Wednesday Afternoon Update

I would first like to apologize to anyone who was worried last night after my post. I was exhausted and emotionally drained and wasn’t thinking clearly about how others might interpret my last statements.

I’ll start at about 8:30 pm when we got back to the hospital. At night, the only parts of the hospital that are open to new patients are Minor Theater and Casualty. We started off in Minor. A young boy of about 12 came in with a bad cut on his foot. I actually got to clean and dress the wound. It was a little gruesome looking, but it didn’t actually bother me to do this. Before the boy came in, the group of us had been hanging out in the staff area and I set my camera down on the table in there. While we were busy cleaning up this boy, some people who were there with him walked through that room and I’m assuming that is where my camera disappeared to. This was really upsetting at the time, because I really hated losing my pictures and it just seemed like another thing that has gone wrong here for me. It just seems like it’s one thing after another. Also, I was very disappointed to learn at this point that I won’t actually be able to give people stitches or to help with surgeries like some people have because the sterile surgical gloves that they have for this are latex and there are no latex-free ones. For those of you who don’t know, I have a latex allergy which I don’t really notice in the US because most things are latex-free. Here, however, it seems to be a much bigger deal, unfortunately. So I was already slightly depressed at this point in the night and the night had really just started.

Just a warning, this next part is quite depressing and you may want to skip over this part.

Then Joel, who had been in casualty, came into Minor and told us that they needed help in Casualty badly and so we all rushed over there. Casualty is supposed to be an emergency room. However, it was absolutely stunning and terribly frustrating because we soon learned that the doctors and nurses working there had no sense of urgency at all for these people. People were literally bleeding out, and those who could help were just sitting down, hanging out, or strolling from patient to patient. A little boy just died on a table all alone, without a doctor even going over to see what was wrong. A tiny baby, maybe 1 month old, was just lying on a table, struggling to breathe, with no one even sparing her a glance. So, naturally, we burst in there and started running around trying to help these people by getting them oxygen or IV fluids or anything at all to help. The nurses and doctors wouldn’t even help us unless we literally dragged them over to a patient. We got oxygen set up for the little baby girl, trying to help her breathe and put an O₂ stat on her to monitor the level of oxygen in her blood (it should be 100% for healthy people). I held the baby to give her a nebulizer treatment and as I was holding her, her oxygen levels just started dropping. At first, we just watched, hoping the neb would start working and helping her breathe easier. However, as they kept dropping, we became more and more frantic, trying to get someone over to us to help. This whole time, I’m holding this tiny baby, and she’s staring into my eyes until she starts closing her eyelids slowly and I can just tell that she’s going to die. I tried my hardest to get her to keep her eyes open and awake, as her oxygen dropped into the single digits. Finally, we give up on the neb and put oxygen back on her, but the oxygen levels continued to stay very low. The baby had closed her eyes. Luckily, we finally were frantic enough that we finally pulled someone over to the baby. I had to leave at this point, because I thought for sure they would just take off her oxygen and declare her dead. But when I laid her back down on the table, she miraculously started to breathe a little better and her oxygen got up to acceptable levels. This should be a happy ending, but most likely that baby never got any more help and eventually let go of life in that terrible room. At this point, the doctors told us we had to leave because we were “upsetting the patients.” It’s so terribly frustrating that these doctors don’t value any of these people’s lives enough to exert an effort at all to save them. I can understand and accept death, when everything possible has been done to help. But I can’t understand neglecting to help these people at all. I don’t know how many people die in there everyday from simple neglect, but it’s too many. Two more babies died just this morning, which was again probably preventable. It’s so sad, I can’t handle it. I was very shaken up over this last night and just couldn’t pull it completely together after holding that baby and knowing she almost died, and maybe still did, just because no one felt like helping her.

Today was better and I guess I’ve accepted that I can’t change everyone’s attitudes in this place, but I still can’t accept senseless deaths. I don’t know if I will be able to handle going back into Casualty for the remainder of this trip, but I guess we’ll just have to see. I spent this morning in the Family Care Clinic, which mostly focuses on giving treatment and monitoring children with HIV. I was with a very good doctor here and she was very informative. She told me a lot about the disease, and maternal transmission of it. She said that about 60% of babies will get it from their mom’s if the mom is HIV positive and doesn’t take the proper preventative medication while she is pregnant. Also, if the baby doesn’t get HIV from the mom during pregnancy or childbirth, the baby can also get it from breastfeeding from the mom. However, most babies born without HIV don’t get it from breastfeeding and breastfeeding is often the only option that mother’s have for feeding the baby because formula is so expensive. Formula costs about $500 for 6 months and most people’s income is only about $350 a year. The baby of an HIV positive mother gets tested for HIV at 6 weeks, 9 months, and 18 months. If the baby is negative at 18 months, they have officially not gotten it through maternal transmission. Most of the children who came in were just getting their blood drawn for a CD4 counts. They get this done every 1 to 3 months, depending on how good or bad their counts are. The higher the CD4, the better. It was a very interesting and informative subject for me, since I am doing my Independent study project at SDSU on HIV in Africa. I’m hoping to spend some more time with this doctor before my time in Africa is done. The good thing about this hospital is that all of their HIV testing and counseling and medication is free to everyone. It’s a wonderful thing that I’m sure has saved many people’s lives or has given them a chance at normal life. The doctor told me that the biggest thing that needs to happen to reduce maternal transmission is education and empowerment of the women in Africa. She said many family’s don’t want a pregnant women to go to the doctor for any prenatal care. They have a large distrust of doctors, which I kind of understand after seeing the emergency room. Many women won’t go against the family’s wishes and go get the proper testing and medication. There is also a large stigma yet in the country against those who are diagnosed with HIV, so many women just don’t want to know whether or not they have it. The doctors at this clinic do not tell the children that they have HIV until the children are at least teenagers and able to handle this news. It seems shocking to me, but that is how they have found things work better here. After the HIV clinic, I went to Minor where I helped clean and dress some more wounds. One guy who was about 25 threw the biggest fit I have ever seen over getting his wound cleaned. We numbed it and everything and he was still freaking out. I finally let him hold my hands and I swear that he squeezed them so hard that it hurt me more than cleaning the wound hurt him. After that we called it a day at the hospital.

We went out for lunch again because there really isn’t anything to eat at the compound for lunch. The lunch meats and bread that they have for sandwiches is much different than what we have at home and not in the good way, so most of us don’t want to eat it. However, it is getting expensive to eat out like this, even if things are cheaper than in America. We are just hanging out now in the afternoon and are still deciding whether or not we want to go back to the hospital for an evening shift tonight.