Rob and the childrens ward

Well I had the great privilege this week of sitting with my husband while he worked on some patients.

Rob is 3month rotations at the moment.
And his first 3months is in paediatrics.

The paediatrics here has 3 wards.
The malnutrition/feeding clinic, main paed's and then special care.

You do 2 weeks of malnutrition and special care and then swap over and do main paed's for the next two. And so that continues for 3 motnhs.

There is one other intern so between Rob and the other intern they pretty much run the kids departments.
So one does one section then they swap for the next 2 weeks.

In main paediatrics there is also a main doctor but she is only there for a few hours a day.
Otherwise your on your own and in malnutrition and special care there is no other doctor unless you called for someone.

Malnutrition is a hard place, most children there are there for a few months recovering from near death due to side affects from malnutrition, mostly anaemia and things like that.
Rob has lost numbers of children here so far as many children are bought in too late, and by the time they find a vein to test child's blood type, it is often too late.
This is heartbreaking when they know that if the child had only been bought in earlier they still may have been able to find a vein quick enough to find out what blood they need.

Special care is severely understaffed with nurses.. Rob arrived yesterday morning to find 3 babies were passed away in the cots..... and no nurse knew how long they had been gone for! Hard to believe but they are so understaffed and the babies parents weren't with them at that time. Many parents have to go and care for their other children through night while husbands are away working etc etc.

MAIN PAEDS

Main Paed's is CRAZY... this is where all the other kids come, most have malaria or some sort of preventable disease.
There is 26 small cot beds.... but the day I was there I counted close to 35 patients plus parents. and sometimes grandparents.
















Once the child is seen by doctor and admitted it is up to the parent to find a spot for them, so if no beds then its often on the floor, and if no floor space due to all the parents on the dloor with their kids, then under the cots.





Rob works 7 days a week.
Weekdays are from around 8am to 4-5ish if in malnutrition but if in main paeds he is usually not home till 8 - 11pm.
And he is always on call. Interns are the ones called in - there are no main doctors there at night or weekends.

Weekends we get a little sleep in and he goes in about 11am and then is home early evening if a good day or later if busy.

Sunday is the same but we go to church at 8am and he goes from there to hospital normally.

Last Sunday we decided we wanted to see how long it would take to hospital to walk.
We had been to church and had lunch, Rob had been having a really bad headache all weekend but had still been working... he decided to go in mid afternoon on Sunday so we walked to hospital.
We thought since he'd had no phone calls from the nurses that it must be quiet so he'djust see new patients and thought they'd only be a few.
We were wrong.

There was a big line up - so for next few hours I sat watching Rob work.
Hospitals are very different here. Nurses and doctors do not go to patients bed 
Due to it being so crowded there is no room to move.








So rob sits in one spot and they line up on chairs to see him - parents hold their sick child.
It is the same for the nurses. The nurses are in one spot near Rob and people line up for their
treatment and see the nurses then.
if the parent has been told the child needs a treatment or medication or an injection in their canuler t3 times a day or something, then they carry their child and sit in line to see the nurse for medication 3 times a day.
















And due to so many patients and understaffing, if the parent doesn't do this, then the child probably won't get its treatment. And sadly this happens all too often, with parents having to leave and look after other kids, or go and leave hospital to buy medications ( not all medication provided)
or to go up to the kitchen to cook their own food ( NO food provided), often the children miss their medications etc.

This makes Rob incredibly frustrating, because there have been times they have lost patients when if the parent had insured the child got its treatment it could have been prevented

Watchng Rob work was amazing. I found it so hard and sad- screaming in pain children everywhere. It all happens in open so I saw many children screaming as a nurse tries to find a vein to put a canular in..... often it takes more than 5 or 6 goes especially in the little bodies that are shutting down.

Rob is so patient although I know he gets frustrated at times when parents have left it too late to come to hospital, but we remember that for many of them they come a long way to get here and money often stops them from having the money for transport sooner.

Rob doesn't know the local language ( although he know 10 languages ) :)
So he has had to deal with lack of knowledge.
He has to rely on other parents to help him interpret but amazingly he has learnt so many local words that matter that he does amazingly well I think.... he says otherwise.

I got starred at for the many hours we were there as I'm sure they don't often have a white girl in there... especially one that is a local doctors wife.

I am so incredibly proud of the man that Rob is. So many of the nurses sung his praises. Rob is incredibly committed to his work and his patients.
He prays for them morning and night with me, and I know constantly throughout the day he is praying for wisdom.

Sometimes I feel like I am not doing very much here but Rob keeps telling me I'm keeping him going. I can't imagine how difficult it would be to do this job he does without someone to debrief with.
Although I don't always like hearing about his day, especially on the hard days when he loses a baby or child, or when it is particularly grouesome... I know that my listening ear, hug or sometimes a word from God is what he needs.
But I must admit, on the days when he cries too, I find them especially hard to know what to say. So I usually just hold him.

I know men are meant to be strong, and Rob is incredibly strong, but he is also incredibly tender. And that is what makes him such a great doctor.

We only have a few weeks left in paediatrics before he moves into main medicine ward but it has left an impression on us both.
Paediatrics I'm sure is where Rob will end up one day.
A cardiac surgeon for children would be his dream.

I have attached some photos from the main paediatric ward, hopefully I'll get some more soon of the other kids wards.

 There's no real bathroom so basins and water in jerry cans is used - children usually use the buckets to for the bathroom and parents carry that to the bathroom,save moving kids all the time.