Back on the Malnutrition Ward

Today was a hard day on the wards.  I am back on the malnutrition unit, after having worked in other areas for several weeks. Since all the medical students are on recess, we are even shorter-staffed than normal; it was just the intern and I. After an hour of bedside rounding, we had only seen 2 patients.  For the past two days, the intern had been rounding in the malnutrition unit by himself, and he did not know the patients’ well. Needless to say, it took us awhile to get caught up on all the hospital events.  

At Bugando, a new intern usually rotates through the malnutrition unit every 1-2 weeks.  But unlike in the US, there is no sign-out procedure and zero communication between the intern leaving and the intern coming on. This leads to a lot of things falling through the cracks--ultimately, a lot of children not being cared for properly. 

One of the children we saw today had become very sick and needed to be transferred off the ward for oxygen therapy. It turns out that the child's mother had been under-dosing the antibiotics. When I asked her about this, she said, "Someone told me to stop the medication after two days." Who was this someone? Don't know. Were they medical staff? Don't know. I was horrified. Another child was supposed to start HIV medications several weeks ago, but nothing had been done yet. I came home completely exhausted and frustrated. 

If there was a stronger system of communication set up for the interns, many problems like these could be avoided entirely. Throughout the past year, I've really come to realize that Bugando not only needs more health care professionals, but drastic improvements in hospital systems.