Thursday, February 2, 2012

Hippo's, Hunger, and the Hospital.....

Hello everyone!
We spent this past weekend at Mukambi Safari Lodge. I think its safe to say that we all had a great time. We went on 2 game drives, one at night and one early in the morning, and a boat drive. We were lucky enough to see a lot of animals. Lions, elephants, zebras, hippos, warthogs, impala, all sorts of birds, and crocadiles. One of the resident hippos greeted us in the morning out front of our room. His name is Basil and enjoys coming out of the water to hang out with us. Warthogs looking at us through our bedroom windows was also a common theme. The weekend was very relaxing and a much need getaway.
It was a great first week in the hospital for us (we were at an outreach clinic last week). The frustrations around lack of supplies, and lack of man power grow stronger and stronger each day. Randi spent the week on the childrens ward. There are many malnourished children who we supply milk to every two hours. Tuesday morning we walked onto the ward and there was no water to make the milk, so the next day we brought a big jug of water, but there was no power to boil the water for a few hours, so the already malnourished babies had to continue to go hungry. We had a baby who was in the critical care unit- the unit is not used often and only has two beds. He was recovering from an intestinal surgery that he had the previous day (he only had a 50/50 shot to survive). The baby needed oxygen, but again there was no power to fuel the machine. We were ecstatic when the power came back on, but then the only machine we had on the ward kept breaking. Needless to say we stayed with the baby all shift. Today he is doing well and I am glad the efforts made a difference. Sometimes I feel so useless on the ward, we spent a day putting together mosquito nets. But then when I sit back and think about things, with a nurse to patient ratio of 1 to 40, these things would never get done. We have been searching the hospital a couple of days now to try and find a ladder to hang the nets, but we have not had any luck yet. These small things make a big difference when half of the children on the ward have come in with malaria. Yesterday we had one young girl pass away. We had no idea what was going on until we heard the mother wailing. By the time we got to the patient she was already cold- we felt so helpless and we are still playing the incident back in our heads, wishing there was something more we could have done for the little girl. It is difficult to know that this death would have been fully preventable in Canada with the proper monitoring. It took a few hours for someone to come and remove the body, so she layed lifeless under a blanket for the rest of our shift. Finally, there is a little boy on the ward with a badly infected, gangrenous foot. He has been scheduled for surgery 3 times, and every time it has been cancelled. He needs a below the knee amputation before the infection spreads and we have to take more of the leg off. When know the time is coming to soak the foot, and the only pain killer he gets is tylenol, it breaks my heart knowing that for the next 25 minutes he will be screaming in pain, trying to hit me or his mother to get him to stop, and probably swearing at me in Lozi. But he is so strong, and we are hoping that he will get surgery soon (even though every surgery was cancelled again today because there was no surgeon to perform them). We make him smile after with bouncy balls, and he likes us again a few minutes later. On to Michelle and Cara's week...

Our week has been very eventful. We started off our first day with 4 deliveries before 9am! Cara saw her first vaginal delivery here in Lewinika Hosital, and now has seen about 15. It is very different from the marternity wards in Canada. The woman stay in the general room until 8cm dilated then move to the deliver room, where things happen very quickly. We have learned not to turn our backs on a labouring woman. The baby will come out with no warning! The women here are very strong. They only make the slightest noise during labour. Once they have delivered they move back to the general room with their baby for one hour and then moved to post-natal ward. We have noticed that the mothers get most of the attention on the ward and not the new borns. Cara and I have taken the duty of assessing baby right after birth to make sure there are no complications. So far there has been a few scary moments. We had 2 premature babies staying in the incubators, barely breathing. We cared for them through out the day, we were really concerned because we knew that these babies needed more care than we could provide. Later in the day we ended up rescusitating one of the new borns. Fortunately the baby came back to us. When we left the hospital we had tp prepare ourselves for the worst the next morning. Unfortunately the 2 babies did not survive the night. It is very frustrating to watch this happen, knowing that no one tried to rescusitate the babies during night shift. It seems that death happens so much here that the nurses have accepted that it will happen and there is nothing they can do about it. It is hard for us to get a grasp of this way of thinking. I guess it is something we do not face in Canada. Later in the week we got to observe a vaginally delivered breeched baby. It was an expereience we will never forget. The baby come out feet first and did not want to let his head come out. The doctor had to use all of his strength to pull the baby out. And the woman barely made any noise. I think she has been the strongest lady we have ever seen. Baby had gone without oxygen for so long, so we were prepared for baby to come out not breathing. We rescuitated the baby with the help of the doctor. Thankfully after about 5 minutes we were able to get baby breathing again and is now doing well! Today we have finally learned how to chart the Zambian way. It was hard to understand where the doctors orders go and reports, hopefully tomorrow (our last day) will go smoothly. We have definitely learned a lot from our experience on the maternity ward. We are realizing that things here are different to home in so many ways. I think sometimes we forget that the people here are complicated in their on way and we will never totally understand the reasons for the care they provide. The hospital staff here are educated and very smart but are sometimes hindered by the circumstances and beliefs around them.

Love and missing everyone at home!
Randi, Michelle and Cara

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