Just realized I have never described the hospital to you. There are 2 hospitals in Gabs, one is a private hospital and ok from what I understand, and the other is Princess Marina. We work at Princess Marina which is the African equivalent to BenTaub. It is a series of one story buildings with walkways in between. (no air conditioning) The wards are divided by specialty and sex (males on one side, females on the other ward). The pediatric ward is a large rectangular room with 4 "pods" which are semi-divided areas that have 8 beds per pod. There are no dividing curtains between pods and absolutely no privacy. Usually the entire side of a pod listens in while we discuss things with the patient. There are beds and a small bed table, but nothing else. No IV poles or anything. All the charts are kept on a table in the front of the pod. The charts themselves are flimsy manila folders with papers inside. Very limited organization. Labs are not really recorded anywhere, just on backs of the paper if someone thought about it (almost always without a date). There is one treatment room where we draw blood and start IVs. A lot of the longer term chemo kids get smaller rooms in the back with only 4-6 kids per room. There are no ancillary staff (no phlebotomists, no respiratory therapists, nothing).
I found a lady today just outside the hospital that makes fresh french fries while you wait. mmmm. I also tried some fat cakes today which are basically doughnuts, but not as sweet and more dense. There are a ton of ladies who sell food around town for extra money for their families. Most are really good too. Lots of them also sell maize, which is basically a really large, not-so-sweet corn on the cob.
Random facts:
The phonebook for all of Botswana is smaller than the Temple/Belton phone book.
This is the rainy season...it has rained twice since we have been here.
Other things we can't get:
Oral cytoxan
PICCs
Portacaths for chemo kids
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could each of you describe a typical day. Your obsticles, who if anyone assists you, the nursing staff, the educational equivalent of the local Dr's, nurses etc. Cleanliness of hospital and clinic. What is difference for us non medical types between services of hospital and clinic. What is total staff of each. size of patient population. Range of illness you see. Mortality rates. Cure rates (is there such a thing. Hopes for the future of the hospital clinic. sources of revenue. Costs to patients if able to pay. Any little thing that will allow us to further appreciate (and brag about) what you two are accomplishing. Keep up the great work (and be safe) Dad in Ne
You need to spread you questions out. My fingers will hurt typing all of this. A day at the clinic is like any other day. We see patients, prescribe meds, admit to the hospital when needed etc... The big difference is that on any given day you may not be able to get some of the labs you need, medication supplies are limited so not only is the choice limited but sometimes you run out and have no options. At the hospital, we have conferences like home. The doctors round as a team and make a plan but very little is documented. Labs and meds here are also very limited and labs can only be done in the morning. For example the other day the blood bank only had one unit of blood available for the whole hospital for transfusion. The illness here are mostly the same as home just more advnaced and there isn't much you can do for the really sick ones. Things like ventilators are limited (there is only one in the NICU) so if you need one and there aren't any available you are out of luck. Mortality rates are high though I don't know exact numbers and it's frustrating because these are things we could fix at home. Staff sizes are adequate for the patient population but untrained. It is a socialist type of system and everyone assumes someone else will do it. Most of the doctors are inadequately trained, there is no medical school here so they transplant in. Residency spots are limited and you have to pay for your spot so most can't afford it and stop training after a general intern year. Nurses do very little for their patients, vitals only in the morning or when you ask. The parents do things like give meds, change sheets and feed patients. Care is free if you are from Botswana and at a public hospital. We personally are doing very little other than throwing in a hand where needed. There seems to be a culture of apathy here that would be very hard to change. I think I hit most of your questions.
Becca
Dad- Portia thinks you ask a lot of questions.
Portia, Becca probably did not tell you but I made my living asking questions. A habit that is hard to break. Besides how else can I get an understanding of what you two are going thru. Am I being placed on a restrictive diet of how many ?'s I can ask?
Becca's Dad (since I don't know your name), I donate my daily quotent of questions to you ;)
Thank you Micah, I am saving them up and will put to good use. The only dumb question is one that is not ask. I'm trying not to look dumb in the eyes of two brilliant doctors (chicks).
What is BenTaub, and what exactly did you expect when you went there? I had to laugh when you said you couldn't get a VCUG there. They are hard enough to get in any small town in the US without a well trained tech and a good Radiologist...
Obviously there are some cultural differences between Botswana and the US. What are some other differences you have seen (good and bad).
BenTaub is our community hospital in houston. "TaubNotch"
Anyway, it is a major culture shock when you come from a hospital where I can get anything I want, most often whenever I want. Intellectually you know about what to expect when you come here, but it is very suprising the gut reaction you still have when you are looking at a child who needs something, who you know could get it at home, and then doesn't here. A big problem is that Botswana states it has everything, says it is just as developed as South Africa....They say I should be able to get a head CT in the night for a head trauma, but can you? no. the radiologist doesn't want to etc etc etc
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