week 2 in review

I know it seems a bit early for me to be writing my week 2 review, but we are leaving town tomorrow and we won't be back until Tuesday. Sammie, Katie, Tom, Shant, Kim and I are going to a safari in Zambia, Emily and her boyfriend are spending a romantic weekend together at lake Malawi, and Angela is staying here and spending time with Katherine (a girl from Michigan that is doing research here in Malawi). I am so excited to go to the safari!!

Week 2 was a good week. There is so much to write about! I still can't get over just how differently things are done in the hospital here compared to the US. I will use this blog entry to highlight some of the differences.

First of all, the sense of urgency that is sometimes felt in the American hospitals is not present here at all. The girls on the OB unit, said that the other day there was a lady in labor and while she was pushing the doctors could not pick up fetal heart tones, (and they don't use fetal scalp electrodes or IUPCs) no body seemed concerned. The c-section room was occupied and so they just told the woman to keep pushing. In the US there certainly would have been a lot more concern and fast moving to get that baby out!
Today when I was in the ward I spent some time with two 3rd year medical students. They have a lot more autonomy compared to students in the US. Most of the time the registrars or consultants round on the wards twice a week. For the rest of the week the students & interns round on the patients that they are assigned to and unless it is a real emergency (I'm not sure what would constitute a real emergency, since a blood pressure of 80/40 did not worry the students) they will not talk to their supervisor until the Tuesday or Friday when we do group rounds. Today one of the patients, who is HIV positive and has a very low CD4 count, was shaking and sweating, and probably septic, and the student decided that he should take some blood so that he could make sure that he would know by tomorrow if this patient has an infection! So different from how that situation would be handled in the US!
On Monday I spent the morning in the HIV clinic. The clinic was jam packed! I mean wall to wall filled with people! The registrar was telling me that some people will be carried into the HIV clinic by family members and by the time that they arrive in the clinic they are nearly dead. While waiting their turn in the waiting room they will die. Unbelievable. Patients are also found dead waiting in the "Emergency room" waiting room.

Hand washing between patients or even throughout the day really is not done. And supposedly hospital acquired infections are rare.
There are 4 ICU beds in the public hospital for all of Southern Malawi
The CT scanner is broken this week. There are 4 x-ray machines, but they don't all always work...

Oh, there is so much more to tell, but I have to get ready for dinner. We met a lady here names Fatima that spent 7 years living in Colorado. She is taking us out to dinner tonight.

Love you all!

Niamh