Wednesday 13 January 2010

Making a difference?

This week has seen the start of my new role as the clinic doctor. I am going out to the outlying clinics 4 days a week to see patients and do some teaching to the sisters there. This will surprise anyone who read my comments on my first clinic visit but since then I have begun to recognise the importance of providing good care to patients near to their homes (so many patients cannot afford to make the journey to hospital) and also the need to support the nurses who work so hard out there and can sometimes feel very isolated from us (as we feel isolated from our referral hospital).
So daily, I will pack up my little lunch, climb in to my enormous 4x4 and bump off down some dirt road to a small building where up to 40 patients are awaiting my arrival.

Day one was however not a good start. At about half past 9 in the morning I saw a baby who had been born at home the day before as his mother couldn't afford to come to hospital. It was her first baby and luckily she managed a normal vaginal delivery (due to the commonest pelvic shape here, a lot of women struggle with this). She had come in for a check-up and the baby had been found to have a very high temperature but otherwise seemed well. In such a young child you admit them to hospital for intravenous antibiotics whilst looking for the cause of the fever. I duly organised the paperwork and drugs and the nurses called an ambulance.
At half past 3 as I got ready to leave, I realised that they were still there.
Officially the government vehicles are only supposed to be used for transporting staff and goods and ambulances are to be called for patients. Apparently if you are found with 'illegal people' in your vehicle it can be impounded by the police. However, I felt that I could argue my case for this one (he had already waited literally half his life for an ambulance).
I bundled them in to the back of the car, teaching the mother how to use a seat belt and trying to ignore the complete lack of a car seat. We then drove the 45 minutes to Mosvold.
On arrival, the baby was dead.
And I know in my heart that I couldn't have done anything differently had I known at the clinic or en route, but the idea that it died in the car, or possibly even worse that I didn't notice as they got in makes me not only feel like a bad doctor, but also quite sick.

2 comments:

  1. Caroline, I think that you are doing an amazing job and it makes me really proud to know you. Whether you believe it or not you are making a HUGE difference to peoples lives.

    Love Jen.

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  2. Ah babes I dont know what to say, but i am sure you are doing an amazing job and making a big difference! xxx

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