Anne and I have spent the first week observing things in the clinic and assessing, comparing, and contrasting situations in the clinic to how things are done at Rush and Anne’s hospital in Indy. Infection control here is a huge issue, and it definitely feels odd starting my day without scrubbing in. I constantly am searching for stat foam, and have to remember it is not at any patient’s bedside. There have been days even when the sinks are out, and we have to walk outside to wash. We have created a survey to assess the needs and perceptions of the staff, and hope to implement a plan to make infection control a priority.
The pace of life here in Uganda is a lot slower then the U.S., and things are often run on African time (add an extra hour or so to the time when you were told to show up for something.) As a NICU nurse I was accustomed to getting tasks done as soon as an order was put in, calling pharmacy for a new medication, and working 12+ hour shifts with little time to sit down and eat. Things in Uganda are much more relaxed, and there is little rush in getting tasks done, rather more time is spent greeting others and taking time to talk to them and find out how they are doing.
The health unit here is a level three unit and does not have an operating theatre or the ability to administer blood transfusions. if these are needed patients are referred to a higher level clinic or hospital, which can take anywhere from 15 minutes ts to over an hour to reach. The ambulance does not run to this private clinic so often it is up to the patient themselves to find their own way there. One such patient who was referred this week was a septic newborn with extreme respiratory difficulty. The patient was extremely sick, and I don’t know if they would make it to another clinic in time. It’s very difficult to see a patient like this sent away when I know the baby could be treated immediately in the U.S.
People here are grateful for the simplest things, whether it be a new shelf to arrange medications on or something as simple as a pen. Sister Angelica, Anne, and I brought three large suitcases full of supplies along with us. Included in that was a fetal Doppler. Previously the midwives had been using a small wooden instrument to listen to fetal heart tones. The Doppler made the heart tones much louder, clearer, and an extra stethoscope attached to the Doppler also allowed the mother to hear the babies heart rate. Seeing the smile on the mother’s face when she heard her child was pretty special.
To all my NICU girls here’s a top five list of what we lack….
1. Stat foam and scrub brushes
3. Bottles, formula, lactation consultants
4. I.V. pumps and syringes
What Uganda does have…
1. No beeping monitors
2. Babies who immediately latch on- we are a “baby friendly” hospital by default
3. No babies with a high comma in their name (as of yet J)
4. Mothers who care for their baby 24/7 during their hospital stay
5. Stoic moms- no epidurals are given, and yet the mother still leaves the hospital on foot with a baby tied to her back
(oh and by the way NICU friends there are no roaches here, but there are lizards!)
A lack of resources, the language barrier, different healthcare protocols, and caring for patients older then 6 months will be a challenge for me, but I hope that by the time I am ready to head home I will have found my niche at the clinic, and made some sort of impact along the way.