Monday, 10 November 2008

The Hospital

At long last, I started at the hospital this morning. The very focus of my journey here.

Uma and I met up with the hospital consultant in charge, Dr Pandey. We talked about the things we would like to purchase, with approximate 400 plus pounds.

So far 650 pounds have been spent at the orphanage. A new double bunk bed has been ordered with all the associated furnishing (mattresses and beddings ) in preparation for 2 more children in the new year. They are 2 sisters to 2 of the children who are currently at the orphanage. I am also trying to get a couple of outings for the children organised before I go. There will indeed be some money left, but I would like to keep that flexibility available for the time being.

The hospital is in a big sprawling area consisting of many out buildings for the different departments. It reminds me of a very old victorian hospital in old England.It is specialised in tropical diseases and HIV/Aids management. It is a government hospital where treatment is free, hence catering to the very poor section of the population

Dr Pandey took me round and introduced me to the heads of different departments.I met the various sisters- in charge. I met my equivalence- Matron cum Head of Nursing for the hospital. Initially she eyed me rather warily, wondering what I was doing there, and only for 2 weeks anyway. However, once we warmed up, she was quite welcoming. In any case,I was pleased to escape her meeting with the departmental sisters, rather stilted and formal like in my nursing days on the wards

As luck or lack of luck would have it, the very first patient I saw on the special unit appeared dead to me . She was an emaciated woman . She was admitted the day before with advanced case of tetanus. Dr Pandey apologised as though he could have stopped her from dying because I happened to be there.Tetanus seems to be quite a common condition for hospitalisation here
The fever wards (diarrhea and vomiting and all infectious diseases) is housed on 2 floors with 100 bed capacity. The hospital can take up to a maximum 100 -200 patients during the monsoon season (june - August ). That meant many patients have to be nursed on the floor when the wards run out of bed. However, there were only 15 beds occupied at present because it is the dry season.He said the nurses are having abit of respite now till next year.

The wards are divided into large subsections . Each section can take up to 8-10 beds depending on the number of patients at the time. .There are no curtains round the bed. Privacy is not a primary concern , to be fair in this society. There are large metal bowls filled with ? lime water for disinfecting used masks, ?equipments etc. They are placed near the nurses station on every ward. They look disgustingly victorian.The mattresses on the bed have seen better days. They are the type we used in the 50s and 60s. They are covered in that horrible black thick plastic -that is, those of us who are old enough to remember. Majority of those mattresses are torn with the sponges or straws, I don't know which, spilling out everywhere. It was quite a sorry sight

I then spent sometime in the admission or rather emergency department with Dr Pandey and his team of Registrars/ Housemen.It reminded me of the vietnamese clinic at Lind. Even though there is a system in place, the people just crowded round the doctors when they tried to give individual consultation to the patients concerned. There was no privacy anywhere, and they didn't expect any. It was quite exasperating to just sit and watch

Every nurse I met today appeared to want to come to England to nurse. I think is to do with the buying power of sterling, comparing that to Nepalee Rupees (1 -123 ). With so much poverty here, and poor pay for the nurses , it is not surprising. So I had to manage their expectations in terms of NMC's strict criterias for practising in the UK

I have been left in the HIV/AidS outpatient clinic for the time being. It does not appear that I will be nursing patients on the wards.I just have to wait and see .I still have 2 weeks here. Otherwise I will need to dispose of the gloves I have brought out with me, thinking that I'll be working on the wards. As a precaution, I put 3 pairs inside my waist pouch this morning, just in case.

All in all , a rather gentle day than I was expecting. And I am grateful ...after the trekking.
Lets see what tomorrow brings

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