Friday fun day...or Friday not so fun day...

I was so excited for today's work on the individual wards...and I guess I was not as prepared for what the reality was going to be. The first two hours I spent in the Pediatric Ward with another student from our group; we got to play with the kids (mostly infants and toddlers) and talk to the mothers (or sort of, as their English wasn't very good) and then do some assessments and teaching through the translation of those who did speak some English, as well as some of the BU nursing students. The kids were mostly hospitalized for malaria, as well as malnourishment, dehydration and then a few burn children as well. There are really no pain mediations here to give the children, but I did get to bring a few smiles to a 15 month boy (not Eric, but another burn patient) who was burned along his left side of his body, including his face and hands. I gave him a small beanie baby (a crab) which he enjoyed, too. He was really fussy though, and even some Tylenol would have been awesome. The reality of the government run hospitals is, that although they are "free" they are far from ideal. I guess they make do with the supplies that they do have, though. I wish that resources were allocated differently...I did get to play with a lot of the other children, and I felt that their smiles were the brightest part of my day.

Then it was off to the postpartum unit, which I did not realize would be the experience that it was. In summation, it was horrible. The postpartum unit was where the post-operative Cesarean Section patients were kept until they went home. Remember when I wondered yesterday about the post-op infections? I looked at the incisions of the women that were on the unit, and every single incision was infected. Not just reddened and warm....far far worse. Every incision that I saw was partially opened, draining whiteish-yellow fluid and the smell was just as bad...I am guessing if the women were not septic yet, they soon would be. Treatment for the infection is also not how it is the US-the shortage of antibiotics I guess is what is the deciding factor in treatment. I was trying to teach one woman to drink a lot of fluids, since they were not going to give her IV fluids to keep her hydrated, and the nursing students from BU told her the opposite; that drinking the water would make her sicker! It was so frustrating. I will also let you know that of the 20+ women that I saw in the postpartum unit, I saw a total of 5 babies. It should come as no surprise that the rest of the women lost their babies...this is in direct oppostion to how it usually is in the US, where a postpartum unit is typically a very happy place. One 20 year old patient that I talked to told me that her baby was "gone". I discovered that she apparently had uterine rupture, which is the reason for her C-Section...and as a result she had a hysterectomy. She lost a baby and all of her future children in one single operation. Her grief was all over her face, and it was all I could do to hold myself together to comfort her. What do you say to her? The nursing students from BU explained that the reason that her uterus ruptured was the "herbs" that she took. This seems to be the common explanation for anything that goes wrong. From what I have seen, the C-Sections that are done "emergently" here are done whenever the doctors are here, and long past when it would be acceptable by the US standards of "decision to incision of 30 minutes or less". How about 3 days??? It was also surprising that the men/partners/husbands were not around to offer any support to their partners during their hospitilzation. It was also hard for me to understand the nursing role in this unit...the babies that I gave baths to, were a full week old, and hadn't had a bath yet. ??? Anyway, there was so much death/grief/loss today...and in what I thought would be such a positive area. I still am having a hard time with everything I saw today. I need a break from the hospital here....good thing we are going to the witch doctors here tomorrow.

I am off to do homework (yes, we have lots to do here, besides our clinical work) and then an evening to prepare for tomorrow. Love to all.