New White Coat

Duncan's Turn:

On Monday I was scheduled to work in one of the inpatient pediatric wards at the hospital.  After 2 months of not picking up a stethoscope to examine a child, I was now responsible to care for about 30 children with many diseases I had little to no experience caring for during my training in the US.   

My morning at work started with morning report, where the on-call intern presents all admissions and deaths overnight.  It is not uncommon to have several deaths occur overnight here--it's extremely rare back home. 

After discussions about the cases, it was off to the inpatient pediatric ward, where I met the intern and medical student assigned to the particular ward I was working on.  We went bed to bed, sometimes with two patients to a bed, reviewing their medical charts, examining the patients and coming up with a plan for the day.  After a few hours of being on our feet, we finished seeing our last patient on the ward, and turned to the busy work of blood draws, inserting IV's and other bedside procedures for the afternoon.

The diseases here are vast; most of them I have never seen at all in the US and have only read about in medical textbooks.  The children tend to come to Bugando when they are already very sick, coming very late in their disease because the parents don’t have the means to bring them to the hospital or they depend on the local traditional “witch” doctors for care until they realize their child it not getting better. Many parents also fear bringing their children to the hospital, since they know they may not end up going home with their children.

The needs here are tremendous, but we hold onto the hope that in the new heaven and new earth, there will no longer be any mosquitoes carrying malaria, dirty water filled with bacteria or infants contracting HIV from their only food source, breast milk from mom.  

But until then, there’s a lot of work to be done.