Thursday, December 5, 2013

Sad Week at the Clinic- warning don’t read/look if you are queasy

So our week “in charge” at the clinic ran smoothly for the most part and went by quickly. Seeing how much there is to do really makes me appreciate all the work Sister Angel does daily. On Friday I spent some time in the inpatient unit, and saw some tough things. First, on Thursday night before we were about to come home a young male child came in with severe burns over most of his left arm, his chin, his back, and a good portion of his upper chest. His skin was literally hanging off, and raw pink skin was exposed. It looked extremely painful, and the child and mother were both crying as the nursing assistant attempted to insert an IV. Apparently hot water had fallen on him. On Friday he had a dressing change of his wound. I watched as the nursing assistant removed the gauze bandage from his body, cleaned his skin, applied a fresh layer of burn cream on him, and then wrapped him in a fresh seat of gauze. The child was clearly in pain during the dressing change, and even urinated during the procedure. I have seen burns before, but never to this extent. Additionally, although only one day had passed since he was burned already his skin had large blisters on it and his arm had swollen quiet a bit. It was painful to watch and made my heart ache seeing what he was going through. I pray that he will recover from the burn, will not get a systemic infection from it, and that his future scars will not cause him to be self conscious of the way he will look.

Warning-sad/descriptive medical information coming up
Seeing a burned patient like this was enough for me for one day, but unfortunately, I witnessed another sad case as well. A mother had come in Thursday night as well with a potential spontaneous abortion. She was placed in the female ward and started on IV fluids and medications. Friday morning she was having severe lower abdominal pain and bleeding. Ali, one of the nursing assistants, came up to me and told me that he thinks the mother was going to abort the baby and should be moved to the maternity ward instead. I told Ali I agreed with him and together we moved her to the maternity ward and then proceeded to do a brief examination. She was passing large clots at this time and at this point we were in a wait and see state. An hour later I returned and found her with the midwife. She had just passed the baby and was extremely tearful. She was sixteen weeks pregnant and the parts of the fetus were clearly distinguishable. Having worked in the neonatal intensive care back home I have seen small babies under 1000 grams, and am not easily shocked by the size of a premature baby. However, this fetus was unlike anything I have ever seen. It’s arms and legs were present and its spinal cord intact. It’s head was there but not attached and it’s eyes were just beginning to form. The placenta was intact, but still small due to the young gestational age. When a premature baby dies at home we bathe the baby, dress it and allow the mother to hold it. However, the baby was about the length of the palm of my hand, and at 16 weeks they do not bury the child. Instead the fetus was wrapped up in a sterile glove package and handed to the mother. The mother was alone at this point, and wanted to hold on to the fetus until her mother arrived so she could show her. I stayed with the mother for a bit, and then gathered up her belongings and walked her back to the female ward so that she did not have to stay in a room with newly delivered babies and happy mothers. She was moved back to the same bed that she was previously in and she immediately curled up in a ball and put her bed sheet over her entire body and sobbed. It was heartbreaking seeing someone go through this and to make things worse she did not have the privacy afterwards that she deserved. I rubbed her arm and tried to soothe her, but what efforts can you really do besides be with her as she goes through this. I wanted to tell her it would be okay, but in reality those words don’t comfort and don’t mean much of anything (and it also doesn’t help much when you don’t know how to say that in Rutoorro.) At the end of the day I just wanted to go to the school and see the healthy and happy children playing or see my village friends and give them a big hug. We take life for granted too often, and seeing things like this helps me realize how grateful I am that I am healthy and happy here in Uganda.

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