To tired to reflect..
God, this day has been busy... Came to OPD this morning, and it was just crowded. People everywhere, children screaming, coughing, having diarrhea and vomited where they sat... I just had to dive right in to the crowd to be able to to the triage.. After five minuted I had located three children that needed emergency care. Picked them upand ran with them up to peadiatrics. Also two very sick adults, we also had to run with them to get them on oxygen. A man and a woman. They where both in heart failure.. Not much we can do about that here. The man we tried to make an LP (test of the spinal fluids) and we,, well what did we do.. yes. He had severe anemia, 2.0. (normal rate is between 10 to 15. An hb down to 2 menas you are almost dead). We gave him blood... Then we couldnt do more, just wait. He had eye oedemas, which means that the eyes fills up with fluids so they almost pop out... He died a few hours after arrival. =(
The woman wasn't breathing and her blood pressure was down to 60 / 40... Glucose in her blood was 2 mmol. That means she was almost in a hypoglycemic coma.... We gave her dextrose/glucose, and a lot of iv fluids.. We had to resucitate her twice.... we bagged her. The first time i bagged her (making breaths with a bag and a mask and oxygen) she came back, and started brething again.. But then she went away. I tried to bag her again, but it was to late.. She was already dead...
And all this before 10 am..... Can you imagine?
I want to recommend a blog; A friend of ours who is hitch hiking across africa wrote about Nkhoma hospital. It is an very truthful and interesting blogpost and I really recommend it. He describes the hospital with the eyes of someone coming from the outuside.. I'm starting to loose those eyes, so it is very interesting to read.
Anyway, this is the address:
www.goacrossafrica.blogspot.com Look for the post called "Weddingdress from the boss", from the 13 of october.
Here you can read a piece of it:
"I walked through the hospital, well hospital, It’s seems that it is for the Malawian standard a good hospital, more developed and with more possibilities, like the Xray. But furthermore try to forget the word hospital as you know it or as I know it. Imagine just a few buildings/stones, large rooms, old hospital beds, in and outside corridors and everywhere the smell of urine.people, many people sitting, laying, sleeping, crying, eating everywhere in the in and outside corridors, dust and dust outside where people are laying with sick children, waiting and waiting. The hygiene what I've seen and heard is not a issue, its almost not there, only as I've heard in the operating chamber. HIV, Malaria, TBC, Malnutrition are the main problems, with not enough qualified doctors, and other staff. So yes it is what they show on the TV in the west, but man o man its so devastating that its very hard to believe for someone from the west"
The woman wasn't breathing and her blood pressure was down to 60 / 40... Glucose in her blood was 2 mmol. That means she was almost in a hypoglycemic coma.... We gave her dextrose/glucose, and a lot of iv fluids.. We had to resucitate her twice.... we bagged her. The first time i bagged her (making breaths with a bag and a mask and oxygen) she came back, and started brething again.. But then she went away. I tried to bag her again, but it was to late.. She was already dead...
And all this before 10 am..... Can you imagine?
I want to recommend a blog; A friend of ours who is hitch hiking across africa wrote about Nkhoma hospital. It is an very truthful and interesting blogpost and I really recommend it. He describes the hospital with the eyes of someone coming from the outuside.. I'm starting to loose those eyes, so it is very interesting to read.
Anyway, this is the address:
www.goacrossafrica.blogspot.com Look for the post called "Weddingdress from the boss", from the 13 of october.
Here you can read a piece of it:
"I walked through the hospital, well hospital, It’s seems that it is for the Malawian standard a good hospital, more developed and with more possibilities, like the Xray. But furthermore try to forget the word hospital as you know it or as I know it. Imagine just a few buildings/stones, large rooms, old hospital beds, in and outside corridors and everywhere the smell of urine.people, many people sitting, laying, sleeping, crying, eating everywhere in the in and outside corridors, dust and dust outside where people are laying with sick children, waiting and waiting. The hygiene what I've seen and heard is not a issue, its almost not there, only as I've heard in the operating chamber. HIV, Malaria, TBC, Malnutrition are the main problems, with not enough qualified doctors, and other staff. So yes it is what they show on the TV in the west, but man o man its so devastating that its very hard to believe for someone from the west"
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