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Our first day at Kamuzu Central Hospital

Monday, November 04, 2013

No additional staff joined the strike, but we're still down 4 out of 5 interns.  We have an 11-month-old girl newly diagnosed with diabetes, but we have no dex sticks to check sugars to know if we're giving the right amount of insulin.  We have a 12-year-old girl with Burkitt's lymphoma who will start chemotherapy tomorrow; a 2-year-old with chronic tuberculosis which is causing right-sided heart failure and breathing 84 times per minute; a 1-year-old who was violently shaken and has irreversible brain damage; an 8-year-old girl with rheumatic heart disease who's in heart failure and looked in so much discomfort; and 220 other children being seen by 6 pediatricians and 10 clinical officers.  

I work in the Emergency Zone, the inpatient unit where the sickest children are brought immediately after being triaged in the Emergency Department.  The afternoon became hectic when children started arriving from district hospitals who needed intensive care:  a 14-year-old girl with an abscess on her scalp that drained 1 cup of pus; 2 different children with cerebral malaria who were seizing and comatose; and a few garden-variety pneumonia patients.  The hospital is so crowded that each bed has 2-3 children, and a parent must always be present, because some units will occasionally have just 2 nurses for 120 patients, and the less critical units (malnutrition unit or nursery for "standard" meningitis or pneumonia) have no doctors covering at night.

The agility and dedication of these doctors and nurses was impressive.  I look forward to continuing to learn from them, and I'm excited that UNICEF has put me in touch the doctor who is coordinating trainings for the one-stop centers for child abuse.  But first I need food.  and sleep.  I'm exhausted.

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