Bad days and Death

Friday... Jess is better enough to go into the hospital. She must actually have had malaria despite negative slide since as soon as she started the medication for it she started to perk up. We decide though to go to Paediatrics again since we know the system and Dr is nice. It was the worst morning for frustration at the system. A small boy is brought in with all of the classic signs of Meningism after fitting all night since 6.30pm. The Drs faff around. They then decide to do a Lumbar puncture before giving antibiotics but no one can find a LP tray. They wait for a while long. We are there feeling anxious but the Dr is atleast giving the child attention. They do the LP and we sit there crossing our fingers that the boy is not going to cone as the CSF comes out at such a high pressure. THEN... we ask...will the boy be given his antibiotics now? Yes Yes... Hmmm... unfortunately it means that first the family have to go and buy them and cannulae. We sit there getting more nervous. When the drugs arrive we look for veins but he is so shut down peripherally and we have never put a paeds cannula in before (and they had only bought one so we didn't want to mess up) that we ask for the nurses help. The Dr tells the nurse to do it while she carries on seeing other patients and the nurse decides to go away and do the the rest of the ward round with another Dr before coming.We continue to ask and ask...nothing gets done. We ask if we can just give it intramuscularly because it was urgent. The Dr said no it needed to be IV and the nurse would come in a minute. Feeling helpless we tried to comfort the boy a bit and cool him down. Then he started fitting again and I ran to get the nurse saying that it was now an emergency and she had to come. He was by this point so shocked that the cannula wasn't going in. She went and got another one. It took three gos and she wasted a bunch of the drug from infiltration cos she didn't check (we told her because it was swelling up). If we had known that they had spare ones we would have got one in a long while back. Even they got one in about an hour and a half after he had come in. I'm pretty sure he will have died. No one will hurry. No one will rush. Its so frustrating and we don't have the skills yet to intervene and know we are doing the absolute right thing. I think maybe the worst thing is that in England if your child has been fitting for the whole night, you would have brought him in after the first one. Also in England, if you went to the GP first, he would have stright away given a injection of penicillin. You would not be waiting for 2 hours for your first dose of antibiotics after you arrived at hospital. You would have a bed you didn't have to share with another child. You would have oxygen...the child would not be left alone by all the nursing staff and Drs and relatives. We had to stay with him holding his hand and talking to him because everyone else had gone. It was a hard morning.

At the weekend we went to the beach. Kendwa Rocks. It was cloudy and I got a dodgy tummy so we came back early on Sunday and lay by the pool at the nice hotel in the bright sunshine. I did not burn...Hooray! I think I may even be starting to go brown, which is impressive for me :)

Today we went into O&G although we didn't do anything practical just watched. An interesting place is the antenatal ward and a far cry from Labour ward in the UK. If the woman is lucky someone will check how dilated she is before she drops child. I actually mean literally drops child because the women will walk from the ward to the Delivery suite when the head is halfway out. Today none were dropped though... phew. We saw a couple of deliveries of healthy babes... amazingly the women make very little noise or fuss and they have no pain relief or support from relatives. Noone is in there with them (esp not the men) and they go through it all alone with barely a sound escaping from their lips. I admire their courage and strength. Generally, women in england have pain relief, support and they still scream the house down! We did see a really sad thing though because a women had been transferred in from a smaller clinic due to obstructed labour. She had a Csection but it was too late. Neonatal resuscitation doesn't really happen although we tried....no oxygen or anything. There was nothing we could have done. She just arrived too late.

After that we went to see the slave chambers under the anglican cathedral which is on the site where the old slave market was. The slave chambers were barely bigger than my box room (well maybe twice the size) and each one ould have had 55-75 slaves in it for 3 days with no food/water whilst awaiting being sold. The high altar of the cathedral sits on the place where the whipping post used to be. It was very interesting to see but sobering to think of so many atrocious happenings on that one now holy place.

Life is not all bad though... it is interesting at the hospital... in a very different way to what I had imagined. Think we are going to take a break from O&G tomorrow and go to a cardiology clinic tho.

I promise my next entry will be more upbeat :)
Salx