Monday 7th October 2019

Well,  what a day.  We were all pretty exhausted after the trip up but tried to set off early and get to work.  Unfortunately Arnold was a little late,  as he had lost his wallet,  plus driving licence,  insurance etc.  So a trip to the police station was required to get copies.

We went to the Referral Hospital first. What an improvement.  The new interns have arrived,  and were doing their first ward rounds,  looking rather shell shocked with no senior assistance and about 20 nurses following them around,  hanging on their every word!

Maternity was well organised with resuscitation equipment clean and to hand,  which was lucky as I had to help with a resuscitation.  Poor baby had struggled to get out,  with a huge caput (for those who understand) but was crying by the end with a major headache!!

The walkways are now all protected from the rain and we saw oxygen cylinders everywhere! Freyja is revising her normal ranges for smaller people as you get onto the adult medical ward once you are about 5 years old.!!

Off to the university hospital,  where we had hoped that everything was arranged for teaching,  only to find that the whole programme had to change.

I had a few people I had to meet to start planning our course next week,  I found one in theatres at the referral hospital and the other in theatres at the University Hospital.  Result.

We then walked around the new University Hospital,  it is starting to work,  with about 6 patients per ward. Freyja did a quick audit of the drug chart,  they are being used for everyone,  they just haven’t cracked putting the patient name on the chart yet,  but we were thrilled.

Then to theatres for a C Section and a laparotomy.  All seemed calm and organised, (not quite doing the checklist yet!!) but we will work on that.  We realise their challenges when the laparotomy, who had been on fluids with a bowel leak for about 2 weeks,  had not had any electrolytes done.  I suggested that we should get one,  only to discover there were no suitable blood bottles in the hospital,  to collect the sample and no reagents to make the measurements either. So we cracked on.   The anaesthetist doing the intubation didn’t like my cricoid pressure!!  but got the tube in and proceeded to ventilate at 600 mls and a rate of 24!!  We reduced that,  but they have a problem,  there are no long acting muscle relaxants.  We used a little pethidine to help relax the muscles!!  And ketamine to augment the halothane and 50% oxygen.  Seemed to be going OK,  till we had to leave.  I will find out tomorrow.

We then left for home and had a few jobs to do with mobile phones.  A nightmare,  I apparently have 2 numbers and can’t have any more. This resulted in another trip to police station where I had to accuse my husband of stealing my card!!  It worked,  I should have a card tomorrow.  Not to worry,  we now have a couple spare for the team next week.

A trip to the market to buy foam for Judy’s suturing tomorrow,  a pineapple for dinner and theatre hats.   It is now pouring with rain, supper filled a gap and the Nile beer was most welcome.

Now for the modern technology and learning how to tweet,  whatsapp etc,  thank goodness for Emma!! (young and knowledgeable)





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