Ja som sagt, idag var det första gången som vi blandade och steriliserade, media, Mueller Hinton och ett annat som kanske var hematin men hette något annat här.
Labchefen gjöt sen ett antal plattor av bägge medierna och sen strök han ut det baktprov som är testmaterial för att se att autoklaven verkligen steriliserar. Det är väldigt roligt, han är åtminstone väldigt entusiastisk och har skaffat hem det mesta för att starta bakterieodling i liten skala. Regeringen eller Healthdepartment, har ett program för just detta , så för det finns det pengar, de är också lovade pengar för att renovera och utrusta ett ganska stort rum som ligger i anslutning till de andra lablokalerna., som ska bli ett baktlab.
Min survey på akutintaget har också startat idag, jag har gjort ett litet protokoll där jag för in uppgifter om pat med infektioner, ålder, kön, var infektionen sitter, allmänna symptom, som feber, smärtor osv, samt behandling.
Min plan är att hålla på i tre veckor och sen göra litet statistik på det och presentera för doktorerna innan vi åker hem.
Bara idag på em har vi haft 15 pat med infektioner, barn med ögoninflammationer, diaréer, hudåkommor, 5 st Hiv patienter varav en var diagnostiserad idag, av de 5, var två kvinnor och tre män. Det gick i rasande takt, med granskning av röntgen plåtar, och annat t ex två långa polisrapporter, som ni förstår ett tvärsnitt på en akutmottagning i Afrika.
Men det var väldigt intressant, och jag hoppas att resultatet pekar åt något håll, vi får se.
För övrigt , blir det varmare för varje dag som går, jag har ännu inte tagit fram mina tunnaste kläder, måste vänja mig vid värmen , det blir bara varmare och varmare fram till slutet av oktober.
Hundarna är nästan borta, eftersom ägaren till tiken med valpar äntligen gav sig till känna och kom hit med en stor korg och hämtade valparna, då hade de pipit högljutt i två dygn, säkert för att tiken inte låter dom dia.
Det var skönt, för det var svårt att höra dom gnälla utan att kunna göra något.
Igår var jag ute på en tidsmässigt, men inte avståndsmässigt , mycket lång resa.
Onsdagar går transporten med urdåliga patienter till sjukhuset i Ndola , jag var lovad att få åka med för att skaffe en dongle( en mobil internetuppkoppling som går på kontantkort, samma som telefonen har), så det var i princip mitt enda ärende, eftersom det fasta nätet är så opålitligt och man får tillbringa timmar på MBAkontorets veranda medan man väntar på att få kontakt. Det är mycket trevligare att sitta hemma och vara uppkopplad , men det är DYRT.
Ja resan startade med 12 pers i en toyota landcuiser, varav tre var jättedåliga patienter som luktade både ett och annat, de hade med sig varsin anhörig, så var det vår gardenboy, två obekanta tjejer, en sjuksköterska, chauffören och jag.
Vi väntade c:a två timmar utanför sjukhuset innan alla tre pat var inlagda på olika avdelningar, sen skulle vi runt till olika apotek. För att köpa olika mediciner, som inte sjukhuset hade hemma, på det sista apoteket fick jag lägga ut pengar för då var sjuksköterskans kassa slut( jag fick tillbaka dem , en timme senare), men jag fick min dongle och det var huvudsaken och igårkväll kom vi i kontakt med nätet hemifrån, det kändes lyxigt.
Resan tog 8 timmar och Ndola ligger bara 6 mil bort, thats Africa. Ingen mat på hela dagen, så jag stapplade in här kl 18, hungrig och varm och trött.
Det var inte den mest spännande dagen hitills, men jag hade gott om tid att studera hur folk är klädda och det är alltid roligt.
Maten är nästan samma som hemma utom naturligtvis att en del inte finns. Jag har beställt en kyckling från Angelas granne till imorgon och den har hon nog nackat och plockat idag.
Vi lever ett nyktert liv så när som två matskedar whisky, för magen, på kvällen.
Ja det var ungefär allt som har hänt idag , ska nu baka lite matbröd, en stillsam kvällssysselsättning. Kram till alla som läser detta från Maria, Ma, Farmor af Klercker
torsdag 2 september 2010
20100902
20100831 by Tom
This is the last day of august and it is starting to get really hot. The morning meeting was sparsely populated and was led by dr Cipaela without much interest in the proceedings. The round in children’s ward went smoothly as Tom was accompanied by Rick, young physician from England. There was not very many patients and the mother of the child in the emergency room thought she could see some improvement. The child had actively sucked out of a bottle of milk. Well hopes are not altogether gone. In he room were we keep the burns we could see that the 35% burned boy was lying with some old blankets and no sheets. The other burnt boy was lying on the bed without any sheets or blankets with only a piece of cloth that his mother provided. This arouse the question of sheets for the kids at least those with burns. Continuation will follow as the nurse could not answer our questions. We sent home a G:E: without G:E. (gastro-enteritis) When the round was finished Tom went to the laboratory to watch progress with the autoclave. There was none as Mike and Maria was waiting for the electrician, Dennis, to bring some suitable tools. As the right thing arrived Mike abstained to do the screwing so Tom had to take away the front. It made some very decisive resistance but in the end we had the front loose. It had a few but important bumps that had to be carefully corrected by a polygrip supplied by Dennis. There was a very tiny switch under the front that Tom happened to set to 1. We put on the front and could with a lot of trouble fasten it. Maria was full of enthusiasm and the main switch underneath made the display shine. That was as far as we got. The autoclave was in manual mode and refused stubbornly to function. Maria and Tom went home for lunch. Tom made a telephone call to Getingeverken in Skärhamn and learned that the tiny switch inside was supposed to be on 0 for the autoclave to function. There was nothing about at in the manual, the tiny switch was not even mentioned. With some extra labour the front went off and the switch was set to 0. Voila! The autoclave functioned perfect, The ultimate test will be tomorrow when Maria will perform a function-test to see if it sterilises OK.
When we got home Ulrika Wijk came and invited us to coffee in their house. We had some very interesting discussions about MBA and MMH and other subjects. We went home when it was dark and the grasshoppers were playing
20100901 by Tom
The morning started in a wrong way. We woke up too late and there was no water in the taps. That is bad because you can only brush your teeth and that leaves you uneasy. Maria disappeared to te bushes as they were collecting the puppies the dog Thaiga had left in our hedge. There was eight of them and they had been weaning and barking all night as their mother, Thaiga, had lost her patience and deserted them, as bitches do. The eight puppies was carried in a basket to their home in the Musaka properties.
Tom was seated in the conference room before everybody else and the conference was as usually short and not understandable for a foreigner. The morning round was very heavy as on child suddenly died. We had passed her and seen that she was ill, presumably with malaria, but then she showed next to normal vital signs. But suddenly her status deteriorated and she was dead before Tom could do anything. No heartbeats and no respiratory movements. Not possible to resuscitate. The rest of the round was uneventful, but for Toms very precise ordination of clean sheet for everybody especially for the burnt. Clean, preferably sterile, wet sheets should be put on the burnt parts of the child.
Maria was going to give the chauffeur Money and her computer so that he could by a internet-modem in Ndola. Nobody knew why, but suddenly the ordinary driver would not go and the new one knew nothing I internet matters so Maria had to go with the car to Ndola to by the thing. When the started I do not know but Maria was still in the hospital when Tom left 945.
Tom went to the Wijks for 1000 coffee and met some nice people. He brought Marias premier buns that disappeared into the three children very fast. The rest of te afternoon was spent waiting for Maria. When she arrived 1825 she was exhausted after a day in Ndola but she had bought a dongle for MTN that worked so now we have internet. It is comparatively slow but works and that is the essential bit. After a micro-heated lunch she went off to the Wijks and saw tem off. They are leaving because they are not popular with the leadership of MBA. The night was spent on the internet to catch up with tidings and filling the blog with text.
20100901 by Tom
The morning started in a wrong way. We woke up too late and there was no water in the taps. That is bad because you can only brush your teeth and that leaves you uneasy. Maria disappeared to te bushes as they were collecting the puppies the dog Thaiga had left in our hedge. There was eight of them and they had been weaning and barking all night as their mother, Thaiga, had lost her patience and deserted them, as bitches do. The eight puppies was carried in a basket to their home in the Musaka properties.
Tom was seated in the conference room before everybody else and the conference was as usually short and not understandable for a foreigner. The morning round was very heavy as on child suddenly died. We had passed her and seen that she was ill, presumably with malaria, but then she showed next to normal vital signs. But suddenly her status deteriorated and she was dead before Tom could do anything. No heartbeats and no respiratory movements. Not possible to resuscitate. The rest of the round was uneventful, but for Toms very precise ordination of clean sheet for everybody especially for the burnt. Clean, preferably sterile, wet sheets should be put on the burnt parts of the child.
Maria was going to give the chauffeur Money and her computer so that he could by a internet-modem in Ndola. Nobody knew why, but suddenly the ordinary driver would not go and the new one knew nothing I internet matters so Maria had to go with the car to Ndola to by the thing. When the started I do not know but Maria was still in the hospital when Tom left 945.
Tom went to the Wijks for 1000 coffee and met some nice people. He brought Marias premier buns that disappeared into the three children very fast. The rest of te afternoon was spent waiting for Maria. When she arrived 1825 she was exhausted after a day in Ndola but she had bought a dongle for MTN that worked so now we have internet. It is comparatively slow but works and that is the essential bit. After a micro-heated lunch she went off to the Wijks and saw tem off. They are leaving because they are not popular with the leadership of MBA. The night was spent on the internet to catch up with tidings and filling the blog with text.
20100830 by Tom
The day started when the portable radio by 630 sounded. It only gave away a sound of heavy winds because we have not found any station on either FM or AM that transmit anything. After a frugal breakfast we went down to the hospital for morning meeting. We arrived five minutes past eight but we were the first people to attend. Soon the room was filling so Maria had a lot of handshaking to do. Dr Okoko was late because his car had a slight mishap so the proceedings were led by dr Chatila. As usual the nurses, giving the report, was mumbling in a not understandable way. We left without having understood a single syllable. Maria went off with Dr Okoko and what was said there you can read in
Tom went to the children’s ward where Timoty was waiting. We had an uneventful round with some discharges. One was a bad burn of one hand were the mother asked to be sent home because she had four more children at home with nobody to look after them. The local health station will have to redress the hand and control how the wrist is positioned. It has to be straight if the boy will ever be able to do anything with that arm. The fingers will probably be quite stiff because of lack of fysiotherapy and adequate treatment. Not to mention the risk of infection in the damaged tissues. The little boy in the emergency room with supposed intracerebral malaria is very sick and will not pull through if you ask me. His parents wanted to take him home but was talked into leaving him with us for the time being. If he goes home and do not have intravenous fluid and antibiotics he will pass out very quickly. Maria entered the ward just before the end of the round and a new set of handshakes took place. We went home for a nice cup of coffee and a good book. We did the preliminary protocol to
In the afternoon I made a very short round and ordered antifungal medicin by mouth to a boy with a very bad lesion in the scalp and one on one wrist, the one in the scalp had been very heavily infected when he came to us but the infection by bacteria is gone now but the fungal one still persists.He will have to eat his medicine for a month or so. We also inspected the autoclave and made I telephone call to
When we came home we had a fight with an enormous amount of small but living cockroaches in the kitchen, especially around the stove. The war is not won yet but will continue.
Maria has started the tale of : There is a lady traveling with a dog. It is the story of our pilgrimage to Santiago.
20100829 by Tom
Today is Sunday the day of rest. We slept for a long time or rather stayed in bed. At 1049 we went to church. It has hard wooden benches and the sermon takes a rather long time, There was a lot of singing and choir-dancing. And everybody seemed to like it a lot. It was the last time that dr Okoko attended and he preached a little and choose a hymn that moved everyone.
After church we went home to have lunch and sat down in the shade and read our books.mA young English couple passed on their way to the market and we spoke with them for some time. They are newly married an shall be in Mpongwe for five months. They expect to be asking a lot of questions
When Maria thought we had done this for a long enough time we went to the MBA office to try our luck with the satellite internet. It did not hold so after trying for a long time we went away. We met Erna, the German midwife, and she invited us in for coffee and cake.. We had some very interesting discussions and left when it started to be darker(the sun had set). On our way we went into the house of the English and tried their wireless internet. It worked beautiful on their Mac, but did not work on our PCs. We decided to try at home And it did in the end work on
20100829 by Tom
Today is Sunday the day of rest. We slept for a long time or rather stayed in bed. At 1049 we went to church. It has hard wooden benches and the sermon takes a rather long time, There was a lot of singing and choir-dancing. And everybody seemed to like it a lot. It was the last time that dr Okoko attended and he preached a little and choose a hymn that moved everyone.
After church we went home to have lunch and sat down in the shade and read our books.mA young English couple passed on their way to the market and we spoke with them for some time. They are newly married an shall be in Mpongwe for five months. They expect to be asking a lot of questions
When Maria thought we had done this for a long enough time we went to the MBA office to try our luck with the satellite internet. It did not hold so after trying for a long time we went away. We met Erna, the German midwife, and she invited us in for coffee and cake.. We had some very interesting discussions and left when it started to be darker(the sun had set). On our way we went into the house of the English and tried their wireless internet. It worked beautiful on their Mac, but did not work on our PCs. We decided to try at home And it did in the end work on
