05.07.2016 - 05.07.2016
My typical day starts with a formal handover and ward round at 0830. We firstly go through the notes of every patient who has been in hospital over the previous 24 hours and discuss any issues. We then visit all inpatients and make a plan. Just like any hospital, there is pressure on the beds and the need to discharge patients quickly and efficiently to make space for more. I then get a coffee break!
At 10.30 I start 'consultations'. The patients are seen by a midwife in the antenatal clinic. If they require medical advice or an ultrasound, I am consulted. I sit perched by a bed in front of the ultrasound machine with a midwife to translate and assist.
My ultrasound skills are somewhat rusty (I now start to regret not doing routine unnecessary scans on my private patients for practice!) but passable. Several midwives are competent at scanning and I'll often let them take over to give me a break. I'd like to think I'm teaching them but it's probably more the other way around.
At lunchtime I wander back to the house and have a home cooked meal waiting. Today, a tasty fish goulash and salad.
At 3pm I return for afternoon consultations. It was quiet today. I saw several women late in their pregnancy with no antenatal care and no idea of their due date, I diagnosed twins on ultrasound at 25 weeks, arranged 2 inductions for women at 42 weeks, treated syphilis and amoebic dysentery. There is no such thing as Down Syndrome screening and no anatomy scan.
I do another round after the consultations, then again at around 9pm. In between times the midwives call me if there are any issues or deviations from the clear protocols that they follow. It is all very well organized and the midwives generally run a tight ship. I've think I've been lucky in the last couple of days with relatively few calls.
I have discovered the universal language....Candy Crush!! I was sitting waiting for a patient and started to play the (much maligned by my children) game.
All of a sudden I was surrounded by multiple staff who had heard the music. They whipped out their phones and all started playing and bragging about which level they had achieved. My respect skyrocketed when they discovered I am on Level 1344 (see kids, I'm not a loser afterall!). Then they realized I had an updated version and the excitement escalated. Did you know there is an app for transferring other apps by Bluetooth? Neither did I....but I do now! I was instructed to download this app via my internet connection. Everyone then turned on their Bluetooth and I was able to transfer the most up-to-date version to them all. The wonders of modern technology in the middle of Ethiopia!
Fun fact: Ethiopia has its own unique calendar. This is very confusing, particularly when dealing with obstetrics. The calendar is made up of 12 months of 30 days and a 13th month of 5 days (6 if its a leap year). The new year starts on September 11. Today is the 28th day of the 10th month 2008!
All the patients and the hospital run on this Ethiopian calendar. But the (non-Ethiopian) ultrasound machine and all the obstetric wheels obviously use our Gregorian calendar. It is impossible to translate one date to the other in your head but fortunately there is a conversion chart (and an app!).
And just when you get your head around this, the time is also different! Ethiopians start their day at 6am (or when the sun comes up) so everything is around 6 hours ahead i.e. when they say 2pm, they actually mean 8am. Very confusing. Fortunately the hospital sticks to standard time!
Finally, a big thank you to all those who gave me sympathy and advice regarding my bowel issue. I have cut back on the coffee and fruit as suggested. You will be pleased to know that things have improved and I still have all my lovely soft loo paper in storage. I will keep you posted........