May 18th

I was able to hunt down one of the doctors this morning and I followed him on his rounds through the women’s ward. This doctor conducted his assessment s of each patient with even less actual assessment of the patient. He did not have a stethoscope and discharged an asthmatic patient without assessing her lungs. He also diagnosed a patient with pneumonia purely on the fact that she had a cough, a fever, and she sounded a “bit rattley.” A patient with presumed meningitis secondary to malaria he deemed as having increased intracranial pressure because she was vomiting, but neglected to complete a neurological exam. Patients were diagnosed and treated for malaria strictly on the fact that they patient complained of headache and fever. There is a federal mandate that states that any patient with fever and headache must be screened for malaria that does not translate into blindly treating for malaria. This hospital is lacking many things but it does have a functioning lab with the ability to conduct the rapid diagnostic test for malaria as well and a blood smear confirmation. Using malaria as a catch all diagnosis is contributing to the rise of drug resistant malaria. When I asked the doctor why he was treating a patient for malaria even though all the tests were negative, he stated that he did not know what else it could be so it was better than doing nothing. Turns out the patient was just pregnant.  

There was a patient in the male ward who had ulcer on his foreskin that the doctor could not diagnosis. He stated that it was not syphilis or a fungal infection. I suggested that he test the patient for other STIs; specifically herpes and I joking mentioned that they should just circumcise the patient. He scheduled the patient for a circumcision later that day since he lacked the ability to test for herpes. Seeing as how herpes is a systemic infection chopping off the foreskin is going to do little to help this patient; not to mention that he is also HIV positive with a low T cell count and will have trouble healing post-surgery.  Oh and for all you men out there this hospital does not have an anesthesiologist so they conduct circumcisions with the patient wide awake with just a local anesthetic.

I feel as though I have spent a lot of time criticizing the hospital. I do not want to belittle the work that they are doing. I know that they are helping people and making a difference it is just hard not to notice all the things that should and need to be improved. It is easy for me as an American who is only going to be here for a month more to point my finger at the flaws, but how much is that actually going to help them. To be honest though I am at a total loss as to how to create a positive change in such a short time. I think I shall start with the lack of mosquito nets.

I only worked a half day today so that I could spend one night back in the village before meeting Ellen in Solwezi. When I made it to Nyansonso I was greeted with a cloud of children running towards me, hugging me, and taking my hand. I don’t think I have ever received such a warm welcome in my life. The joy that these children bring me after a few short weeks is amazing. I spent the evening teaching the kids how to ballroom dance. They thought I was crazy but they each wanted a chance to dance with me and fell over laughing every time I spun the around or tried to dip them. We played Frisbee and jump rope. I was sorry when the sun went down.