Thursday, July 5, 2012

A Rough Day in Peds

Quick Recap:
Let’s start with the interesting fun stuff today since my experience at the hospital may or may not be a bit draining for you to read (see below if you’d like to read about it).  Last night we celebrated the 4th of July with a great American meal including some great hamburgers, fries and carrot slaw (yum!) followed with some smores with digestives instead of graham crackers—again super yum!  Later on we went to a local bar with some of the doctors we met the day before and chatted with them over a few drinks.  Tonight I am going to bed extremely early since we have to be at the hospital by 8 am tomorrow.  We are having another Braai since there are new backpackers at Old Vic’s (I am NOT complaining).  Right now I am just relaxing and writing by the fire next to the bar for the evening.

**Patients in maternity and ward 7 (at least) have to be pushed outside to get to the main hospital where the operating rooms are located.  Often times the elevators are broken which requires the patients to walk to the operating room or be carried up the two flights of stairs in a wheelchair.  They will still bring patients in the rain from one building to another**

Details from the hospital:
If I thought that yesterday was confusing and difficult then I don’t really know where to start for today.  When we first arrived at Rob Ferreria I decided to spend my time in Pediatrics thinking that I would get to play with the children and compare the facility/staff and procedures to those at Victoria Hospital.  Needless to say, I was nowhere near prepared for what I was going to be dealing with.

I’ve already spent so much time reflecting over this experience that I honestly don’t know where to begin.  Maybe the beginning is best.  When we first walked into one of the rooms with 6 small children/ infants I was surprised at the serious lack of happiness—no colored walls, no paintings or toys.  The beds were so old the paint was chipping from them and their little gowns were dirty.  Two of the smaller babies were crying (most likely from their symptoms associated with Gastritis) but none of the doctors or nurses seemed to pay any attention to them.  This continued for a while so I eventually got used to the screaming and wailing.  I later found out that this was more the norm in the peds ward, especially once I met the worst case of the day, Nation.

Nation is a 3 year old boy who has the body and development of about a 1 year old.  He has Kwashiokor (the puffy belly), HIV+, extra pulmonary TB (most likely) and is extremely malnourished.  He looked nothing like the 3 year old that was standing and trying to high-5 me next to him.  The next thing I noticed was that the 5 nurses in the room (with 6 kids again) paid no attention to the fact that Nation had no motor skills to feed himself even though they had placed his oats/porridge in his crib.  This would explain the porridge that was all over his gown and face.  My friend Emily offered to feed him and the nurses seemed so indifferent like it wasn’t a big deal.  When I asked for a cloth to wipe his face they looked at me as if I was crazy.  Excuse me but the poor kid cannot feed himself, you weren’t going to do it and now you wont even give me a towel to clean him?  I was disgusted.

Nation and this other child Miranda who were both potentially MDR TB or Extra Pul. TB were in the same room as other children with HIV—a little side note, HIV patients who are exposed to infectious diseases with already compromised immune systems from the HIV virus are so much more likely to contract this other disease.

We walked outside of the room to find other kids running about with their bandages half off throwing boxes at each other like it was no big deal with the nursing staff laughing at them.  I felt like I was in a zoo or some deranged hospital that had no standards, ethics or morals.  I know that sounds harsh but I honestly have no other idea how to describe this.  Today was the first day that I almost cried after leaving the hospital.  The only reason I didn’t cry was probably because I ended up removing myself from the ward early and moving to another section of the hospital.

I eventually found myself calming down after I spoke with my mom briefly and made my way to Ward 7 which seemed like a different world compared to the pediatrics ward.  The doctor that was on was extremely caring and nice to both the patients and us.  Before she showed us a patient with a chest drain for TB she introduced us and asked the patient if she minded us seeing the drain.  The nursing staff seemed very dedicated to the patients in the ward which were severely ill patients.  The patient that had TB in the lungs and had the drain was 26 years old, HIV+ and has TB.

Lena was another patient that I peeked in on who is suffering from Stephen Johnsons disease, a side effect to her ARV treatment. S.J. causes the skin to blister and in a sense burn/ peel off. Her entire body was COVERED in these burns and we saw her as they removed the bandages from her body.  I assume that this disease is quite rare and I would most likely never see this in the states so I took in the medical side of it and tried to leave my emotions to the side.

The last girl that I spent time with today was Ellen, she is 15 years old and is suffering from Cerebral Palsy.  Both of her parents died from HIV and her aunt that had been taking care of her dropped her at a neighboring hospital a few years ago and never came to pick her up.  That hospital was sick of caring for her so they tricked Rob Ferreria into taking her as a patient by saying that she had bedsores.  We helped her play with a doll, I gave her a back massage and we fed her lunch in the hallway.  All of the nurses and doctors seemed to really like Ellen and were very attentive to her needs which made the day a bit more uplifting and made it end better than I thought it would. 

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