We picked up Angellah and son, Tristen, Friday morning and journeyed to Salima District, the Senga Bay area, to visit with the Masekos. Peter Maseko (clinical officer at the district hospital) was on call all week end and we wanted to make rounds with him. We have visited the hospital many times before, but never been one on one with Peter as he evaluated the patients, gave orders, contemplated treatment plans, etc. It was quite the experience. We also had a chance to spend some time with others in the family - Emma, Alpha, Angellah and Tristen, and for a surprise, Wezzie came in from Ntchisi so we got to see her, too.
The district hospital again has no doctors - just clinical officers (who do a fine job!!). They also have some clinical officer interns, who also spend time on call, so that is a great help. Peter is in charge of all the OB - Gyn cases, and occasionally he is asked to be the clinical officer on a case outside of his ward. That tends to happen if it is a diabetic. They have no way of testing for blood glucose at the hospital. They manage diabetics using urine dip sticks. However, a couple of years ago we took a glucometer and test strips to Peter, and bring more every time we come (thanks to people who have made financial donations, helping to make this possible!), so Peter is the resident 'diabetic expert'. He had two diabetics that he was managing - one young girl that appeared to be in diabetic ketoacidosis (DKA) and a gentleman who was not as ill. Now, you medical folks out there realize that DKA should be treated in the ICU - well, no, she was on the ward (with 8 other patients), with a tiny IV, with the only way to monitor her blood glucose was when Peter came around to check it. The good news is that Peter called me last night and she survived! This time, anyway. The ward was actually 3 wards seperated by a 'half wall' so there were actually 24 beds there with one nurse. The patient's section of the ward had 4 fluorescent lights high up on the ceiling, only one of which was working (the one fartherest from the patient herself). Fortunately she was by the window, so Friday afternoon everyone was using the light from the window to try to start an IV. They were not successful. She did have a tiny (23 gauge) IV in her left hand.
In the OB Gyn section of the hospital we saw post- partum (after delivery) Moms with their babies (if the baby lived), and Moms whose babies did not live - all in side by side beds. We saw patients with complications of pregnancy (probable pre-eclampsia, but who knows for sure because the hospital was out of urine dip sticks that week-end, so no one could check for protein in the urine??), pregnant ladies with malaria, and one very sick pregnant young woman with probable pneumonia - again in beds along side new moms with tiny babies in their beds. You keep your baby in the bed with you unless the baby is sick. We got to discuss the cases and 'consult' with Peter - which consisted of - "this is what we would do in the US, what do you do here?" Interestingly, most of the care is the same, except they don't have the tools / supplies / equipment to carry it out. So although Peter knows how to best manage cases, he is simply not able to always do so because of the 'third world' medicine restraints. The sonogram was not working at the hospital, so he was palpating to see if a woman had twins (she did) and maybe how big they were (big), and since she had a C-section before, decided to take her for a repeat section once she went into labor. He had to use just clinical judgement to decide if woman had retained products after delivery of a dead baby....and take her to the OR. They can do hemoglobins, but no leukocyte counts, no electrolytes, no liver function tests, no cultures (except for TB), only glucose testing is by Peter himself... they can check for HIV, Hep B and malaria. We saw cases that needed so much more than he is able to do there, and yet he tries with all his might. It is a challenge beyond my comprehension and yet he carries on......
While we were in the hospital we saw a tiny sheet-covered body being taken out of the pediatric ward, followed by a group of women, all with children on their backs, except one, who was obviously grief stricken beyond consolation. And that was not the only sheet-covered body we saw that day. Not that all is bad.. we saw happy Moms with their new babies and we saw ladies getting better with their treatments.
Please pray for Peter as he works his heart out to treat / save Moms and babies.
Pictures: a 16 year old new Mom with her sweet baby girl, the sign outside Salima District hospital, Alpha and Tristen Maseko, and lastly Virginia, a nurse that we have met before, and me outside the OR (major theater) waiting for Peter.
Also, if you search my name on Youtube, you will find a couple of new videos - one of the kids (Tristen and Alpha) and one of Anne Maseko Alaniz's project outside of Salima "Pothawira"- the plan is for an orphanage, school, and clinic which will hopefully become a birthing center.
Thanks to all who follow us on this blog, for your prayers and your continued support. May God's blessings be upon you all!
No comments:
Post a Comment