3rd World Healthcare...

Today after a long day of home visits I was coming home to do some things when I got a phone call from Evas, the Ugandan nurse I work with in Words of Hope. She told me that one of our patient's family members had called us to tell her that our patient was very sick and vomiting with high fever. We had just seen the patient the day before and Evas was afraid it might be cerebral meningitis. So I knew I needed to help transport this patient to the hospital or else she may not get there since transport is expensive and she was too weak to walk. 

When we got her there we found many people waiting at the Medical Ward to be seen by the admitting doctor. It's hard to explain how they do things here in the hospital. A new patient doesn't come through the ER or admitting like they would in America. Based on their symptoms they go to the ward they think they would be admitted on and wait to see the admitting doctor who then assesses the patient and decides whether they will be admitted or not (that is if it is after 5pm, before 5 they go through the outpatient department). There is no nurse 'triaging' on the medical ward... there is just a bench where patients sit or a floor where the ones who are really sick lie down in a dark corridor and wait to be seen. I asked why it was so dark and I was told that the light bulbs were 'finished'! Can't just call 'maintenance' to come and fix it and who knows when it will ever get fixed.

By the looks of the line today I knew we were going to be waiting a while. Even though I am on the wards frequently I stood and watched this 'system of healthcare' shaking my head. A 14 yr old girl came in who was lethargic...she couldn't even hold her head up without her mother's help (every patient here has to have an 'attendant' when they come to the hospital who bathes the patient, cooks for them, helps them to the bathroom etc. because there are sometimes 2 nurses for as many as 60 patients...how's that for patient load!) We found out that this girl had overdosed on phenobarbital! I asked Evas, "doesn't this patient need to go to the Emergency ward?" She said 'no poisonings come here to medical'. I watched as this girl vomited outside in the gutter...I tried to stay near her because I was scared she might stop breathing. I tried to talk to the other health care workers and get her to be seen, but one of the intern doctors examined her and said, "ah what do we do? It will eventually wear off!" Uh, yeah I guess it will if she doesn't die first! I asked if they would do gastric lavage and they said maybe. The intern left and I found a wheelchair for her to sit in and to wait in the line again. 

The sad thing is because the patient Evas and I brought in 'had connections' (Evas is a nurse on the ward, people know me with the AIDs clinic plus I'm white) we found a doctor to come and see her quicker while this poor girl who had overdosed had to wait. No one asked why this 14 year old had taken too many pills and I'm sure there won't be any kind of 'psych consult'. Even after our patient had been seen and admitted and an IV of quinine was started (diagnosis probable malaria) this poor lethargic girl was still waiting. Who knows what will happen to her. A day at the hospital here definitely makes me appreciative for our healthcare back home. We are so blessed! Just thought I would give you a glimpse into what 3rd-world healthcare is like and this is just one of many stories!