Tuesday 23rd April 2013

Our last full day in wau, with so much to do. We arrived at the hospital overwhelmed with the task in hand. Rob was a man on a mission…..to get oxygen flowing in theatres. He started with  fixing a  power stack in theatre, so the new O2 concentrator can be used without concern it will be fried by a power surge !!.

Following that he checked on the blood bank fridge and found it working now the solar panel is getting sunlight but the current battery is 13yrs old and struggling to hold its charge and will need replacing soon.

Ben was busy in theatre, observing and operating with DR Paul. 

Kate continued with her clinical teaching on paeds ward B. Teaching was focused on how to use the new O2 concentrator and how to look after it, Kate also taught nurses on how to use the haemacue and gluocometer. 

Frankie delivered more teaching sessions to the nurses she hope will work on the new HDU.

After observing a ward round, I taught student midwives how to plot fetal heart rate’s and maternal vital signs on the partograph (labour progress chart). I also had a meeting with the lead midwife and junior doctors to discuss eclampsia and the use of magnesium sulphate.  They  reported to me there has been three deaths to eclampsia in the last month.  There are currently no guidelines for maternity care at Wau and the women attending the hospital have had little or no ante-natal care. Together we read  WHO recommendations and considered how they can be applied to practice in Wau. 

The baby that was transferred to paediatrics yesterday survived the night and the mother had started to express colostrum into the babies mouth, the baby is not not suckling yet but is showing interest in the breast. The Mother has been giving sterile sugar water to the neonate via a nasogastric tube every couple of hours.  There is no infant formula available in the hospital,  formula milk is expensive to buy here and there is no where to sterilise bottles correctly so artificial feeding is out of the question for this baby. The baby appears content being nursed by its mother in kangaroo care and there are no no signs of respiratory distress and its observations are stable. The climate also helps the baby to maintain its temperature!

In the afternoon the team reunited at the office from our separate departments to sort out the last of the items we had brought out. Taking an exercise bike to physio, suture sets to out patients, books to HIV department, hats and blankets to maternity,  haemacue to theatres, syphygmanometers and stethoscopes to the wards and distributed some nurse watches to staff that had attended training.

We then finished arranging HDU. We all felt very sad to be leaving it unfinished , but it represents PAL’s commitment to the hospital and acts as a reminder for the local staff that a PAL team will return and help them to develop the unit in just a few months. 

The day was finished with a trip to the catholic health institute for afternoon tea with the nuns. We enjoyed delicious paw paw cake made by sister Dorothy and had an opportunity to reflect on a very bust week of motivation and mentor ship.

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