Today I got up at the normal time and had Sierra Leonean oatmeal for breakfast, which looks a lot different from our oatmeal but is very good. We all went to Morning Handover, normally only Tanis, Elizabeth and I go, but today Nicole and Charlotte wanted to say goodbye because it was their last day working on the compound. Charlotte left before the end, but Nicole gave a presentation on the stages of development in children. Marcel, the business manager, also came in and announced that he had been informed of some dishonest behavior on the part of the staff occurring, especially in the children’s ward. Staff has apparently been telling patients that they must pay for certain things, and that they must pay the nurse immediately, which is untrue. All payment is handled through the secretary, who writes receipts for everything. He also started talking about the ‘crisis in the children’s ward,’ and everyone started looking around like “What? What crisis?” He is upset because about ten of the thirty-eight beds in the children’s ward have two patients in them, which sounds bad but that’s how it is this time of year. All the kids are getting malaria because it’s the rainy season, and they don’t want to turn anyone away, so that ask mothers if they would be okay doubling up and as long as they’re okay with it they get as many children as they can admitted. Marcel was appalled by this, but then again he just started there about three months ago and he formally was working as a teacher in the States. He kept talking about pulling staff from other wards, especially the operating theatre, to pull extra shifts without pay in a wing another building that’s not being used right now, because he wants to move children down there. The problem is, no one wants to work extra shifts, and people are already begging for raises, so no one wants to take shifts without pay. The hospital is also already understaffed, so you’d be taking a one of the nurses away from the regular children’s ward, when we already have children who are pulling out IVs because the nurses need to help other patients and the parents can’t be bothered to watch their children. Another problem is that there aren’t any beds down there, which Marcel has completely overlooked, and he keeps saying that we are going to put the ‘less sick’ children in that wing, but the less sick children are the children who need a blood transfusion and had a temperate of 40 ºC (104 ºF) last night, but are less feverish today. There aren’t any ‘less sick’ children.
After such an eventful morning, I went on rounds with Dr. ABD. Today he wanted to see if the new CHO (sort of like a RA) named Alpha (the one who purposed to me) could do rounds on his own, and they spoke mostly in Creole, which can be hard to follow sometimes, so I felt a little left out. After we finished rounds, I went to the lab where they do blood work to ask if I could see some other their old records. They gave me the book of all the blood work they did in 2010, which has the name, age, sex, and the test results all organized in it. I think it will help a lot in determining if there is something to be found out about HIV versus Hepatitis in terms of which is more prominent and which one causes more deaths in Sierra Leone.
I went back to the house with my book, and worked on my little project for a bit, when Nicole came and told me that after doing such an awesome job with Excel the other day when I worked with Mr. Swaray, that my services where being requested by Amelia for computer help. Amelia just wanted the same for that I made for Mr. Swaray, and a lesson on how to use it, which would have been really easy if Mr. Swaray’s computer was working. I told her that as soon as it’s working I will get if from his computer, load it on hers, and show her how to use it.
At about 13h45, I noticed that the lights were still on, which meant surgery! I hurried over and got to watch Dr. ABD open up a man he’d already operated on, as infection had set in and he wanted to know the source and to clean it out. The source in the first man turned out to be the testis. [It’s incredible that an infection in the testis can cause the whole abdomen to full completely with pus.] The second surgery was much the same, but the infection was worse and located in the gull bladder if I remember correctly. After about 45 minutes of trying to clean out this mans abdomen and remove all the infection, Dr. ABD finally decided that he was have to just start regular cleanings for a couple days in order to get out all the infection and to make sure it didn’t get more infected.
After Dr. ABD was finished and the OR cleaned, Dr. Erdi came in and I got to watch the delivery of twins! Two baby girls, both healthy, where delivered by C-section. It all happened very quickly, much quicker than most of the surgeries I’ve seen, and I actually caught most of it on tap. After that, I went back to the house and did some more work on my project until dinner. Jack, the cook who has been here for most of the time that Nicole and Charlotte have been here, was just a replacement cook for David, who came back today. I’d heard good things about him from Mallory, but he hasn’t made a very good impression with us so far. He yelled at our little kitten that we’ve adopted, and in general has a very unhappy disposition. He also prepared fewer dishes than Jack normally does, which means if you don’t like fish you had fries for dinner tonight. He also cut up the fruit for dinner at noon-ish, and left it sitting out uncovered all day. When dinner rolled around and he brought it to the table, fruit flies where into it like crazy. I hope things improve, or I will be losing weight even faster than I am now. I have already lost a kilogram at least (about 2 & ¼ pounds) between eating less for breakfast and lunch and the fact that we’re active and sweating out all our extra calories all day long.
After dinner, a friend of Dr. Erdi named Steve came over. Steve is English, and has lived in Sierra Leone for a couple years now. He’s a very funny guy, and very fond of beer. When we were talking on the porch tonight, I put on long sleeves and long pants because it was a little chilly and because of the bugs, and everyone thought I was crazy, so I must be getting used to the heat. Tomorrow we are getting up early to go to the beach in Freetown, so it’s off to bed for me.
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