Teaching students
Waiting for the student to come up with the right answer
Things can get a little crowded!
Charting (in a fraction of the time it takes in the US! - a side benefit)
And, of course, caring for patients
My clinic where I see patients on Wednesdays. I'm really enjoying the continuity of following these patients, though it requires multiple specialty hats! In clinic today I saw patients with sickle cell disease (hematology), epilepsy (neurology), congenital malformation of a leg (neonatology/orthopedics), severe malnutrition with stunting (nutrition), genetic syndrome (genetics), & chronic ear infections (ENT). No simple well child checkups here!
Nursing students are a big help in getting IVs in patients
In other news, we've really struggled lately in finding enough oxygen for the patients who need it. We brought 4 oxygen concentrators with us on the container (thankfully donated!), but they're all 110V, so they require either a transformer or one of our few 110V outlets here with a plug converter. Basically we can provide oxygen for up to 4 patients at a time - out of approximately 80 patients in the hospital. I often have 4 patients on pediatrics alone who qualify! And that doesn't leave any oxygen for the operating room or anywhere else. We lost a premie last week because he was taken off oxygen prematurely in the middle of the night. And when the power goes off (sometimes for several hours per day), no one gets supplemental oxygen. There are hard ethical questions sometimes on a daily basis deciding who gets the oxygen - I've dealt with these questions with limited ventilators in the ICU in Kenya, but never with something as simple and (relatively) harmless as oxygen by nasal cannula.
In the midst of these challenges, I have been so encouraged to see help on the way via some friends in Birmingham, AL. The Grants are friends from my church (Red Mountain Church) there and have two children who are NICU survivors. In honor of their sons, they are raising funds for our new NICU and pediatric wards here - to include oxygen! People have already given so generously and we've started renovating a room in the OB ward for a small NICU. It's now painted and we're just waiting for incubators to be constructed so we can start caring for our smallest patients in a warmer, cleaner, more controlled setting (the premies are currently in boxes on their mother's beds in the open ward when they're not doing kangaroo care - skin to skin - with the mothers). Please go to the Grants' blog here and read about their experience and our hopes for these new centers of care for Burundian children.
