(This week, Ruth was challenged to write about some of her regular work at the hospital, to paint a picture of what it’s actually like on a day-to-day basis.)
Just like in Northern Ireland, the first port of call every day in the hospital is ward rounds. Rounds start at 8am; we go in, find an available translator, and make our way around the inpatient wards. Over the past month, I have tried to round with nurses who speak French rather than English- they are great at teaching me new vocabulary, and some Hausa words as well. The initial conversations will always be similar to those you would have outside of the medical setting – ‘Ina kwana? Ina yara?’ (How are you? How are your children?) Conversational protocol means that regardless of the truth, the answers will always be positive! After probing a bit further however, we can make an assessment and decide the next steps.
With a few extremely busy days in the past couple of weeks, there’s pressure on the space available. A lot of patients might find themselves on makeshift beds in the corridors, literally a mattress on the floor. We recently had an intake of new government-supported nursing students, which is very helpful. Getting to know them better and work alongside them has been really interesting, as has the opportunity to encourage them in their work.
A typical Monday morning in the PMI.
After rounds is over, I head over to the PMI beside the hospital. There’s a large waiting area, and adults will come early in the morning with their children to get into the queue to be seen. There’s three stages involved here: firstly, a screener sees everyone and triages patients. If there’s an emergency patient, they jump in priority (more on that in a minute!). Then, two nurses see patients and treat those who have straightforward issues – things like simple malaria, pneumonia, or malnutrition. We all work in the same small office, and they refer the more serious cases to me or my colleague Marc for further assessment, treatment and often admission.
The Hausa-speaking people are not a quiet group! It’s usually pretty noisy in the PMI and in our office, with people speaking over each other. Often I will be speaking, with my translator, to a patient whenever someone will just wander in the door. Because people are polite, they will always speak to them straight away, even if it is only to shoo them back to the waiting area! Sometimes, the screener might burst in with a severely ill child, and everything will be put on hold. Overall though, it’s a pretty effective system. In February, we saw an average of about 60 patients a day, so the turnover is pretty rapid!
I try to return to the ward during the day to monitor children who have been admitted and make sure treatments prescribed have been delivered. We often have to encourage urgency for particular cases, and explain which patients we believe should take priority due to the severity of their condition.
We’ve mentioned the CREN before on the blog, which provides support for malnourished children. We visit several times a week to check on progress, checking the growth charts of the children there. Malnourished children who are being intensively fed frequently show a significant improvement in a relatively short space of time, so if they aren’t improving we look for an underlying condition, such as HIV or tuberculosis. Visiting the CREN is always fun because the community of mothers there are eager to show off their children’s progress! There’s always a bit of a buzz and a relaxed atmosphere as families socialise and prepare meals alongside each other.
This little girl was admitted at four weeks old to the CREN, at a weight of only 2.5 kilos. Her mother was not making any milk. Over four weeks, she started to gain weight with feeding, and we were able to teach the mum how to make replacement milk (from goat's milk, sugar and peanut oil.) When discharged, she weighed over 4 kilos.
Over the past two weeks, I’ve also had the chance to shadow the Obstetrician here. I wanted to improve my OB practice ahead of working in Danja, so when time has permitted I visit her clinic. She has been very helpful, and it has allowed me to catch up, recalling knowledge learnt a long time ago at university, and getting some vital experience.
Working here at Galmi, flexibility is essential. You just have no idea what could be about to come in through the door. I’m constantly learning new things and having to read up on conditions and ask for advice. It’s difficult to resist the temptation to demand for things to be done like they would be at home, but the perspectives and priorities of this culture are so different from our own.
I’ve included some pictures in this blog of patients and their mums. We asked the parents if we could photograph the kids and they were delighted. It’s nice for us to have reminders of the children that we’ve met and have been able to help in some way, and whom God has healed. Otherwise, many of them may not have survived, so it’s very encouraging to us.
This little boy, only weeks old, was severely ill with pneumonia when admitted...
...after a week of antibiotics and care, we were delighted to be able to send him home!
The last picture below is of a malnourished little girl in the CREN, she’s two and a half years old but is so weak she cannot sit up. She is wearing one of many hats which we have received from ladies at home.The mums and babies thank you all for your hard work in knitting them – they are really appreciated.
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