Amelia inspecting a placenta after delivering a baby

 Dana listening to lung sounds on a baby

3 days in Choma...

Hello-

     
Well, we successfully finished our first week at Choma General. Overall it was a great experience. If I'm not mistaken there are about 200 beds available, and about 84 are being used currently. There is a female and male ward, pediatrics, psychiatry, theatre (OR), outpatient, ART clinic (clinic for HIV/AIDS patients) and a dental clinic. The majority of our patients do have HIV/AIDS, they call it RVD (retro viral disease) here. They go to an ART clinic as prescribed to get there medications, children and adults. One of the doctors told me that 70% of HIV patients will get TB also. In the adult wards we see a variety of diseases such as: HIV, TB, pneumonia, malaria, burns, sepsis, meningitis, measles, liver failure and various heart diseases. In pediatrics we see alot of burns in the toddler age due to lack of supervision, broken bones in the elementary school age, malaria, HIV, pneumonia, severe dehydration, malnutrition and various other diseases. We see alot of burn patients, and unfortunately, most of them have died. Yesterday 3 of us were in the peds ward caring for an 11 yer old boy burned in a house fire (both of his siblings died), we left for lunch at 1200, and he died at 1215 from collapsing. One thing that is hard for us is often feeling different about the treatment for these patients. We are taught that edema  (swelling) does not mean a patient is well hydrated, it just means the fluid is in the wrong place. With a patient who has been burned, it is priority to give them fluids because of the damage done to their cells, they are leaking fluids and their heart will no longer have fluid to pump around the body without proper hydration. However, when a person comes in with burns here, and they are swollen, the nurses are under the impression they don't need fluids, and this patient normally collapses and dies soon due to hypovolemic shock (not enough fluids in the body). As a nurse, this is really hard to handle. The doctor said that patients with at least 40% of their body burned, will not live, they just don't have the resources. 
     

The students have had a myriad of experiences. Blood draw, IV starts, catheters, delivering babies, debriding wounds, mourning with families, bathing patients, holding babies, reading X-rays, scrubbing into surgery, handing medications out at the pharmacy and tons of other stuff. The students will come back torn, frustrated and enlightened. They all have a new perspective on life and have definitely been changed, we all have been.

Bethany