First week in Mzuzu
on Rachael's VSO experience (Malawi), 19/Feb/2011 10:49, 34 days ago
In typical Rachael style I forgot my USB stick where I had specifically saved my blog and some photos so will just do a quick blog now and then updae it properly next week.Ok so The week started weirdly as we were told Sunday morning there was no petrol in Mzuzu so the hospital couldn't come and get us, so we went straight to the VSO guest house and figured we'd be there for a while.. So at lunch time one i'd just hung my clothes out to dry we get a phone call saying the driver is on his way to get us. After a lot of messing around we eventually leave around 1600. It gets dark around 1800 and being driven in a huge van on Malawi's roads at night is not a brilliant experience and nt one I want to do again!! so we made it and the hospital said that Czar and I would shar the flat on the hospital grounds for the night as it was about 2300 by the time we arrived. The flat was disgusting and the bed sheets were filthy so I climbed into my sleeping bag and went to sleep. Monday morning we decided we ought to go and see the hospital director and let her know we'd arrived, she asked if we could start work on Wednesday so we spent monday and tuesday running around Mzuzu trying to buy cleaning products and enough food for the week and were also shown around the hospital.So Wednesday morning I arrive at work at 7.20 to start at 7.30, between 7.30-8.30 the rest of the nurses arrive. There is a very long process where the nurses get handover on some of the 'sick' patients (although not all the HDU patients which scares me!) then we all go into the staff room and have a MDT handover but again only the sick patients. The nurses then seem to just hang around the nurses station for a while ordering drugs and not doing a whole lot of work! The doctors do the ward round with a nurse and discharge patients or make a plan. I was working in HDU and we cleaned HDU, this involved me chasing a rat off a patient which was interesting!!There are about 60 beds on the ward although it's only designed for 32, there were 108 patients on my first day lots of children are on matresses on the floor. In HDU we didn't do much work we hadn't done any obs or anything!! Then the nurse went for lunch at 12 and he never came back... Malawi attitude for you!! So in the afternoon I worked with the ward manager and we admitted two patients to HDU both with malaria, one with an Hb of 1.6 the other 1.8 and both had BMs below 2!! We attempted to give one a 20ml/kg fluid bolus but there are no infusion pumps so the volume is just estimate. Basically you run the litre bag as fast as you can and once about the right amount has gone through you slow it down!! The child still didn't really have a peripheral pulse but noone else seemed bothered so we had to move on to the other child, both have since done really well and should have gone home today!! Blood is a problem in Malawi on Friday the hospital had no O- or O+ blood!!There are normally 5 nurses on a shift and they love to do no work and talk a lot which makes it difficult for me as I want to understand what they do so I can help make sme small improvements. The ward is filthy and smells horrid, they don't isolate patients with D&V they only have two side rooms one is reserved for nurses and their relatives children!! The other they tend to isolate children with meningitis or measles, I did have to point out that putting both meningitis and measles in one room was not a good idea!!! I am spending two weeks on the paeds ward one week in HDU and one on the general ward then a week in the neonatal nursey and one week in A&E/OPD. HDU is comprised of 7 beds although normally 11 patients, these children can have oxygen although there are only 2 oxygen concentrators so 6 children can have oxygen 3 on each side but you can't change the oncentrator for each child so they all have to have the same, normally 2 litres as the only have nasal prongs! Malnourishment is a huge problem yesterday I looked after a boy who weighed 14kgs at 8! you wonder how their little bodies cope and at times I do feel like I've stepped into an Oxfam advert!! At the moment the nurses aren't very receptive to me but I've only done two full days so I guess that is to be expected!In general I'm enjoying life here, work is going to be hard and at the moment I am still getting the flat cleaned up so it is liveable but once thats done it'll be grand. Went to the Mzoozoozoo with some of the nothern volunteers which is a back packers hostel really nice to be around other Brits and not be the odd one out. Often it takes me a long time to walk around Mzuzu as people want to know who you are and why you are here so I get stopped all the time by people! Most people are friendly you do get occasions where people are all staring or start laughing when you walk by but people aren't used to seeing white people and have quite a bad impression that we think we are so much better than them. Well I've spent a long time in the internet cafe and it's probably costing me a fortune so I'm off to buy some food for the week.I'll update more soon, hopefully with pictures if I remember my USB