First attempt at a ward round today. I arrived on the ward, M1, and was once again immediately approached by throngs of patients proffering their hands for shaking or greeting me with manic shouts. By now I am getting used to it and feel more comfortable wandering out into the courtyard and along the concrete floors, stepping over patients, greeting informally but without committing to a full conversation. The courtyard and corridors are filled with many white-uniformed bodies, milling around in groups talking uneasily to each other, and sometimes engaging with a patient. My initial reassurance at this apparent surplus of staff turned to mild frustration when I saw that they were all nursing students, very few of whom were interacting with patients, some listening to iPods. In the smallish office there is apparent chaos, two patients sitting with torn clothes on the floor, shouting at a fellow patient outside, various white-clad nursing students flipping idly through patient notes, and the nurse Monday writing furiously while telling a patient to get out and a student to come in. He flashes a brief smile when he sees me and I ask him if he’d like to do a ward round. There is a brief ripple of his temple muscles as he contemplates the further chaos this will cause now. “Of course, you know, we can do a round.” I check again, “What would be good for you Monday? I can see things are busy here.” I feel helpless, not speaking the language, not yet knowing how patients are admitted, or even how many there are on the ward today. I don’t want to cause more work for anyone. Monday is sure though, “No, we can do a round. Let me call the patient.”
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Posts Tagged hospital
First ward round: Counting chickens
This is how the hospital works… (Day 1)
Induction as expected, very slow and painfully detailed, including such details as the full list of all hospital employees and their government pay grade, from chief superintendent down to cook and porter. I found out that our night-guard, provided by the hospital, gets paid more than the VSO allowance for night-guards, which means we do not need to apply for the grant. Cross that off the list. I spend some of the time going over Chichewa verbs in my head, with the book next to me to glance at surrepticiously.
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“You are most welcome”
Zomba seems to be a noisy place at night. Unable to shake my vague feeling of unease from the previous night, I slowly drifted off to sleep on my mattress on the floor, to the faint sounds of lively African music blaring from a tinny speaker somewhere in the distance. A short while later I was woken by a chorus of at least four howling dogs only a few houses away. They were almost synchronised, starting and ending within a second or two of each other, perhaps echoing the initial wail of their chorus leader. Each howl swooped up and drifted down in a mournful arc of sound, joining the other howls in closely spaced chords. Barbershop dogs, I thought. It was almost but not quite beautiful. Feeling sorry for the dogs, I drifted once again into sleep. Moments later I noticed a new sound, another mournful melody, too structured for a dog. A melancholic phrase was being sung repeatedly into the dark night, as if half-sung half-moaned through a shoe-box. I could not make out any words, but the tune was the same every time. Repeated again and again, sometimes louder, sometimes softer, always penetrating. Why? Had somebody died? Was this a very clever dog? Was I imagining it? I checked my watch in bafflement – it was 5am. And still dark. I tried to ignore the sound, and managed to get back to sleep. Read the rest of this entry »
Shadows in the dark
Malawian roads at night are hazardous. After a morning of reviews, summaries and reflections (VSO style), all the volunteers and employers had a last lunch together, followed by heartfelt goodbyes and good wishes, and a final trip to pick up extra supplies. VSO has thought of most practical things, and supply a foam mattress, cooking plate and fridge (and other smaller sundries like mosquito nets and water filters) to everyone. Our employer, Zomba Mental Hospital, had kindly sent the clinical nurse manager, the HR manager, and a driver to meet us and drive us back to Zomba. Tagging along with them was a detective who used the opportunity of a ride to Lilongwe to get details of a case he was working on.
Everything must go!
So it was a tight fit in the hospital’s double cab bakkie! We left Lilongwe with seven people squashed into a double cab (the senior nurse sitting on the lap of the HR manager in the front, four of us in the back), with three mattresses, a fridge, multiple bags, backpacks, an iron, boots and the driver’s sister on the back. It would be a four hour ride down to Zomba. Read the rest of this entry »
Gareth in Malawi 