The next installment

Well I’ve rather neglected the blog for a couple of weeks what with all the washing, mopping, ironing I’ve had to do! Hum poor excuse- I’ve actually been busy having CPD sessions with Marianna- ie watching Grey’s Anatomy and shouting annoyed at the screen about how unreal the medical conditions are! Ever heard of a hemi-spherectomy for a 5 year old with a twitchy leg?

Anyway I have now settled back on female ward where I’m battling through the daily 45 patients, to only 24 beds, but they keep coming in as fast as I try and discharge them! The ward really is too tiny to manage with the number of admissions and it’s quite uncomfortable trying to see patients when there are 3 sharing a bed in which the mattress has completely given way in the middle of it so that they all sink towards the centre. It’s smelly and stuffy with little ventilation- apart from the smashed window with shards of glass exposed next to a patients’ bed that no one had bothered to fix, despite me asking daily. In the end I frog marched the maintenance man to remove the broken glass which he had to do with bare hands in the end as he claimed there were no gloves. This brings me onto the frustrations of today with the complete lack of resources. I have a patient who I came across on the ward round- of course no one had highlighted that this patient might be sick and need more urgent attention- they were having fits every 2 minutes, and had been like this over the whole weekend but no one was called to se them because apparently they are known epileptic so it was ok. Nevermind that they had a fever and headache. Anyway I attempt a resuscitation- oxygen? the machine’s not working, diazepam? there isn’t any, phenytoin? no, phenobarbitone? none either. So I tried Mag Sulphate- no effect. The patient is still fitting every couple of minutes so I decided to send her to the central hospital just to get diazepam. Is there a vehicle to send her there? No. (I’m tearing my hair out by now). Eventually after a lot of feet stamping I managed to get an ambulance to take her to the central hospital - only 4 hours after the initial decision! Very frustrating.

Other things in which we are lacking- no gloves- which means- no blood taking, no blood testing in the lab, no internal examinations, no results no diagnoses- stuck. And also we have no normal saline and no dextrose- not great when you need it to give quinine intravenously for malaria, especially not great when there is no oral quinine so you have to give IV. Not entirely sure how we can run as a hospital. Apparently there is a car going in a few days to get some drugs. But I’m learning lots on female ward- I’ve always shied away from gynae things coz I’m not a great fan of it but I’m forced to learn it here as there are so many miscarriages that need manual evacuations. And I’m still seeing fascinating pathology- an elderly lady came in this evening with a black leg for 2 weeks!! Like properly black from lack of blood- pretty nasty.

Unfortunately for us but good for him we have lost a clinician to the College of Medicine to study medicine which means we are even less and there is no one to cover the OPD which is the busiest department. I worked in OPD last week which runs like an A and E at home. I quite enjoyed it except for the fact that once the patients knew there was a Mzungu there they all wanted to see me! And again there were frustrations as there is no equipment to examine/investigate/ treat people – this is what I applied the funding for. VSO had actually offered me the money which was great news but now there are issues with the VSO budget so I am not sure whether I will be receiving it. Boo.

I’ve had an excellent couple of weekends too going to Nyika national park which is absolutely gorgeous and strangely looks like the rolling hills of the Yorkshire dales! Reminded me of the trek we did across England earlier this year. There were even some blackberries growing amongst the ferns. We camped in the park and it was freezing!! A real shock to the system and I spared a thought (and a chuckle) for all you poor soles in the UK snow! And I also went to Vwaza again this weekend and saw loads of hippos yawning! Yey! But I also managed to get eaten alive by tsetse flies and now my toe has become all blistered and horrible.

And I’ve been enjoying more nightlife in Rumphi. We saw 2 famous African bands in the local watering hole and as if its’ not hot enough we danced around in a sweaty mosh pit to bum wiggling (which I’m not good at) African music.

My domestication is going well!  Well sort of. I made a potato salad and added a mixture to it that was made of oil, water, vinegar and eggs to create a curdled sauce wondering what the hell is was supposed to be and thinking that I what I really needed was some mayonnaise. Marianna later informed me that in fact that was how you made mayonnaise! Just not quite right- hum try again. I’ve also tried curry- realised that you had to simmer is for ages, got bored and ate it anyway so it didn’t have much flavour and am becoming rather good at French toast. But my garden is coming on well! I’ve planted lots of exciting things in my nursery- tomatoes, cucumbers, rocket, lettuce, green beans, beetroot, peppers and soon they will be ready to transplant into the garden! Can’t wait to have more veg to eat.

The rains have come too – I can barely hear myself think when it’s coming down over the corrugated iron roof. But thankfully at last the air has cooled down and with it brought a lot of bugs which swarmed into my house last night and I looked like I was trying to o some tribal dance attempting to kill them all. I gave up in the end.

Anywho I hope that all is well at home and you’re tucked up in your beds away from the cold.

Until next time…..