Monday, we went in to work full of excitement and not having any real idea of what we were getting into. Juliette (the woman who picked us up from the airport) walked us the 10 minutes from our house to the hospital, and as we approached the hospital we saw a collection of one story, slightly shabby buildings connected by outdoor pathways. The buildings were the wards - specifically, there's a Male, Female, Pediatric (< 5), Maternity, Operating Theater, and and Outpatient ward... there are also some other smaller miscellaneous rooms for things like dentistry, opthalmology, a minor operating theater, HIV/malaria clinics, etc.
We walked up to the head nurse in charge of the hospital (we've found that despite a huge lack of doctors, there are MANY nurses, especially student nurses). She showed us around, signed us in, and then basically told us to get to it. I had decided I wanted to spend most of my time in the Operating Theater, and Anne Marie chose to go to Maternity.
The Operating Theater is pretty crazy. Like all the other buildings, the ceiling tiles are missing and the floor is hugely stained and dirty looking, but there's pretty good adherance to sterile technique in the most important areas. Walking in, you remove your shoes and put on sandals. The nursing students were all just hanging out in a sort of lounge talking, and I joined them for most of the morning just waiting for something to happen. I met some awesome people though - Barbara and Paul especially. Finally, an anesthetist came in and began scolding everyone for not having a qualified nurse there teaching us things (which didn't seem to me like any of their faults), and after he left the morning continued to drag on much as before... uneventfully. Finally, 2:00 rolled around (lunch time in Uganda) and Anne Marie and I set out for lunch, just as it began to pour. We get soaked on the run home, and realized as soon as we arrived that we'd left the key to our room at the hospital... so after eating lunch soaked the bone, we returned to the hospital to find that all of the surgeries for the morning had already been preformed while we were out to lunch. I hung around for another couple of hours waiting for surgeries that didn't come, and left around 5:30 feeling a bit disappointed that I hadn't seen anything.
Even though I didn't see any surgeries Monday, I feel like it's as good a time as any to describe surgery in the operating theater. It's nuts. You change from your sandals into big river-wading boots and put on your gloves. The surgeon doesn't scrub in (there's a paucity of running water everywhere in the hospital), but does put on sterile surgeons gloves and has a scrub nurse who puts helps the surgeon into a gown, mask, and cap. The instruments are all well sterilized in an autoclave, but the windows are wide open and dusty air is constantly blowing in. The most common procedure is a Caeserean section, which involves a woman being carted in completely naked and being laid on the one table in the center of the room, atop a plastic tarp. An anaesthetist knocks the patient out with a mixture of ketamine and valium, and sometimes ether. The surgery takes place, and it's a very bloody affair indeed, because there's no suction or anything to clear away the blood (so it just flows all over the patient, surgeon, and floor - hence the river-wading boots). Once the surgery is done, some buckets are filled with water and poured all over the patient to wash off the blood and urine (in C-sections the patient is catheterized, but the tube simply pours onto the patient/floor), and some bleach type liquid they call Jik is mixed in, and poured all over the floor. This is then squeegeed into a drain, and the room is again ready to go. Meanwhile, the patient is carted into a recovery room, where inevitably they wake up moaning or screaming in what appears to be pretty significant pain. Yikes.
No comments:
Post a Comment