Continuation of Day 2

Last night was by far the hardest time I’ve had at the hospital.  We went in around seven and made our way to minor theatre.  Not much was happening there so some of us went over to casualty.  Laura and I introduced ourselves to the doctor and asked if we could observe him.  He agreed but we ended up sitting behind the desk for at least twenty minutes, and the casualty area was overflowing with people lying on beds waiting to be seen.  Finally the doctor started moving and looked at one patient and then retreated back to the desk.  One of the guys thats been here for three weeks is in medical school and stated taking charge and talking to patients.  Its’ frustrating watching that because the doctors and nurses have no urgency to help their patients even though they are working in the emergency section of the hospital.  Another girl and I look around at the patients and start taking vitals when I notice a bed with a lot of blood dripping on the floor.  I make my way over to her bed and see that her bottom half is soaked with blood.  I go find the other student and have him check on her.  He talks to her and we find out that she has had her baby early- only three months- and the placenta is retained within the uterus, something pretty serious.  We go talk to the doctors in charge of the area and they don’t seem concerned at all about her.  She lost a lot of blood and was groggy so we asked if she was scheduled for surgery yet.  They said no and that she couldn’t be moved to the women’s ward because there were no beds to move her to.  Being proactive we asked what the name of the Gyn surgeon was and the doctor said he didn’t know, we asked the nurse, she said she didn’t know either.  I was honestly so frustrated and confused because this women needed help and they were sitting behind the desk. We walked up to the women’s section of the hospital to ask if we could move the woman and there were numerous beds available but we needed to talk to the surgeon first.  We made our way up to major theatre to find him because he was in surgery and ended up calling him and he said he would send someone down. At least we were getting somewhere. 

It’s funny how the people see you in scrubs and ask you to look at their loved ones because you are white and expected to have the knowledge of medicine.  We moved from patient to patient doing what we could with our limited knowledge when a man approached us.  He was furious that no doctor had seen the two men he brought in who had been in a motorcycle accident. He pointed out a child that had been lying on a bed waiting as well.  We assured him we were doing what we could and we would try to prod the nurses and doctors into moving faster.   

There was a nurse there that was in minor theatre and one of us students talked to her and asked if she was working in minor theatre tonight.  She responded “no I’m in casualty tonight” and the student smarted off and responded “well you are aware this is minor right? You’re not in the right spot and it is very busy over there.”  She was just standing around hanging out when there were people fighting for their lives.  Later we were walking back over to casualty and she again was sitting on the benches outside.  The same student said “oh taking a rest are we? You’ve been working so hard. I understand.”  It was so frustrating yet funny because she didn’t respond to his smart response just kept on sitting.  It gets even better. After being in casualty for a couple hours we were going to rest in minor when we walk in and all the lights are off. The same nurse was sleeping in the area where we wait for patients with a sheet over her head.  The same student was steaming.  He picks her up by her shoulders and tells her to wake up, forces her into her shoes and orders her to do something.  Her excuse was “I’m tired.” I can’t even explain the incompetence that exists in the hospital here.

Later we went back to casualty to check on the women who had the retained placenta. The doctor had come down and talked to her and she was going to receive surgery.  About two minutes later I see a man carrying the child who had been laying helplessly on one of the beds into another room.  His eyes were taped shut and he was wrapped in blankets.  He had died because of pure negligence.  The mother was very upset, as any parent would be, while the doctors and nurses seemed unaware of the situation.  I had to step out for a minute after I saw that and take a breath.  When I entered us students were everywhere checking vitals and checking on patients.  I assisted in putting in an IV.  A baby and elder had come in as well who were very short of breath.  The baby could barely breathe and was so helpless. Us students attended to the elder lady and got her some oxygen.  Dealing with the baby was so sad.  She was tiny and you could hear the struggle with each breath.  The medical student wanted to apply suction because he thought something was blocking the airway but the nurse argued that we couldn’t because it had already been suctioned and we wouldn’t want to do it too much.  Instead they put a nebulizer on it while a student held its head up.  The parents cautioned themselves away from the child almost like they were trying to keep their distance so if something happened it would be easier.  The nurse soon came up and scolded us saying there were too many of us in the casualty area and we needed to leave. We retreated back to minor theatre frustrated and upset.  No one needed showed up and it was about one so we decided it had been enough for the night. 

I don’t mean for this post to be completely negative but it’s so hard going there every day and knowing that some of the doctors and nurses don’t care about their patients.  They put that child’s body in a room outside of casualty with a sheet over it but when I went back this morning the body was still there. No one had moved it, anyone could stumble upon it.  Everything is just so different and you come to realize the small things we take for granted like blood pressure bands, gloves, and patient/doctor compassion.  The medical student who had been here a while had a terrible experience a week before we arrived. He came upon a patient in casualty who had not been attended.  His heart stopped and he had to perform CPR on this seventeen year old boy. After five minutes of CPR one of the nurses brought over the only AED in the hospital and asked if he wanted it.  He said of course and the nurse responded with “Oh, but it doesn’t work.”  So why would you bring it over? Why? Why is the question I ask myself a lot here.  He is starting a fund to get an AED for the hospital so once we get the fund set up ill post the link and any donation would help.  It’s incredible that Sioux Falls has an AED for every school, pool, and the hospital has dozens yet the hospital here in Africa doesn’t even have one functioning AED. I know that some medical care is better than no medical care and I’m trying to stay positive here. A positive is that with our pestering more patients were probably seen than if we weren’t there. Switching wards every couple days helps because there are some doctors that do care and do have the drive to teach. Sorry this is so long….lots to think about from last night.  It rained hard as we left the hospital last night, pretty fitting for the mood we were in as we went back to the compound.