No Room for Errors

I got really excited yesterday when the temperature dropped to 25º in the shade.  Winter is approaching and all the locals are wearing jackets, if they can afford them, and protecting themselves from the cold.  The downside was it was too wet to go out.  Everywhere was flooded, there was no transport, boats were required, and all the shops were shut.

Some of my students have gone to Wau teaching hospital for their clinical placements.  I have been going there in the mornings to teach them in the wards.  The wards only run at 30% capacity for a number of reasons.  No one would ever criticise the Edinburgh Royal after seeing this place. Everything you do and teach has to be adapted for the environment and limited resources.  Malawi had so much compared to here.  Goats and dogs wander round the hospital and sometimes go into the wards.  Water is pumped in the yard for the wards, patients sit under the trees with their families when they are able to mobilise, and some of the buildings are derelict.  If you can’t pay for drugs you don’t get them.  Staff and visitors sometimes have a whip round to pay for drugs or catheters etc for patients.  A few months ago a patient died after surgery so a relative went there and shot and killed the surgeon. So I’m hoping I don’t make any mistakes.  I think someone should consider an effective complaints procedure.

In the afternoons I’ve been returning to college and teaching there.  No matter what I’m teaching I finish each class by asking them to work out a drug dose and a drip rate. I realised, to my horror, that many of them lack basic maths skills, or sums to you and me.  Everyday I tell them that there are 1000 mgs in a gram and 1000 mls in a litre and they continue to make the same errors.  As far as they are concerned there is anything between 50 -5000 mls in a litre. They are not so extravagant with mgs and grams but make huge errors including 100 grams in 1 mg.  I’ve given them a formula to work out drug doses and drip rates.  Sometimes there is a glimmer of hope then it fades away the next day. 

Most of the students are lovely people, some have been soldiers since they were kids, many of them were refugees, and some are supporting families.  They have to study by candle light; some of them never saw a text book until they started nursing college.  They have learned by rote and have never had to understand anything or work anything out.  They just remember things.  Trying to get them to think critically or see the bigger picture is daunting task.

The students have started calling me sister; they used to call me teacher.  Sister means lots of things here.  There are the nuns and they know I’m not one of them.  Sisters on the wards they tend to call “the in charge” but mostly sister means friend.  It’s a term of acceptance as being one of them.  The street boys call me sister too.  If they call you mother that is showing respect and if they call you grandmother that shows the greatest respect but there is no warmth in these names or acceptance.  So it’s good to be sister.

If anyone wants to email me John can give you my new email address but messages are still forwarded from my lineone address.  I hope all is well and you are enjoying the cooler weather.