Monday 22nd April 2013

Today we all set off at a frenetic pace in the knowledge we are going to be leaving Wau on Wednesday – we’re all a little frustrated but extremely eager to try an achieve as much as possible.

After sifting through yet more kit to be distributed to a range of areas around the hospital we all headed off in different directions.

Ben set about taking lots of equipment to the eye unit, including their new microscope which he helped set up and then he spent the rest of the morning teaching/ learning with Dr Paul (Prof). It was a very productive morning.

Kate went off to paediatrics, also with lots of kit, including an oxygen concentrator for paeds ward B. She managed to do lots of teaching on each of the paeds wards on the use of the oxygen concentrators and Lifebox oxygen saturation monitors.

Meanwhile Maddie was finding things to do in the maternity unit – over the weekend there had been a new arrival in the unit, who had turned up early, a baby born at around 28 weeks (guestimated) and managing to hang on in there! Maddie contacted Kate, and with the family and doctor’s blessing, they moved the child to the paediatric ward. With just a few minor interventions the child seemed to be doing well and there was a little bit more of an optimistic future than if nothing had been done. Well done ladies!!!

My day started off very differently, having delivered bits of equipment I went to check on our post op/ HDU patient from the previous week. I was really disappointed to find that the Obs charts hadn’t been filled in over the weekend as the students who’d been managing this weren’t there. It wasn’t all bad news though, the patient was looking much better and I was informed that he was mobilising and starting to drink (and maybe eat a little) which was fantastic news.

After my brief visit to the ward I went to the blood bank to see if I could fix the solar fridge as it had been out of commission for 6-8 months! So current practice was to take blood and give it almost immediately. I was very pleased to find two men on the roof dismantling the panels for me. It meant I didn’t have to clamber around up there in what was becoming a very hot day. I went and checked on the internal system and discovered it needed completely re-wiring and all the bits that weren’t a blood fridge disconnecting from the system. With the system re-wired, the panels cleaned and connected and some minor tinkering with the fridge, it fired back to life! They do however need a new battery- the one in situ lasted a very impressive 12/13 years! Oh and I even made sure to show the local sparky how to do it for future repairs, all in 40*c + temps!

In another part of the hospital Frankie lent her expertise to the morning ward round and shortly after started some formal training on using and interpreting ECG’s. A group that included doctors, nurses and nursing/ midwifery students attended. It started with a practical demonstration on how to setup and use the ECG within the HDU area and they then went to do some theory training in the resource centre. It was all very well received and caused quite a buzz!

So morning over (yes really, that was all just the morning!) we set about getting things done for the afternoon. After sorting through more kit I headed off to check on the fridge in the blood bank, sadly there was no one there so I couldn’t gain access, tomorrow then! So instead of this I went to check the HDU lights but couldn’t get them to play either and with no bits on the horizon someone from the next team may have to finish the installation.

Ben then asked if I could help him sort out the new microscope as there was some rather suspect wiring. So we headed to the eye unit and were lucky to catch some of the team before they called it a day. I manage to take the affected cable apart and discovered that a soldering iron would be extremely useful! As I didn’t have one, I sured it all up as best I could with the bits I had, and made it all a bit more stable. We plugged it in and powered it up and all but one (not essential) function seemed to be working.

If any of us had felt like we hadn’t quite done enough we reconvened in order to go and do some teaching at Sr Gracie’s and at the CHTI. Frankie, Kate and Maddie went to Gracie’s, Ben and I to CHTI.

Kate taught about Respiration obs, Oxygen and saturation monitoring, Maddie taught about the use of partographs in maternity/obstetrics and Frankie taught about HDU management and setup.

Across town I taught a large group of CHTI students about Leadership, team-working and their importance in medicine and nursing practice. I was pleased it went down very well, the students were engaged and participating, I even managed to get a few laughs. Ben used the time to have some discussions with the tutors about the future for healthcare in South Sudan and had a rare opportunity to send some e-mails. Oh and he got some photographic evidence of me doing some teaching!

After an exhausting day we had a lovely dinner back at DORCAS and then went to Amarula lodge for a dip in the pool (which was heavenly!) a few well earned beers and the rest of the team tried to use some internet with mixed results. I don’t think anyone will have trouble getting off to sleep tonight, especially me!

 Rob

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