We now have 2 kittens at the base, Simba and Alfie. We kept spying a rat popping its head out of our toilet, which was quite disturbing, so action has been taken! We have been told that we should stop feeding them now, and ‘let the battle begin!’
The NRD training weekend went really well. It’s a relatively new organization, who co-ordinate local volunteers going into schools across Kambia District, providing sex education, and other health promotion topics that are not covered in the school curriculum. It’s run by a very enthusiastic man, Lamin, who is very good at persuading people to help him! The weekend had an opening ceremony, which lasted over an hour (!!), a chairperson, interestingly started with Muslim followed by Christian prayers, followed by speeches by the district council and other local development groups (many of them funded by DfID and UNICEF) who were all very supportive of what the NRD is doing. It was really interesting to get a better picture of what is going on in the district, lots of good work.
25 volunteers came for the course, and we talked about learning theory, learning styles, giving presentations and running training events. (We had to learn it all first!) On the second day the participants all gave presentations to the rest of the class, so interesting… (We did have to clarify that AIDS could not be cured...) Everyone was extremely grateful, and I hope found it useful - I learnt a lot!
We had a visitor on the base the following week, Dominic, a public health registrar who was over to see if it would be feasible to try and design a project to improve the recording of health statistics in Kambia. I think one of the limitations of a previous report (trying to measure changes in health outcomes) was that the data appeared unreliable, e.g. Vaccination rates close to or over 100%... I went out to one of the peripheral health units (PHU’s) with him to look at the recording systems in place – all the data is handwritten into big books, and different statistics manually counted up at certain intervals. It’s easy to see how mistakes are made –the vaccine man re-counted the number of vaccinations given during one clinic, and found the recorded number was 32, when actually 40 vaccinations were given – and the health board will only pay for the number recorded as given, so they run out of money or vaccines… Running out of medications is also really common in the hospital, possibly for similar reasons, so it’ll be good to see what comes of Dominic’s visit.
The Kambia Appeal have donated 5 motorbike ambulances to the PHU’s, and they were handed over to the District Helath Management Team (DHMT) this week (including ceremony and many speeches). They’re motorbikes with a stretcher side cabin, especially useful for pregnant women who can’t get on the back of a bike. They’re kitted out with emergency supplies, a hangar for a drip, and are providing emergency transport to the remote and rural communities. If they are successful I am told the appeal have pledged to provide ambulances to each of the 65 PHUs in the district.
I’m getting settled into the paeds ward. We had quite a few cases of watery diarrhoea (and constant crying) this week…so many infection control issues when there isn’t even a tap on the ward, and the toilet is a trench outside… I was quite worried earlier in the week… we sent off some cholera swabs to Freetown, but thankfully the children are now better and the ward has calmed down a bit.
We had a surprise visit on yesterday from 9 month old twins who had arrived on the ward about the same time as me, and were discharged last week – the classic big fat twin and little tiny skinny twin about half the size. The skinny twin was extremely malnourished, had pneumonia and malaria, and had a horrible rash that looked like it was eating right through the skin leaving deep cavities in his neck and chest, and had looked so sick for so long, I didn’t think any of us thought he would survive, but he gradually picked up on the feeding programme and a lot of antibiotics, and is now doing really well! The fat twin just had malaria, and a random (?febrile) convulsion half way through his stay… It was so nice to see them both looking so well, and their mum so happy.
It’s amazing seeing kids who look so sick get better, but sadly not all of them do. We had a sad case this week of an 8month old baby who had been unwell with a high fever and not passing stool for a few days. They had initially been given native herbs (we have seen quite a lot of complications from native herbs). They were really sick when they came to hospital with severe respiratory distress and a very distended abdomen. We did everything we could but the baby died. It’s frustrating because we’ll never actually know what the baby died of, or if we could have done anything differently. But we can try and that’s really appreciated. If we weren’t around the nurses would have been treating that baby alone, with some support from the Medical Superintendent if he was around (he did actually come and review the baby too, but is often not around, or is operating in theatre, or very busy in outpatients). The staff here have to deal with seeing children die all the time here, not really knowing if they could be doing anything differently, and they don’t have the luxury of being able to go home and read up about conditions/management; they often ask us for books.
I think that’s why teaching the nurses is actually so rewarding. I don’t really feel I’m qualified enough to be teaching fully trained nurses with years of experience, but they all keep coming to our sessions, and are keen to learn. And we have lots of resources to look through and try and prepare interesting sessions, and a tiny understanding of what it’s like for them on the wards here. And from a selfish point of view it’s forcing us to read around topics and really properly understand them in order to teach them – so hopefully win win.
We had a surprise visit on yesterday from 9 month old twins who had arrived on the ward about the same time as me, and were discharged last week – the classic big fat twin and little tiny skinny twin about half the size. The skinny twin was extremely malnourished, had pneumonia and malaria, and had a horrible rash that looked like it was eating right through the skin leaving deep cavities in his neck and chest, and had looked so sick for so long, I didn’t think any of us thought he would survive, but he gradually picked up on the feeding programme and a lot of antibiotics, and is now doing really well! The fat twin just had malaria, and a random (?febrile) convulsion half way through his stay… It was so nice to see them both looking so well, and their mum so happy.
It’s amazing seeing kids who look so sick get better, but sadly not all of them do. We had a sad case this week of an 8month old baby who had been unwell with a high fever and not passing stool for a few days. They had initially been given native herbs (we have seen quite a lot of complications from native herbs). They were really sick when they came to hospital with severe respiratory distress and a very distended abdomen. We did everything we could but the baby died. It’s frustrating because we’ll never actually know what the baby died of, or if we could have done anything differently. But we can try and that’s really appreciated. If we weren’t around the nurses would have been treating that baby alone, with some support from the Medical Superintendent if he was around (he did actually come and review the baby too, but is often not around, or is operating in theatre, or very busy in outpatients). The staff here have to deal with seeing children die all the time here, not really knowing if they could be doing anything differently, and they don’t have the luxury of being able to go home and read up about conditions/management; they often ask us for books.
I think that’s why teaching the nurses is actually so rewarding. I don’t really feel I’m qualified enough to be teaching fully trained nurses with years of experience, but they all keep coming to our sessions, and are keen to learn. And we have lots of resources to look through and try and prepare interesting sessions, and a tiny understanding of what it’s like for them on the wards here. And from a selfish point of view it’s forcing us to read around topics and really properly understand them in order to teach them – so hopefully win win.
And we have plenty of time to relax… Sunset by the river near our base… we’ve also just discovered a lovely new swimming spot in the river (it’s ok, we’ve not heard of any crocodiles…just schisto)
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