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| EENT WARD AND CLINIC |
One of my friends was asking me about
the hospital and as I explained it I thought maybe I should write
about it here. Some things I have talked about in other blogs but
some will be new. The Hospital is free and funded by the government.
Many times drugs and supplies are “NOT THERE” and the patient
suffers The hospital sits on a equivalent of a block. There are 14
separate wards of buildings and a morgue. There is a private ward
that you can pay to have a private room in a private building I have
only visited friends there the students don't go there. It is next to
the morgue and physical therapy. All building have metal roofs with
a ceiling inside that is about 20 feet up so when it rains some of
the noise gets absorbed.
The EENT clinic and hospital is funded
by the Lions of Norway and is clean, neat, has a OR in it, and
staffed by very knowledgeable people. It is a shiny star at the
hospital, and has a light patient load most of the time. They do
cataracts and have a Dr of Ophthalmology who comes sometimes. Most
of the hosp is staffed by clinical officers. They are 2 or 3 years
short of MD but do most of the work. If it is complicated a pt get
referred (but can't afford the transportation fee to get to Kampala)
or they just give up and go home.
Next is a nice new building for
diabetic clinic. Because the society here were very hard workers and
big carbohydrate consumers when they get laid up or old they still
consume the crabs but aren't doing the physical labor anymore and
this is the disease making it's way into society. Many are on oral
meds some on insulin but this is hard as continued resources to buy
insulin and needles is very hard. Probably why the average age of
death is 57. (I have a year to go)
across the street is Arua Hosp AIDS
project run by MSF (Medicus San Frontier (DR WITHOUT BORDERS)) It is
a clinic for testing, counseling, medication refill, and check ups.
Well run.
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| HOW MANY LEAVE THE WARD |
Up the street is Nutrition MSF run
again great program with wonderful results but a high return rate.
The discharge part of the picture is lacking. Malnutrition is the
disease of the 2 child. Reason being baby 1 is born and breast fed,
baby 2 comes along in 11-14 months and baby 1 has not been weened or
learned to eat independently and goes into shock when new baby is now
getting breast and quiets eating so that is why the disease comes
when 2nd baby comes. I am amazed at the sad size of these
little ones. Many come with 1 or 2 more diseases along with the
malnutrition They are put babes on formula and breast and give feeds
ever 3 hours to start and 6 as they get better. When hey go home
they are given a peanut butter bar called Plumpy nut that has all the
vit and minerals added and the babe is to eat 2 a day. Well mom eats
them too or they get sold in the market as the mom is 16 with 2 kids
and needs $ for something else and baby gets cassava porridge at home
which has no nutrition only carbohydrates in. Limited education,
young parenthood, multiple births, no employment for men who are
encouraged to have many children (this is your wealth) with up to 4
wives, and then aren't around, keep this disease or condition alive
and active here. This week I and a friend are going to the Hospital
in Kampala to do a filming of the discharge instructions given to
mothers there. Before the mother leaves she must demonstrate how
much and how to cook for her malnourished baby using local food.
Like adding dried fish to the water you make the cassava portage out
of or adding an egg. We are then bringing the tape here, I will have
the students watch and re do in the local language and we will film
again so the Nutrition ward can show it (when the power is on) on the
TV daily we hope. By the time the mom goes home we are hoping she
will have heard the message enough times she will remember and
implement at home from her garden. For my friends the nutritionists,
Lynn and Myrna please pray and email me if you have other suggestions
we could do that are cost free for the mom's.
Next is Male Medical which has many
young men with liver failure from alcohol abuse, malaria not treated,
shisto (a liver parasite from the water) worms, pneumonia,
malnourished, a few with congestive heart failure, meningitis,
typhoid just to name a few. But majority is alcohol abuse and
moringe use (a stimulant that is like crack your brain wants more and
more and in a month of chewing the leaves the men are burnt out. The
Sudanese and Somalian people use it but they do not have the brain
damage that the Ugandan's suffer. This ward is over crowded with
people sleeping on the floor on a mat or on a bed with a mattress
with the covering so Pee soaked the place stinks. The Nurse in
charge is excellent and does well but resources are limited to 2
box's of gloves a week for the ward of about 60 men.
Next is the AHAP maternal child
preventing mother to child transmission clinic. If a mom test + for
HIV she is monitored here. Her prenatal are done here and when baby
is born the midwives follow the mom on the ward and start the baby on
the anti retro virals. If the baby continues on them for 6 months
and is retested they are often HIV free but the meds are the key and
they have some big side effects so baby is monitored at this clinic
too.
The next building is the Maternal Child
Health Clinic. It is across the street from the Maternity ward
In this building you get prenatal
checkups, cancer screenings, family planning, and well baby checks
which are weight and shots. So in Maternity you walk around until
you are ready to push, you bring your own mothers kit which is a
garbage bag cut in 2, 2 pair of gloves, a ½ straight edge razor to
cut the cord (leading cause of tetanus in the newborn) and 3
blankets, a gauze pak and several rags for wiping, a basin and cup
for tea if you are out of energy to push the answer is you need
highly sugared tea. Seems to work as all the babies come eventually.
Anyway, after you have your baby they clean you up give you the babe
and you take your mat and lay on the floor in the hallway to recover
for 24 hours. If you don't hemorrhage you are discharged to walk
across the street and get your baby immunized, then get on a boda
(motorcycle) and go home. Hopefully with your aunt or sister or
maybe mom if she isn't having her own baby. With 20-30 births a day
and ½ the population under 15 the system must work. Maternity ward
is under stocked for equipment and supplies and they have a few cats
that wander around and sit on the shelves under supplies when a woman
is birthing. The culture does not have anyone as birth attendant
except the midwife. No male presence here and only female caretakers
are let in the ward but not when the work of pushing is happening.
She just brings in fresh rags for clean up and the tea. I feel very
bad for the moms. To me this is not a pleasant experience, especially
if this is baby 1 and you are 15.
The other part of the maternity ward is
for C sections, and a ward for cancer, gynecology surgery, child
defilement. Place is always busy, not well supplied but pretty clean.
At the end of the road and closest to
our main gate and road is the Mental Health Ward. Funded well with
a donor from the US who set up a ward for trauma victims after his
son was killed in the towers of 9-11. They still do electro shock
therapy though (Like in 1 flew over the cuckoo's nest) Main problems
treated are epilepsy, depression, alcohol and marijuana addiction, bi
polar, dementia, schizophrenia. Trauma counseling is done too as this
area had child soliders and war not that long ago. This is too long
so I will add to another day. These are the pic of the students
working on the wards. If you come to Africa come healthy and stay
that way... Bring you anti malarials it is the number 1 killer of
kids here. TIA MARC
