Wednesday, March 4, 2009

Volunteers Get Creative In Providing Care

I don’t think I have ever associated creativity with medicine (even though I guess you do have to be pretty creative to come up with some of the methods we use to treat people and the treatment) but yesterday I got to witness the creativity our ER nurse Donna and our physical therapist, Beth.

Today was the first day I was able to visit the ER—they call it casualty here—at the ENRH. It took me a couple of minutes to find it because like most of the wards it is separate from the main building and I had never been there. While the ER is not the worst I have seen, it is pretty bad. The unit is small, and has a smell, from the waiting area through the door leading to a small foyer that leads to two consult rooms and the main emergency room. Once in the main emergency area if you go right you can reach the pediatric section—not much of one but it does have two cribs—and then the female patient area. If you go left, once in the main emergency room, you go the suture room. The suture room is not very tidy; sharps (needles and razors) are not disposed of properly. Patients are left without treatment until their relatives pay and there is very little patient care besides getting them an IV. When I visited there were no sheets on the beds, and currently they are transporting patients to other units—up the hill—like the operating room, by taxi because the ambulance has broken down.

When I came down Donna gave me a tour and told me they had run out of drainage bags. They had put a catheter in a man but had no bags which meant the man would be left exposed to infections, seeing this Donna found an empty, small, clear plastic bag and attached it to the catheter. She used what limited resources she had available to keep this man from being at risk for an infection. When she did this a local nurse said to her “welcome to Africa.”

I followed my trip to the ER with a trip to visit Beth in physical therapy. While I was there a woman, who suffered a stroke 6 years ago, came in and wanted help with her walk. Beth worked with her but also noticed she had not regained full use of her hand and asked her if she writes. The patient responded by saying that she was learning. To make it easier for her to grip a writing utensil Beth showed her how to wrap a piece of cloth around a pen and pencil so that it is wider and easier to grip.

I’ve been writing a lot of stuff lately for this blog but I am not sure I have touched on how hard this can be for our volunteers. The Project HOPE volunteers know they are going to see some things that will be hard for them to be around but it isn’t in-your-face real until you see it. Experiencing a loss of a child who could have been saved had they been brought in a couple of hours earlier, wondering when the local docs will tell a new mom that her child hasn’t been brought to her because it was actually still born, or if a patient’s family has abandoned them or will come back with money to cover the cost of his treatment can be a really hard pill to swallow when you know you can help these people if only you had more time or the right equipment. Many days I have run into one of our volunteers and seen the same look on their faces and when I ask if they are ok they tell me a patient has passed away. It’s not that the local people don’t care it’s that the resources are lacking and the training isn’t there which is why Project HOPE sends in volunteers not only to work with patients but also to mentor the local providers and try to teach them new strategies.

Since we have been here there has been mention of so many simple, everyday things they need that we take for granted. For instance Donna says the ER has run out of surgical gloves—can you imagine this happening in the states—or even tennis balls for walkers. Many of the walkers people use here don’t have wheels on them, putting tennis balls on them would make them glide. Also sheets, once the sheets in the ER are all dirty they don’t have any others to replace them with while they are cleaned.

These are items you and I might just run to the store for but in other places around the world they may be hard to find, too expensive to purchase or not a priority.


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