Monday and Tuesday

Today was our first day at Bugando Medical Center.
Cheryl went to the Oncology ward. She observed some clinic patients being treated by a Dr. from Duke University. She was introduced to the Head nurse Sister Mary. The oncology unit only had 1 patient in it today and that pt was being discharged. She followed Dr. Kristin the pediatric oncologist from Duke to follow up on 3 consultations, toured the  laboratory and  assisted with a needle biopsy of a 2 year old with multiple facial tumors. She then spoke with Sister Mary about the different types of cancers they have treated the last year as she was preparing a yearly report. To prepare this report she scans a log book that each patient is entered in with their birthdate, address, and diagnosis then she made tally lists. All of this is done by hand, no computers noted on this unit. She had lunch with 2 pediatricians from Baylor who are here serving in the HIV unit across from the hospital. 

I (Sarah) had my first experience in an ICU at an African hospital.  I was nervous that my knowledge and experiences would be so different that I would be of no use in this unit; however, there was no need to be nervous.  I walked into the unit and saw a patient on the ventilator (one of the same kinds that we have where I work) and felt right at home.  After receiving report from the previous shift, I went to work with the nurses, nursing students, and nurse assistants.  I had the opportunity to teach a nurse intern how to complete and document a basic head-to-toe assessment on the ventilated patient.  After spending about 45 minutes assessing the patient and teaching the nurse intern, I turned around to see that several other students and nurses had stopped their work and were trying to listen to my teaching.  The next thing I knew, I was asked to teach several others how to complete basic assessments.  After we finished assessing the last patient, a new admission came into the unit.  I knew immediately that this patient was critically ill and needed to be placed on a mechanical ventilator ASAP.  I assisted the doctor in intubating the patient–quite a different experience than what I am accustom to–but it was good to see how they do things.  After we intubated the patient, we had to move her bed to a different spot in the unit where there was a ventilator.  This ventilator was like none that I have ever seen before, but it worked perfectly.  I have learned that the African medical providers are amazing at being innovative.  Many times they do not have the exact supplies that we would use at my hospital; however, they would find other supplies and make them work…they do this without any complaint.  There is much that we could learn from them!  While they are very creative people, there is still a great need of basic supplies.  For example, our newly admitted patient was unable to be placed on the heart monitor because we did not have anymore electrode patches to use–such a reminder of the challenges they must face every shift.  Overall I was very impressed with the staff and the compassionate care that they provided to their patients.  They were very gracious and welcoming to me.  It was quite fun to learn about how they care for their patients and they taught me a TON about being creative and not complaining! In addition, they were excited to learn anything that I had to share with them about ICU nursing.  There is a great opportunity to do some teaching about priorities in caring for ICU patients and I am looking forward to working with the staff again tomorrow.  

Mark & Gayle:  On Monday we had the honor of touring Dr. Isidors small private hospital that is owned by 5 physicians.  We did rounds on the wards and did a couple surgeries.  Mark and I decided that if we are sick that is the hospital we are going to.  I was a long day but a great day!  Then today Mark and I went to the grand round orthopedic report and then went onto the wards.  You cannot believe that horrible trauma patients we saw and some choose not to have surgery because they don't have the money.  The people here use a lot of traditional healers.  When an orthopedic patient goes to them, they make deep cuts and put medication in the lacerations.  They couldn't answer what type of med they used.  Then when they finally come to the hospital the have horrible infections and gangrene and sometimes need amputations.  We then went to see patient all day in orthopedic clinic.  They just kept coming…No oral intake or output throughout the day but God is working through us.  We have lined up surgical cases for tomorrow.  Dr. Isidor is a very skilled orthopedic surgeon and is eager to learn.  They are excited that we are bringing a neurosurgeon in May.  That will make big changes and offer people some hope.  

We have had very good Chinese food and went for a lovely walk this evening.  Please pray for us as we continue to serve these awesome people.  Sending a lot of love and hugs to my friends and family.