Shame (said in 2 syllables: shay-m) = that stinks

One of the most difficult, frustrating things about Bara is the lack of resources. The doctors are every bit at educated and well read as any doctors at home, but they are very short on the number of sisters (nurses), as well as medications and other medical supplies. The doctors are persistant to get the best possible care for their patients.

Example 1:
We went to see an outlier (patient in another ward, whose primary team is general medicine), and discovered that the sisters were giving the morning medication at 1200. Hmm . . . our patient had not had her "bloods" taken for labs yet, she was dehydrated with her IV fluids stopped, and was throwing up. She had received an oral anti-emetic, but had been unable to keep it down. My registrar and I hung the fluids, mixed the Zofran (IV antinausea medicine), and took the bloods while we were there.

Example 2:
For about 4 days now, we have been trying to get an echocardiogram for one of our patients. The registrar has taken the patient to the cardiology department 3 days in a row, but they have not received the echo.

I have come to discover that persistance, as well as a well-respected attending physician can get you much more in Bara than anything else. For the lack of resources here, the difference from the US is that these patients never worry about where the funds are going to come from to pay for their care. When they need chemo, they receive the top of the line regimens that are proven in the literature. Although I have spoken with several who wished they had taken out medical aid (insurance) prior to becoming ill, they do receive the care they need without worrying about how they are going to pay for it if they get well. The also do not worry about it running out, especially since most of our patients are in the hospital for several weeks to a month. They all are also relatively young, so many of them never anticipated becoming ill in the first place. I know so many people like that in the US.

Miss you!