Saturday, April 4, 2015

Week 3: Jaclyn and Jess go to the Child Ward

This week we were on the pediatrics ward, which was a frustrating but a rewarding week. I started off the week on my own (Jessica was sick with a bug that has been circulating through the house) which I was nervous about at first but the nurses and Dr. Idi were very welcoming. Over my few days on peds I spent time with Dr. Idi, learning a lot from him about the different illnesses and how they are treated as the illnesses are very different then what I am used to. The first day I became accustomed to the ward and how the shifts go with rounds, handover and the care of the children. The second day however was very frustrating and difficult as when I arrived on shift I was informed there was a death over night. A 5 month old baby, one that I had seen and spent time with the day before, my heart dropped when I heard this. Not only had the baby passed but the body and mother were still on the ward waiting for the doctor to arrive. It wasn't so much the slow moving of stuff being done but the events leading up to the passing that bothered me the most. I had seen the baby the day before and had been with the doctors when they ordered tests and later deciding that the baby didn't need surgery. With the limited tests that could be done there was no way of knowing how dangerously ill this baby was until it was too late. Watching the mother carry her baby off the ward made me feel like we had failed, I felt like I somehow should have known something was horribly wrong, but how could I have known? I just felt like we should have been able to save the child but after I realized there wasn't anything more we could have done with what we had which still feels like failing to me,  a truly horrible feeling. After this day I made the goal to try to make a change in a child's life, to push for tests and whatever else to be done no matter what. 

Jaclyn with a patient and his Mom. She developed a strong relationship with this family. You can't see it in this photo but he has Canada tattoos all over his arms.

So on my third and final day (Jessica was finally well enough to join me) we had a child that had come in the day before due to malnutrition. This child was truly skin and bone. We had never seen a child that had no energy, no fat, no muscle, and cheeks that were so sunken. She was a year and 7 months, and less then 13 pounds. Her mother was young, did not speak English and did not seem to know what needed to be done. The day before the dietician had made a jug of F75, which is a milk mixture that has electrolytes and everything a baby needs to gain weight. Although the dietician had explained that the baby needed to eat every 3 hours and a specific amount, the mother was not doing this despite her saying she was, we knew this because there was very little that had been used from the bottle made the day before. We looked at the doctor and the dietician saying the child is not getting the required amount, the child was more lethargic then the day before, and the dietician tried to argue. As the tension grew and thinking back to yesterday, I (Jaclyn) could not fail this child and let this child go longer without food so I went to get the bottle to show and prove to Dr. Idi that it was not being given. After this they finally agreed and there was more teaching done to mom about the need for the feedings and the frequency of them. Once the next feed was due we went with mom while she prepared the milk, warming and measuring it. Jessica and I then went to the bedside to monitor how child was taking food. The child was very lethargic and spitting up majority of the food. We spoke with the nurse on the floor to advocate the possibility of an nasogastric tube being inserted to ensure the child is getting the nutrition needed to recover. It felt so good to finally be getting things done and we felt like maybe we were finally accomplishing something. 

          Jaclyn preparing the F75.

Although working on the Child Ward was frustrating at times we both found it to be very rewarding, particularly at the end of each day when we brought out the toy box and played with the kids. 

Blowing bubbles at this beautiful little girl. She wasn't quite sure how to feel about it. 

I (Jessica) only got to spend one day working with the children but I valued every moment I spent with them. A highlight for me was spending time with a shy little guy who was probably around 8 years old. All morning we had seen him sitting quietly on his bed with Mom at the bedside. He seemed very serious, not even cracking a smile. We had brought mask templates and crayons so we went over to him and sat down. It was difficult at first to communicate what we wanted him to do but after miming and demonstrating he slowly began to colour. I will never forget how meticulously he coloured each section, he was so serious. It was adorable. We then held the mask in front of his face and took a picture so he could see what he looked like. I will never forgot his reaction to seeing himself in that mask. I am tearing up now even thinking about it. It's amazing that such a simple thing can bring such joy and in that moment I felt like we were making a difference, even for just a short time. That little boy may not remember us as he grows up, but I know I will always remember him and that beautiful smile. 
 Taking a picture to show this patient     what he looks like in his mask. 

           A masterpiece in the making. 

             Masterpiece Completed. 

Throughout the week Jaclyn had brought some donations that we had collected prior to our trip (THANK YOU), including colouring books, bubbles, Canadian tattos, stickers and puzzles. These little things brought the biggest smiles to these kids, and knowing how much they were going through it was uplifting to see how powerful play can be.

This week on the Child Ward, though difficult at times, served as a reminder that even though there is little that we can change, our presence here in Mongu does make a difference.  
-Jaclyn and Jessica 

1 comment:

  1. Dear Jaclyn & Jess,

    You had a hard week on the Child Ward to start with losing a child. An everyday event inside and outside Lewanika Hospital in Western Province for too many families, as I know you realize. At the same time, your stories remind us of the power of art, play, music, nature, and other non-medical interventions to help and heal, even when other treatment is not readily at hand. And there is actually research to demonstrate that empirically. Yet, both here and in Zambia, we so often neglect to bring these non-medical therapies into the picture. Why is that, I wonder?

    Happy Easter to the UBCO Nursing Zambia team and to all of our Zambian colleagues,

    Tricia Marck