3/11/11 - May contain strong images

The wing I work in, Ethel Muharika Maternity Wing

I was not fully recovered last time, but thought I would be, but I wished! Things came back even worse, but this time I had had enough, so I just started with Metronidazole straight away, and it did miracles! I love that drug! It is just an antibiotic, nothing more serious, for those of you that are not into medical stuff... So I had another day off work, well actually half a day, cause I went to work in the morning, thinking all would be OK, but it didn’t, so I went home at lunch hours. But started the medication in that morning, so in the evening I was a completely new person (at least I had a new stomach)!

A lot of thing go around in my head these days (not only my stomach...).

Work is going OK, but there are some difficult cases coming in, and the conditions are really serious. And not that it has to be, just that they are because we are in a developing country.

I will give you a few examples. Last week there was a 16 year old girl that came in early in the morning, around 6am. She was 5 months pregnant, and had severe malaria. The morning before she had went to a health center (Nanthenje), about 40 km from Lilongwe, because she had fevers and was not feeling well, they had found that she had very low Hemoglobin and started her on Quinine for malaria. But because they don’t have the possibility to transfer blood, she had to go to Kamuzu Central Hospital in Lilongwe. Her condition would have given her an ambulance, but because of the fuel crisis the country have now, they didn’t have any, so she had to arrange transport for her self. She had her mother there to escort her, but they failed to get transport (read 40 km) because they didn’t have the money for it, and when they finally got the transport, and arrived in the hospital at 6am next morning, the young pregnant girl was gasping for air, pale as a ghost, and her Hemoglobin was at 0,3g/dl! That is so extremely low that it is amazing she even got to arrive at the hospital alive. She died just few minutes after arriving to our ward.

And I have the last two weeks had two cases of young girls (7 and 8 years old) that had accidents when they were out playing, having sticks and nails to enter their vagina and causing trauma. When I hear this I only think that this must be a terrible excuse for child abuse. Of course this can only be my fucked up mind, but I cant see how a child can fall on a stick or a nail that can penetrate all the way into the cervix. I’m sorry if this is a bit strong for some of you to read.

I have discussed the issue with some of the nurses and doctors in the ward, and they all agree with me, and say that they sometimes get cases like this, and after a while the mother admits that the child has been abused. I just hope I don’t have to see more of these cases. It is just too much.

So the hospital is short of everything... Blood for transfusion, painkillers, antibiotics, intravenous fluids, disposable gloves, but if we don’t have disposable gloves we use surgical gloves, and next week we don’t have surgical gloves for sterile procedures, the laboratory doesn’t take full blood count (hematology), electrolytes, kidney- or liver function tests. They don’t have the reagents for the machines. And if we want a urine analysis, we have to send it before 10am, cause after 10am they don’t do urine analysis... There is just so many things we have to accept every day, that should be unacceptable. But we make the best out of it. What else can we do?

Today there was a lady that came from a district hospital, after a removal of a cyst in her uterus two weeks ago, and she has not recovered as she should. So after two weeks of not recovering, they found out that she probably has a bowel perforation after the surgery, or maybe a fistula, and feces are coming out in the abdomen. So they cut a small hole in her stomach, and now the feces just runs out freely, and she went for surgery just before I left work today. I hope everything worked out, I am eager to see tomorrow. I had a lot of work with her today. Thankfully there is a lot of nurse students in the ward these days, so they do a lot and help out, and it is great help! They work harder than the nurses in the ward. Thankfully!

I hope this blog didn’t depress any of you, it is just how I work these days. But I feel I’m coping quite well, I take things as it is, and I cant do everything. I am only me. And I love the challenge!