2010902-05 by Tom

Eftersom Maria skriver också kommer ja fortsättningsvis att hålla mig till Mponwe Mission Hospital och mina göranden och låtanden visavi det. Det blir fortsättningsvis på engelska eftersom jag misstänker att de som har detta speciella intresse också kan engelska.

Wednsday the 2nd of september started out as most days here. Leave bed as the light gets enough bright say about 6.30. Frugal breakfast and a short walk to the hospital. The mornin conference is as usual not on its way ubtil 815 and the nurse tha is giving the report is mumbling in a way that is unhearable at least for me. She is using bembenglish a mixture of bemba and English and is mumling so as to make it very hard to understand. We had a dead child during the night and I hardly heard even that. The morning round was full of disappointments: No weiging of even the one on special diet for malnutrition, no fluid charts even for those on intravenous nutrition, no sheets in the beds, not even for the burnt children. The care was left for the parents wwho had no education whatsoever. Of course the resources were extremely scarce but ….. We got in a new burnt child. He was 12 years of age and had tipped a pan of boiling water over him. Result was 35% to 40% of his body surface had second degrees burns. He was in great pain and had no clean sheets, or wet sheets on the burns. They had not started a fluid list and were not giving him fluid intravenously. He was shortly left to die, which he of course did during the following night. I found out that some of the tests the referring CO had proposed and I had attested were not taken and the answers of course not delivered. The cry for a slow lab was illegal. The nurse in charge sent a dresser to assist in the round. Mostly the dresser was no good in English so it was very hard to get a complete story from the patient. On the other hand he nurses gave a good impression to be well trained but their feeling for the patient not to mention the Scandinavian doctor was not what I had expected. The kryptorchid boy was operated on but dr Chipala could only find one testicle so he left it by stitching it to the bottom of the scrotum. The boy has to be with as little movements as possible, but that is hard on him. Maria have got the autoclave working , and she and Mike Masona are testing it to see if the results can be trusted. So far so good.
We have borrowed two bicycles from Stella Holmgren. The male one is extremely heavy to ride but I will get good muscles from it. We biked down to the market to get air-time for the internet modem Maria had purchased and hat was about all we had the power to do in the present heat.On the morning round the 4th we went to the isolation ward to look after a small girl with possible measles. The patient and her mother was nowhere to be seen. Someone told us that they had been seen heading for the market. The mother had apparently not been informed why she was in the isolation ward. By the way : They had not fixed the light in the ward – the lamp did not function and the mother did not like being in the dark with the sick child. But go to the market she could!! I told the nurse very precisely that this hospital may be short of recourses but we did not do sick-care in the dark if there was electricity around