30.3.10
Tansen, Palpa
29.3.10
update
21.3.10
start of a new day
Breakfast consists of bread and deep fried shrimp chips. Very basic foods here lacking nutritional value.
Walk out and find my safa tempo (electric three wheeled vehicle with a small front cab that fits 3 then 2 benches that fit a snug 10. The thing is, vehicles here look SO banged up rust everywhere. I realized that regardless of how well ppl dress, they are bound to get dirty. So everything looks dusty. Anyway, things are as per normal rubbing up against the damp bodies around me. Then the tempo suddenly stops, the driver was taking a call on her cell. This is quite interesting cause we just implemented a law in Canada banning cell phoens and driving. I should have congratulated her. But yesterday I saw some guy dialing and talking on a motorbike, mad skills that i'd like to master some day...
Finally get off and pay the driver for my trip up, only to receive some very damp change. i don't even want to know what that paper is soaked in. Sweat? urine? i wouldn't be surprised by any of it. holding it by the corners i'm not sure whether to just throw it out (and for me to throw out change it's gotta really bad) or not. I get to the pharmacy to buy some more metronidazole and to my surpirse is it's exactly 10NPRs, my change for 10 tablets. The trees have just been trimmed and in the process half the electrical wires have also come down with it. ke garne? what to do...
a day in a life.... and for some the last....
The doc's day started here at 0630 (after leaving the hospital well after 2100 last night) with a surgery then a constant flow of patients streaming in through the doors. Everyone from the underprivileged pt who only has the shirt on their back and hope that this thing called a 'hospital' can make things better for their child to the carefree diplomat.
everythign is a lack.
Power outages: Are a dime a dozen in this place. It's as if this place is gets a shot of adenosine at random intervals. Lights, computers and all electrical equipment gets momentarily suspended... the generator kicks in but ppl don't know to reset all the electrical things like the AC.
A child comes in reporting that a surgical consultation at the only Internationally recognized hospital in Nepal was 12,000NPRs. They were promptly turned off and checked in at another hospital that charged only 50,000NPRs for the consultation, surgery, recovery and entire hospital stay. It's brutal times for healthcare in this country.
Note: a good salary in this country is 5,000NPRs/month.
Mechancial ventilation 3,000NPR per day at the government hospital
mech. venitlation 10,000NPR per day at private hospital
Congenital Heart defect sx free. up to 14yrs, but the problem is qualifying them for Sx. recurrent infect'ns prevent them from being candidates.
another ER case turns into a disaster as i learn of what standard protocol in a country where wppl dn't know better is. due to the lack of resources and knowledge certain procedures are left not even sure what i'm to write. you'll just have to come and see for yourself. i'm just appalled at the situation. doesn't make sense at all the things you see here.. today was quite depressing, see that body.
should i be telling their entire stories or are these stories best left untold? perhaps i liiked things better not knowing what can be done or what's going on
don'tknow what to think/do... but it guess that's wat keeps you going...
19.3.10
update
Hey crew, sorry it's been a whil since updating, I'm goign to need some
approval for some expenses incurred. At the current moment I've spent
15000NRps for duty fees in getting all the donated supplies across the
boarder. The boarder rep was originally asking for 25000, but I arbitrarily
asked for 15000. When the final bill came out, I realized that only 1700 was
required by the government our boarder rep pocketted the rest...
other potential requests are
- air hose y-connector,
- screening for windows to prevent flies from entering the hospital wards
-
still trying to setup a bank account
So a typical day. Woke up at 0530 and saw off 2 friends at a bus station.
Went into the hospital early to get a head start only to be greeted by the
most ridiculous time waster exercises. E.g. physically cleaning ethernet
connection in the back of the computer to connect to hospital network. So
frustrating spendingso much time on things you know should take a fraction
of the time. It definitely teaches patience though. So finally finish a
draft for donation list for the charity and a coupon draft for free
pediatric consultations at the hospital. There's still a ton to do for the
conference which is in a week and the CPAP machine has yet to be setup due
to some connectors that still have to be obtained.. Things are slow in this
country.
Anyway, rounds today are a bit less depressing as most of the patients are
decently managed. But it's overkill for the director who rounds twice on
every pt in the hospital while doing outpatient services from 0800-2000
everyday. I remember the first day tha we rounded, there was pneumonia case
in the NICU intubated and ventilated on PC 25/5 FiO2=1.0, RR=60bpm. Modelled
and let's just leave it at that. Goign through charts, it seems there are
enough cases of kids who come to the hospital a bit too late. Perhaps
reflective of the fact that only ~19% of Nepal's births are attended by a
skilled birth attendant.