Wednesday, May 30, 2012

Solola' Hospital (post by the good dr)

To start with, I'd like to say thank you to Beth for inviting me to bust onto the blog.  This is the first time that I've ever blogged, and I'd always dreamt about hijacking her blog and putting a hilarious spoof post on here.
Now that I've been invited, I figure I should be good and take this seriously--and besides, as the following photos will show, nothing too funny (well, some of them are--just a little ).

The following are pictures from my trip to the local hospital here in Solola'.  One of the directors here at Eagles Nest was kind enough to arrange for a tour of the hospital.  When we walked through the front gates, we were met with the telephone reception desk.  I don't know if they were charging money for use of the phone or not.  (The desk operator was not wanting his picture taken, apparently, as he ducked his head when I turned around to get this shot.)  

This is a picture of the many long hallways between the different areas of the hospital.  

This is one of three pediatric rooms.  There were approximately 7 beds in each room, and three or four children in each room while we were there.  Most of them had either pneumonia or were not eating adequately, probably due to a virus that is going around this area right now.

If you look at the picture above and below, the bags tied to the ends of each bed are for holding the X-ray jackets for the children.

On the way down the hall in the adult wing, heading towards the critical care unit, I noticed this board announcing which drugs were not in the pharmacy:  lanzoprazole, ampicillin, potassium chloride, ketorolac, ranitidine, dexamethasone, and a couple I can't figure out.  Most of these are pretty basic stock items, though interesting enough, we have had shortages of many drugs we would consider basic in the United States over the past couple of years, too.

And the ICU.....

I found this woman's case very interesting.  (Oh, by the way, I don't think they have HIPAA-type restrictions on healthcare information, because the nurses were more than happy to share about all of the patients in the ICU.)  She had surgery in the middle of the night last night for a ventral hernia (hernia in the middle of the abdomen).  She has a central venous line going into the vein under her right collar bone to give her fluids and to monitor her volume status.  Normally we would monitor the pressure in the vein by using a transducer and it would produce a number on a monitor.  Look closely at the pole....  

A piece of IV tubing is attached to one port of the central line and the other end of the tubing is cut and taped to the pole, with centimeter markings on the piece of tape behind the tubing.  They use this to directly measure the central venous pressure.  Old school, baby.  

And I guess this oxygen saturation monitor (the only monitor present in this ICU) qualifies the unit as intensive care.  It was attached to an inebriated gentlemen who was still shaking off the night before after noon.  He still looked happily comatose while we were there.  In the bed next to him was a brittle diabetic in restraints, likely from delirium, but difficult to say given the language barrier.  They think he might have a pancreatic cancer, but they aren't sure.  And there isn't a CT scanner, so I'm not sure how they'll figure it out.  

 It is very eye-opening and humbling to see a place such as this.  Eye-opening, because I realize how  basic the ability to care for people is in developing nations.  Humbling, because I realize that these doctors and nurses are doing an amazing job with what they have, they truly are--and that I am not so sure I am as capable as they are without the technology and other advanced tools I've become accustomed to relying on to diagnose and treat patients.  At first glance, my thoughts were, "Well if they had this piece of equipment or this lab test..."  But they don't.  The next thought I had was, do I know what to do without those things.  Could I help these people?

And last but not least--don't get hurt in Guatemala.  They have very small ambulances.  :)

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