Sunday, April 12, 2015

Creating relationships (Nicole and Jaclyn)

Female ward

This week Nicole and Jaclyn worked on the female ward. Both of us have an interest in surgical medicine so we followed rounds with the general surgeon. Half way through rounds we came upon a young female patient lying on the floor with her mother and one month old babe. The patient was a 16 year old from a small village. Towards the end of her pregnancy she had attempted suicide by ingesting battery acid. This led to severe corrosion and damage to her esophagus as well as hyper salvation. Because of this she wasn't able to tolerate any foods or fluids by mouth leading to severe wasting syndrome. Due to the lack of the resources at the hospital and the severity of her condition we were afraid that she might not be around for much longer. 
The two of us saw this infant and were immediately concerned of babes health and wellbeing due to the condition of mom. We were afraid that it was not receiving adequate nutrients and fluids. Just by looking at this infant we could see that it was under weight for its age and on a slippery slope to becoming dehydrated and malnourished. We knew that something needed to be done. 
We advocated for the mother and infant to be transferred to the post natal ward where baby could be closely monitored as no one had paid attention to babe at all on the female ward.
We both had rotations at save a life centre and we knew how quickly young children and infants can deteriorate without feeding. We contacted one of the girls currently at save a life centre to ask about the process of admitting a child. We were asked to involve the nutritionist and social worker to refer the babe to the centre. Once or twice through out this process doctors and nurses made references to "the whites", knowing there was a place that helped children like this, but they were unaware of the process and lacked the tools necessary to make this happen. 

It became a long and tedious process as the nutritionist was away sick and the social worker wasn't able to fully assess the situation. Social workers here cannot be comparable to social workers back at home. In reality she was used for the purpose of translating and legal documentation of transfer of care of the child to save a life centre. Initially we were pleased upon hearing that we would be working with a social worker, but were immediately disappointed as it was very difficult for her to understand situation. She didn't collect enough information from the patient as we hoped and just didn't grasp the potential decline of the child. We had to keep coming back to her to see what progress she had made only to feel like each time we had made little to no head way. It was frustrating to constantly be having to repeat ourselves to these health care workers when we figured they would be the ones to understand what we were trying to do. It felt like it was just the two of us working by ourselves. We could tell if we hadn't taken this on nothing would have been done. 

On the third day we had help from one of our instructors as well as a different doctor who personally contacted the centre. Workers from the centre finally came in and spoke to mom about how we they could help babe by providing food and shelter while mom remained unwell in hospital. They also made it clear to mom that this was temporary to the situation, that mom could visit and retrieve babe once she was healthy. When mom finally understood the whites weren't trying to steal her baby away she was grateful for our help. 
Even though this process was very frustrating for the two of us, it enabled collaboration and the building of relationships between different wards and community. Because so many people were involved we hope that they share this experience throughout the hospital letting the workers know there is a resource for children in need of help in the community. We know that some of the health care workers have a basic knowledge of the Save of Life centre but lack the tools to utilize its services. Helping to create these relationships will be positive down the road should this arise again. We were so happy to see this babe get help from the save a life centre. Knowing that were helping to make a difference in this community was an amazing feeling. 

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