Kate's first week at work
Written on Sunday 12 October, 2008
We’ve come to the end of our first week at Kisiizi. I’m sitting at our desk in our living room, watching the torrential rain create rivers in the red mud, and thinking about how to summarise my experiences so far.
It has been a busy and challenging week. Eleanor and I are some of the most senior doctors in Kisiizi, and definitely have the most paediatric training. This has been daunting in itself. It is fantastic to have Ann around to ask for advice – as she has extensive clinical knowledge and experience after running the paediatric services for the past 12 years.
I have spent most of my time on the Children’s ward and the Special Care Baby Unit. The Children’s ward has about 25 beds, but if there are more children they share. Thankfully, it has been fairly quiet this week – just as well as I still manage to take most of the day to complete the ward round! Eleanor says that it takes twice as long because of the need to translate; I’m kidding myself that this is why it takes so long.
Cases that we have seen this week include a 15-month-old with TB spine and a skeletal dysplasia; cerebral malaria; burns; and cervical spine subluxation after an assult. I also learnt that wandering through out-patients after work to take photos is not a sensible idea. I came across a malnourished child with pneumonia, hepatomegaly, and malnutrition. He did improve with IV antibiotics and a blood transfusion (his Hb was 4.7!) but we are not sure what the hepatomegaly is due to.
SCBU is also rather daunting. We have 4 incubators and a heated nursery for the other babies. Treatment is limited to NGT feeds, IV antibiotics, IV fluids and aminophylline for apnoeas. We have a 33-week twin who probably has necrotising enterocolitis but as the only fluid we have is dextrose and saline, we are having to reintroduce feeds. The nurses who run SCBU are generally enthusiastic about the babies, which is great.
Next week includes introducing resuscitation training for the doctors – it will be interesting to see how their practice compares to APLS / ETAT!