We arrived to find the child with meningitis had sadly, but not unexpectedly died during the night, but another boy with encephalitis was very much better.
Jane has been on the delivery ward, where a lady having her first baby was in the second stage of labour for over 3 hrs; the baby was alive but must have become severely asphyxiated shortly before delivery. The midwives had tried to call the obstetrician but no one came, so the woman did not get the forceps delivery, which would have probably saved the baby. Both Jane and Antoinette tried to resuscitate the baby for half an hour but it was too late. One obstetrician has been in Addis for 6 weeks and is now stuck in Juba and the other we haven’t seen since we arrived!!
The maternity patient who received our antibiotics is improving, however.
I managed to persuade the administrator to release a trolley from the store to use as a resuscitation area in the delivery ward. The Ugandan midwife who is working here for a year…and doing a great job, was delighted. I did see 2 midwives asleep on the beds this afternoon though!
We have been distributing the various items of donated kit to the wards and Antoinette & I discovered a child on one of the paediatric wards, very sick with malaria, who had been fitting for 3 hrs while the nurse took no notice and appeared to be busy washing her feet. There is a big lack of effective nurse leadership. There appear to be only 2 senior nurses here at present and they spend a lot of time in their offices and little time on the wards teaching and leading the nurses: its very discouraging, as I spent some time on the last visit trying to persuade them to get more involved in ward management and teaching.
The newly refurbished Emergency department seems to be running well, and they have a reasonably effective triage system set up to prioritise the sickest patients.
The teaching programme for the student nurses and the doctors is very well attended and going well and they all seem to be really enjoying it. Although we started late due to the plane delay, as far as the teaching programme is concerned, we have had a far better attendance and taught far more doctors than on previous visits.
We have also been to visit our friend, Sister Maria in her newly built Comboni hospital (the former military hospital). At present just the OPD is running but its already an amazing centre with excellent facilities, rivalling many hospitals in the UK and will eventually house inpatients and a maternity unit.
Hilary and Antoinette with nurse’s baby in new emergency dept