“If any of you lacks wisdom, he should ask God, who gives
generously to all without finding fault, and it will be given to him.”
~James
1:5~
The thing about living and working in a developing country
is that you learn to make do with what you have. Queen Elizabeth Central Hospital (QECH) is the
largest government hospital in the southern region of Malawi, servicing close
to six million people. Yet, it struggles
and in the 2 ½ weeks I've spent so far orienting, I've seen how the lack of
resources brings out the creativity of people! So when I was prepping a patient
for theater (the OR) and had to insert a foley catheter (mind you it was
ANYTHING but 100% sterile… had no choice, granted on what was available!) and
we ran out of catheter bags… one on the Malawian nurses handed me a surgical
glove (we later changed it out for a tube feed bag J ). When you run out of chucks (the blue, flat absorbency
pads placed under patients in the hospitals), one uses a large adult diaper.
Or, when your orthopedic patient is in Bucks traction and there are not enough metal
weights… can you say bricks and, by the way, who cares if they’re touching the
bed…right???
In my 2 years of AMERICAN nursing training, I’m discovering
that I am having to be “re-educated” on
how to adapt what I've learned to not just a brand new culture , but to
diseases I've never seen (like malaria) and to conditions that are so far
advanced, that one wonders why someone wait so long to come to the hospital
(many die)! Not to mention that I’m learning, very quickly, the importance of
triage and prioritization with an overwhelming nurse patient ratio at 1:20 or
1:30 (sometimes 1:45… at least on the TB ward!).
Malawi is one of the poorest nations in the world. At times it can be exciting to combine
critical thinking and improvisation but, there are dangerous setbacks. The
other day, for instance, a patient admitted for diabetic ketoacidosis (DKA) needed
IV fluids. Ignorant of the admitting diagnosis, a nursing student saw that her IV
was running low and decided to hang another bag. However, there was a problem;
the ward ran out of normal saline and hung 5 percent Dextrose instead. Now, one
can get mad at the student however, one has to remember the registered nurse to
patient to ratio… who’s following up (the nurses are sometimes not available)? Thank God, one of the doctors caught it and
brought to their attention! There are
other challenges; lack of equipment (ex.
ONE ultra sound machine for the entire hospital!); lack of materials,
like glove when there 80% of the patient population is HIV positive; lack of
trained medical personnel (due to the shortage, nurses rely heavily on the
guardians to inform them on a change in the patient’s condition and medication
administration); lack of space (with some wards having more patients than beds,
some patients sleep on the floor!) and of course, there is the problem with
follow-up.
There’s apparent need and I’m just grateful I can be here to
observe, learn, share, and, hopefully, make a difference!
Tu hijita,
Joya
No comments:
Post a Comment