Wednesday, March 26, 2014

day 6: settling in & a few hiccups

thought you all might enjoy a quick exterior tour of new workplace: 

driving in to the hospital. most signs are in both english and zulu.
just after coming through the front gates: new building being constructed (new ED, outpatient clinic)
driving around the back of campus for parking: great view of the main building.
another view of the main building. the trailer in the foreground is the iteach office which is home base for us.

our second day (tuesday) at edendale started in a very familiar way: 8am morning report! led by the post-call registrar (resident) or intern, the flow is fairly similar to any other morning report you might find yourself in: a case presentation followed by discussion. at edendale, the post-call intern or registrar typically presents an interesting case they admitted overnight. it's not typical to have any "admission labs" back at that point, and no imaging would have been available apart from radiograph films which could be viewed on the light box. the focus is primarily on the presentation, physical exam, and differential diagnosis; the discussion typically focuses on the management of the ultimate diagnosis.

morning report room. note the light box for xrays on the front table. no computers here!
at the end of morning report, an actual morning report (fancy that!) is given to the teams coming on to intake (call): number of patients waiting in the ED for beds, to be admitted, and any exciting overnight events. on this particular morning, the night resident also interjected that part of first floor of the hospital was completely uninhabitable secondary to sewage pipes having burst in the hospital overnight. (suffice it to say, we weren't the slightest bit disappointed to wear our masks today!) this rendered a large part of the ED, the waiting area, and a room where already admitted patients waited for beds (columbia people: think 'launchpad' patients all put in the same room!) completely unsafe for people. additionally, the operating rooms had to be closed. the medical outpatient area (MOPD), which had actually been without lighting for unclear reasons the prior day (clinics were being held in semi-darkness with flashlights!) would also have to be closed. so much for business as usual to get oriented to.
the ED: i had snapped this picutre the day prior to all the excitement.
as a result, the consultants (attendings) and medicine teams sprung into action and all descended on the inhabitable parts of the ED and waiting area. it was amazing to watch the surgeons, ER docs, and nurses all pitch in to help find places for patients to wait to be evaluated -- and to watch all the medicine teams work tirelessly to help triage patients as quickly as possible to ensure expeditious care for the sick. ward rounds had to wait. although it was far from a "normal" day at edendale, i quickly got a sense of the spirit of the place and the admirable efforts of the teams.
this appeared in the doctor's room sometime in early afternoon. (MOPD = outpatient clinic area)
getting better acquainted with members of the team and nursing staff has helped flesh out edendale hospital's motto: silwanezifo, silwanobubha, sinikaithemba (zulu for 'fighting disease, fighting poverty, giving hope'). it is a place of tremendous hope in a country struggling not only with the devastating disease burdens of HIV and tuberculosis, but the after-effects of years of apartheid -- a place where passionate, deeply-caring white doctors work alongside their zulu brothers and sisters, striving to mend broken relationships, all aiming for a common goal of bettering their community and ultimately their country. i consider it a tremendous privilege to be witness to this, even in small ways available to me... even on days the hospital is covered in sewage. :)

until next time,

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