Hospital?

Really?  That was a hospital?  Don't get me wrong the building was pretty nice for here and there were IV's hanging on a couple people, but that was about it.  They are so hurting for meds, equipment, and energy it was almost unbearable.  I was supposed to go to a far out clinic along the main road today, but I just couldn't stomach the ride.   It would have been 1 1/2 hours bumping along in a packed Land Rover type car, 3 hours of work and the same bumpy ride back.  So not worth it so I said no, and went to the hospital with Cher, a retired ER doc from Hennepin County.  She knows her stuff that's for sure.  We saw some interesting patient we could do nothing for.  One was an HIV positive 20 something with probable TB.  She'd had TB a few months ago and never finished her meds.  She was gurgling and hacking up a storm.  She was without a mask and in the women's ward with another HIV positive woman with typhoid who was 19 and looked 10.  When I heard the diagnosis I backed way away from the woman and made sure she coughed only into her piece of cloth she was holding.  First thing was to explain infection control to the workers and get her isolated.  From there we could talk treatment but in an environment in which there is little testing and few meds and one in which the clinics don't know what the hospital has or is doing and vice versa, there is little hope for this woman.  

The other patient worth mentioning was a man in his 20s or 30s who was referred to the hospital by one of our team who was working at another clinic.  The man had stolen a pack of cigarettes and as a vigilante punishment been heated on his head an back.  He was sitting on the ground when someon poured a bucket of "caustic water" on his upper back.  The chemical ran down his back into his pants and he sat in it.  He had third degree burns on his buttocks and upper thighs and second degree burns on his face, arms, legs, scrotum and penis.  He was a mess.  The ambulance ride was torturous over these roads.  We had Tylenol for pain and 10 mg of of diazepam.  Cher decided to de ride the scrotum and perineal burns while leaving the scarred buttock burns alone.  The man was understandably agitated so we decided to give him half of the available diazepam IV.  The hospital staff was laughing and chatting so the administration of the med was leisurely to the point Imalmost took over.  I did become somewhat drill sergeant like.  The IV was useless and by the time that was discovered they only had a tiny bit left.  Needless to say the man suffered all the way through.  Harper is a more affluent city south in Maryland county.  The man is from Maryland and has family there.  He should be getting his treatment there because family members can go buy supplies and bring them to the hospital if they are needed.  Turns out the man is a criminal wanted in Maryland County and is afraid to go back.  He is going to need months of care if he doesn't get septic and die.  He, like many others, is in a real pickle.

My day was exhausting and interesting.  Cher and I worked well together.  The glacial pace of the place and the lack of knowledge of what supplies they had drove me nuts.  There is a super complacent attitude born out of chronic deprivation that has almost completely killed creative thought. I get it.  I would probably have the same problem, but it is very frustrating and very, very sad.