Our time at Tenwek is drawing to a close. The past week I’ve been very busy finalizing details for the redesign of numerous process and operational changes.
Two days ago I met with the 16 charge nurses to go over some of the proposed changes. The feedback was very positive. Yesterday I met with a couple of long term missionaries to go over 6 pages of details as they will be taking over the implementation of the proposed changes. It was nice to be able to pass them on to a couple who are very capable and passionate about quality improvement.
There are still several details and revisions to finalize this week but I feel a real sense of satisfaction and accomplishment with what has been achieved so far in a relatively short period of time (it would likely have taken two years to accomplish the same amount of changes in a similar sized North American hospital due to the numerous layers of beaurocracy).
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As a result of lots of time spent on administrative tasks, and the fact that on the medical floor my time is spent supervising and teaching the interns, I haven’t had as much direct pt contact the past few weeks. This weekend however I’ve been on call and have had some direct patient contact with a few people who died.
This morning I was present with the mom as she watched her 26 yo daughter die in respiratory distress due to severe TB, pneumonia and HIV. All I was able to do was put my arm around her to comfort her. As her daughter slipped away she started to wail. She was then taken to another room by the chaplain for further comfort and support (and to remove her loud wailing from a room of 16 other patients). There was more wailing an hour later when the rest of the family arrived during visiting hours and discovered an empty bed. It was particularly difficult to hear the higher pitched wailing from the 4 year old daughter, with no mother to comfort her. Many of the people who die here on a daily basis are children, teenagers, young wives, husbands and parents. There are many heartbreaking situations.
On the brighter side, I had a very happy mother of a 20 year old son come to the nursing station to show me how well her son was doing today – she was beaming, and so was her son. He is currently on his 8th day out of the 10 day treatment for bacterial meningitis he is currently undergoing.
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Many of the patients come to Tenwek in a state of severe physical malnourishment due to vomiting, diarrhea or difficulty swallowing. I was struck by the contrast of how well nourished most of the people in hospital back home are – in fact “over nourishment” is a major contributor to many chronic diseases. However, many people around the world are also plagued by a more insidious and serious condition – spiritual malnutrition. It reminded me of the scripture “what does it profit a man if he gains the whole world but loses his soul”.
Daktari,
Dad
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