Abraham. He got his ultrasound this morning (I didn’t stand in all of those lines yesterday. I saved some for today.) We learned that his spleen is normal, or at least as normal as any child who has had malaria a bunch of times. Yay!! But his liver is way too big for a kid his age. This finding really does a number on his differential diagnosis and the hepatomegaly makes me REALLY wish I had added a liver panel to the labs. But now we kick back and wait until we see another doctor on Thursday afternoon.

Abraham enjoying some R and R with is new favorite toy (thank you Elliot for sharing!) at the guesthouse this afternoon.

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