So, everyday I spend the morning at the Health Center, doing rounds with Scott Will and Jennifer, seeing all of the sick kids in the Pediatric Ward, deciding what treatment they need, dispensing medicine and doing short procedures like IV's and LP's (spinal taps for those of you not in the medical field).
Now, those of you reading from 8East, this is a whole different world here...all of the kids are in one room, there's no having to worry about who gets the private rooms and arguing with parents about what kids should/shouldn't be in rooms with what other kids, there's no calling/faxing down to the kitchen for special food requests between meals...there are no meals provided here, the mom/caregiver (often the mom's have died) has to bring food with her and prepare it or people bring them food, it sits out on their bedside tables between meals and overnight...there's no storing breastmilk in neat/tidy little bottles with a marked name/date/time on each - the mom's ALL breastfeed and there's no etiquette about how/where to do it or who happens to be around/looking, you just pull your shirt up/down and the kid latches on, grandmothers/aunts relactate to breastfeed their grandkids/nieces/nephews, there's no taking of vital signs even unless the kid is close to death...it's not like they have BP meds to give anyways if the kid is hyper/hypotensive (I haven't even seen a BP cuff acutally)...there's no thermometers, so a kid is noted to have fever if the mom says the kid feels hot, there's no isolation gowns, no NG tubes for even the worst of malnourished children, no IV beeps to chase all day/night, no CR monitors or pulse ox's going off constantly for every twitch/movement a kid makes, but that because there are no IV pumps or monitors of any kind...oh and the kicker, they inject meds directly into the IV fluid bottle (the bottles are plastic) and just leave the needle in the bottle so that they don't have to use another needle when the kid gets another med, just reattach the syringle to one of the three needles sticking out of the bottle and voila...I'll have to take a picture, I almost fell over...but really, for what they have/know they do a phenomenal job of keeping whoever they can alive, it's incredible...everyone and their mother is anemic, like Hgb = 3.0 and so forth, and then they're okay to go home if their Hgb is > 5 for a day or two post transfusion (they transfuse whole blood - not PRBC's, like it's nobody's business - evidently because of malnutrition and chronic malaria and lots of other immune system compromises everybody's just anemic at baseline...) When you send the kid to the lab to get a test done (the mom walks/carries them over) you most of the time have to send a pair of gloves with them for the lab person to use because they don't have any in the lab...and there's no fighting with the OR about times and who's next and were they NPO for long enough, etc...you're lucky if the person working in the OR is there that day, and you just send the person over to that building to wait until they come or until it's their turn to get the procedure they need done...oh geez, I wish you guys from 8East were here to laugh about how high strung we are in the States about stuff...there's kids getting treated for TB like in every other bed and well, if they're coughing, look the other way :)
But there's also the heart strings getting pulled...you know even at work at home, there are some kids who just pull on your heart strings from the moment you lay eyes on them, and it's different kids for different people...the kids I thought were just the cutest or the ones I felt the most empathetic for, Pam would totally disagree, and she had her favorites that I just couldn't get along with or whatever...today my heart strings got pulled. There was a little boy who is way below the growth curve...he's a 1 1/2 yo and his OFC was in the 50 percentile for a 4.5 mo...he's tiny (big belly but sticks for arms and legs and you can see his whole ribcage/spine in one glance). And his mom said he didn't cry for 4 days after he was born (obviously some kind of complications at birth, but that's all we know)...and he just looks neuro, you know what I mean? Not a syndrome-y face at all, just the cutest thing you've ever seen, but the way he moves his extremities is slow and kind of nonpurposeful, and he does sit up by himself but tripods when he does it, and I don't know, his mom is really young and pregnant again, and he just got me, hook line and sinker...one of those you just wanna pick up and never let go of...
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