Leaving on Saturday after the clinic was a bit of a challenge. It was a great day and I’m getting into the sync of things, but it went longer than we had hoped. I had some challenging patients and very rewarding ones.

The team was waiting for me to leave and found me with a 5-year-old beautiful boy with Malaria, HR 164, RR 64, temp of 104+. These are newborn infant pulses and respiratory rates, not atypical of 5 year olds. He was a sick little one. The quick test proved he was positive for severe Malaria and I had to write orders for quinine infusion over 4 hours and then to be repeated twice (every 8 hrs).

He was to stay in the “overnight tent” with the nurse staff that would be up all night with him and any others. Being sick with malaria can turn into cerebral involvement and cause brain damage. This overnight observation/treatment is such a huge improvement. We could not stay overnight at the camps and had to either refer patients to a local hospital or send them home to their villages hoping they would improve. I hope for a good report on Monday ….

• • •

Monday morning… I usually set my alarm to wake between 6-6:30 am on my iPhone. Do you 50-somethings remember the TV show “Dark Shadows?” Well the iPhone has a “sci-fi” ring for an alarm. It’s kind of a hoot to wake up to but a bit weird for the rest of the house to hear. So, I found the song I have for Chelsea’s ring tone and set it for my alarm. This morning when I awoke, I could see the sun rising pink in the distance and a beautiful landscape appearing. If you actually look close at the way the people live in the forefront, it’s not really so beautiful, but nonetheless, these were the words I awoke to and it was perfect. I think I’ll leave that alarm tone for the rest of the month. Imagine these words while watching the sunrise, enjoy!

Monday Clinic Highlights

• Today, we arrived with the waiting room FULL -- 40+ pregnant mommas were waiting to be checked at the prenatal clinic. The midwives handle this. Then the room is full of other people already checked in with their weight measured and waiting patiently on the benches or floor. It really is quite remarkable that there are not fights while waiting. I guess the last team implemented the idea of benches.


• There are lots of weird rashes, tropical ones that are hard to diagnose, even the Ugandan staff think so. In fact, they asked Dr. Jo to do a continuing education day on skin diseases on Wednesday. Go figure, we thought they may know more than us on the tropical stuff.


• I saw a 9-year-old boy in the wound tent getting a scalp dressing changed. The staff happened to notice he had jiggers under his nail beds, and apparently, under his toe nails too. This is a parasite that comes from the dirt and poor hygiene. .. Again that darn soap!


• Pain is just all too normal and people are so stoic about it…My worst patient of the day, or the saddest, was the most “patient” patient. This may be gross, sorry, but it’s nurse talk:
  

  She was a 20 year old G2P1Fetal death1, which means she has had 2 pregnancies, one live child and the loss of one. The baby died at delivery. She says this all so nonchalantly. I asked if I could examine her. This young lady had what is called a vaginal-vesiculo fistula where they must have nicked her bladder in the c-section and she had been dealing with this for 6 months.

  It was sooooo sad to me that she didn’t think to get help sooner and she’d been living like this. I confirmed my findings with Dr. Jo and made a referral to the Embarara hospital for repair. They may have to wait for a specialist to repair it. I wonder what other problems she may have after the repair? We will visit the hospital tomorrow to see what our referrals are headed for.

  I am so thankful for our medical care at home but life is so unfair, she should have the same.

• One of the funniest things that Deanna and I are enjoying is giving out the reading glasses. There is a bit of a glee when someone who hasn’t been able to read can read again. Pretty simple.

Good night all from Uganda…
Nurse Janey