Thursday, July 1, 2010

Hospital Tour

Wednesday afternoon we went on a tour of Mbale Regional Referral Hospital, which is located just across the street from TASO. One of the UBC kids met a nurse who works in the pediatric ward on the bus a few weeks ago so she showed us around. I knew that it was going to be an emotionally tough experience, but it was harder than I could have ever imagined. We walked through all of the wards and patients lying in rickety beds or on the floor with IVs in their arms. Many of the babies had ports in their heads so that they could be easily hooked to fluids, etc. if necessary.

There were about 30 beds in the pediatric ward. Sister Esther, the nurse, said that sometimes they have up to four patients in each bed and more on the floor. This is standard throughout the hospital. In addition, patients have to bring their own sheets and have a relative to serve as their attendant.

Malaria is the most common cause of hospitalization. It is the number one cause of death among children and the number one cause of miscarriages among pregnant women. The hospital has separate wards for women who's children survived and those who did not. In the latter ward, a woman was screaming and being comforted by her relative attendant. She kept thrashing and moaning. In the other ward, we saw two newly born babies. One was swaddled in blankets and laying at the end of the bed while its mother rested and its father looked on. I thought it was fantastic that the father was there. He was the only man in the entire area. As we peered into the ob-gyn operating theater from the door, we met a 15 year old girl who was in line for a C-section. One of my friends commented to me that she definitely wasn't in that position by choice, but I wondered if that was true or not. I certainly hope that she didn't intentionally become pregnant, but I don't think I would be shocked if she told me that she did. I think in some areas here girls still do have children quite young, well before they're mature enough to care for them.

In the surgical ward, men and women of all ages laid in bed with casts on their legs and pins in their knees holding their legs straight. In the surgical ward, the charge nurse gave us a tour of the facility. It was newly renovated and by far one of the nicest buildings in the entire complex. The old ward was a single room building with no windows that was very run down from the outside. The new one is made of brink and absolutely pristine. Aside from the building, however, some basics of care are lacking. The dirth of beds throughout the hospital is even more evident in the psych ward. There are a few mattresses scattered on the floor in the different areas, but there are not bed frames. Some patients even sleep on cardboard laid out on the ground.

Throughout the entire hospital, few patients have their own room. Those that do pay for them, whereas others receive services free of charge. Wards are separated into male and female sides to allow for some sense of privacy.

The most painful part of the tour occurred at the very beginning. When we moved into the second wing of the pediatric ward, we were confronted by a dead child, perhaps 3 or 4 years old. At first, we weren't sure whether or not he had actually died. His head was limp and his eyes were kind of rolled back, but because of the way the doctors were moving him it was hard to tell. Then they began taking his IVs out and closed his eyes. Even then Nrupa wasn't convinced; not until they put a sheet over him were we all 100% sure. Apparently his blood was too low (I'm not entirely sure what that means) and his family brought him to the hospital too late for the doctors to treat him. Worst of all, his mother and father hadn't come to the hospital that day; an aunt had brought him. She wrapped him in the sheet and carried him to a private room as I fought to hold back my tears.

It was so amazing to see the hospital. Despite the inefficiencies of the American medical system, we are quite lucky to have all that we do. Patients in the west complain of sharing a semi-private room with one other person whereas here rooms are shared with 30 other people and there isn't so much as a sheet to separate beds. In a sense, though, I kind of like this system. I think it better serves to unite those who are suffering.

Another experience that was painful and thought provoking in a different way (not appropriate for children): Nrupa and I were walking home today when we passed a man (who probably should have been admitted to the MRRH psych ward) sitting on the ground. He had no pants on and, even though we should have known better, both of us looked down to see him playing with himself. It was so gross, but no one else seemed to mind very much. Are we prudish westerners to think that it's inappropriate to have ones genitals out in the middle of town like that? I mean, we did see half naked women in the hospital and sitting along the Nile and it was entirely fine.

A few minutes later we passed the same man walking on the sidewalk (still with no pants but his shirt was long enough to cover him). I think he was trying to ask for money so he reached out and tried to touch us. We both veered out of the way and kept on going. Again I couldn't help but wonder about the differences between home and here. That man would have been arrested in a heartbeat if he was walking around DC with no pants on, but here a security guard walked by him right in front of us and didn't even flinch. How do these discrepancies in pubic decency develop and where does one draw the line? Are we naive and prudish for being disgusted by this man's actions or are we cold-hearted and unsympathetic?

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