Hospital Time
Feeling very thankful for medical donations from the Home and Community Care office on Cook Street, Cool Aid Community Health Centre, the baby scale from Dolly Freigang’s office and eye glasses from Audrey Takoski which nudged us into the hospital and various outpatient clinics that we don’t routinely visit each year.
If not for the reading glasses we might not have stopped in on Sr. Matilde, a clinical nurse specialist in ophthalmology, who runs the eye clinic in a little room and has an amazing understanding of pathology. The real deal; earnest, sensitive, committed, we met her one day in the hospital attending to a newborn with serious post delivery eye infections. Worried and wishing to insure the child received the treatments as ordered and on schedule, she made frequent visits to the wards where she outlined her interventions for us one day. One day he was concerned the child would go blind and the next rejoiced that the infection was beating a retreat. Sr Matilde has a wall of prescription eyeglasses but no working machine to measure the prescription just in case anyone should have such a device they might wish to donate!
In the maternity ward Dr. Mgazi and all the nurses came out to receive the baby scale and even a swaddled new born arrived to put the scale to a test. Many mothers- to- be circulated, coming in as they do to guarantee a hospital birth and access to intrapartum treatment if needed. Still perhaps 40% of here deliver at home, far from services, without trained birth attendants or access to treatment to prevent maternal child transmission of HIV. There was much enthusiasm for the scale including ululations. “Lalalalalalalalal..”
Our group visited the HIV centre where Dr Denis was our guide, showing us the counselling rooms, the testing room and pharmacy before letting us sit in on a steady stream of clients who that morning all seemed to be doing well and tolerating their antiretroviral- ARV- treatment. Some patients come from as far away as Arusha, Himo and Marangu to avoid the stigma they can experience if they went to a clinic near to where they live. There are 1,800 clients now registered at the clinic and Dr Denis feels the rate of new infections is down in the area. All HIV and TB medications are free but because of the high numbers of patients on care the clinic can no longer supply free medications for pneumonia and other infections common to HIV positive patients. This becomes difficult for children like Aloyce, a vulnerable and HIV + kid with pneumonia and a sick grandfather in the hospital. His antibiotics are no longer free.
The most distressing visit remained the hospital where we circulated among the male and female wards, pulled to change dressings here and there by nurses, family members who, without curtains for privacy, watched us at work on neighbouring patients and occasionally patients themselves. We saw multiple burns, neck abscesses and lower leg wounds. So many of the wounds had been un and under treated and were therefore dramatically infected, always painful and in need of months of treatment or in some cases, to avoid that, amputation. Like most places people do not let go of their limbs readily but our lack of confidence in healing a wound had us talking amputation more than once. We were also amazed that people had not yet died of their wounds. The hospital has insufficient dressing materials and we with our donations were awash in various more technical dressings that would never turn up here if not brought by volunteers. Given the hyper-specialized, hyper-technical wound care world that I inhabit in Canadian, I will be interested to research what lo tech solutions/ adaptations work in resource poor areas… like the gauze and tape world we experienced here. Credits to one nurse, Sabine, who seemed interested in some of the materials we were using and expressed a desire to learn more about dressings and approaches to wound care. Perhaps we can focus more on this next visit.
Speaking of that the hospital is interested in medical volunteers, nurses, doctors and a special request for a surgeon this year was made by the hospital administrator Dr. Masawe and surgeon Dr. Mlay.
Once again thank for all the donations!