Wednesday 19 March 2014

Little by Little



Sometimes when you get caught up in the day to day business of consultations and complicated deliveries and operating it’s hard to see all the changes that are happening around the hospital .

A few weeks ago I was showing a visitor around and I realised that instead of saying we hope to do this and that, I was able to say this is being done or even that has been done.

So what are these ‘small’ changes. Some you might not notice like having the documents available all the time to keep the notes up to date and keep the out patients running smoothly. Having a steady stock of drugs in the wards, maternity, operating block and emergency room even with a degree of control when the nurses remember to fill in the forms .Getting the paint touched up when it’s peeling and other small repairs. You wouldn’t notice too unless you had been before that there’s no longer chaos at the cash desk as the patient form an orderly queue on the benches after they are let in the gate.

Other things are more obvious like having curtains on the ward to give patients much needed privacy. A new desk instead of a plastic table in the maternity. Having solar lights in the single rooms as well as the wards and also plumbing that works. Painting of the wall between outpatients and inpatients looks good and we soon we will be adding pictures for health education and evangelism. We have boxes next to the beds too with bibles in Arabic and French and a place for the notes.

 
Our recent bigger change has been offering vaccinations. Finally the solar fridge is working the vaccines have come and we have mastered the paper work. It’s great to see the new born babies and pregnant women vaccinated and the children coming as now it’s not too far away. So far we’ve seen over 100 women and the same number of babies in just over a month.

Most of these changes have happened as we have become a bigger team with a pharmacist and administrator and two nurses. It’s great that we can all work together to improve things. Malc and Sue are having a well earned rest and home assignment in the UK at present and Claire will leave next week so I hope we can keep things up now with our reduced team.

We continue as well to improve the medical care we offer in other ways and little by little the midwives and nurses take on more responsibility. One doing her first D and C for a miscarriage last week and our anaesthetist now confidently doing spinal anaesthesia. A few weeks ago we managed to save the life of a patient by giving her a blood transfusion in record time and then later attaching her to both oxygen concentrators to get enough oxygen into her blood after her lungs filled with fluid when her kidneys stopped working. She went home well 10 days later.

 It’s a good job God is with us turning our little by little into something bigger for him.

Saturday 15 March 2014

Man is but a drop of dirty water

So began out first ever physiology lecture at medical school and Marks recent teaching o
n fluid balance and dehydration. Thursday mornings at 8 o’clock is teaching time so far we have had courses on diabetes and malnutrition Malaria Hypertension and diarrhoea all things we see a lot of. This time it was back to basics and calculations on the blackboard borrowed from one of our staff who is having French lessons to help him be a more effective administrative aid.

Water has been in our thoughts these last few weeks as the dry and hot season is upon us. The water bottle taken to the hospital is now coming back empty and often more is needed We took a lot, about 80 litres with us on our recent holiday as we travelled   850 km to Zakouma Chads safari park.

On the road we passed many camels and lots of cattle and sheep and goats. What was most impressive though were the collections of animals and people around the water holes and wells outside the villages .Most of the countryside is dry and parched and it’s hard to see where they get enough for the animals to eat but the water sources are all too clear.

The dry season means it’s the best time to go to the park as the animals are looking for water and we had a great time seeing all sorts of animals including 100’s of giraffes on our early morning safaris and huge collections of cranes pelicans and Maribou storks gathering at the waters edge in the evening. At night we passed a leopard in the bush and several hyenas out hunting.

Our trip back passed through Bitkine where the water for the town comes from the Ouadi dry at this time of year but filling intermittently in the wet season. Time to consider how much water you use when it’s all brought up the hill by a heavily laden donkey.

Time too to consider where does our real source of life giving water come from as we sat on the hill overlooking the town and watched the sun go down.
We may be a drop of dirty water in physiological terms but we are also fearfully and wonderfully made.