Never Leave Home Without Immodium

The Spanish tummy does not have a look in with the African tummy. I'm looking on it as part of the experience, a part I could well do without. Apart from that its been a good week.

I survived my first week's orientation in a paediatric ward. There were 60 beds and through out the week the number of children ranged from 201 and 240. 3-4 to a bed, very ill children mostly malaria and associated problems like meningitis, anaemia, febrile convulsions and pneumonia. The other main problems were TB and HIV. 40% of the children born in the hospital are HIV+ve. There were a lot of children with burns as well. Most of the families cook in doors over open fires with no ventilation leading to accidents and chest conditions later in life.

The nurses have to improvise all the time. They use giving sets to administer 02 and suction tubes for NG tubes. They don't have the right size if needles or cannula. Its horrible seeing a baby having a huge cannula put in their wee veins. They run out of drugs and equipment half way through the day and just accept it. If a drug is out of stock they don't think about using an alternative and although they improvise there appears to be a lack of initiative.

The ward staff welcomed me with open arms were so helpful all week and appreciated my input. I know I'll never question why I'm here. Some of the nursing practice is questionable and since I'm only doing orientation just now I'm not in a position to try to change things. There is little in the way of infection control but since most of the children are on massive doses of antibiotics it helps. There are no such things as nappies or rubber sheets on the beds and most of the beds are burst with the stuffing coming out so you probably get the picture.

When all is said and done the Malawians are such happy people with a wonderful capacity to laugh. They accept their lot and get on with it with dignity. We have a lot to learn from them. I've not had any more unwanted visitors to the house as far as I'm aware. The priest has threatened to visit later this afternoon so I've told him I'll be out late. I'm looking at another house later today so maybe I'll get something more permanent sooner than I thought.

I'm off to a VSO meeting for the first 3 days next week and the I have 2 days in the HIV clinic. I can't believe that will be my first month in. Thanks again for all the comments its good to hear from everyone. A special note for Sara "Tell your Mum its OK for you to visit".