Friday, June 6, 2014
How Do You Walk Away?
Overwhelmed. That's the best word I can find to describe the last several weeks of my life. I recently began my 8 week internship at Jinja Main. The internship is part of the requirements I must go through to become registered as an RN with the nursing council of Uganda. Registration is necessary for me to do what I do here legally and for my work visa. I have wanted to write this update everyday since I started this process, but I'm so exhausted at the end of every day I just couldn't do it. So this is just going to be a brief update to let you know what is going on.
Jinja Main is a government hospital and is the main referral hospital in Jinja. It serves well over half a million people and has a 500 bed capacity. It frequently surpasses that number. I'm not even sure how to describe in words what this place is like. Sure, you may be able to imagine what a third world hospital must be like, but to experience it in person...not just as a spectator, but as a nurse doing patient care, it's....overwhelming.
For the first two weeks I was on Ward 4, a men's medical/TB ward. The incredible suffering of the patients there and the lack of resources is crippling. Even when we know what to do for the patients, the resources to address the problem are often times simply not there. This hospital can't even take your vital signs unless a nursing student has brought her equipment...blood pressure cuff, stethoscope, thermometer. If you are in the hospital as a patient, you better hope you have family or friends who are willing to come and care for you, 24 hours a day. They must provide everything for your care: bedsheets, food, gloves for the nurses, medications, IV cannulas, tape, gauze, everything. Otherwise, you lay there, unattended, hungry, dirty and worsening in condition each day.
I watched as Ben, a man in his early 40s, lay there in a dirty bed, on a torn foam mattress, naked...day after day. He was a living skeleton. Ben was suffering from full blown stage 4 AIDS. Rose, a nursing student, and I tried to keep him covered, to preserve dignity, but he wouldn't allow anything to cover him. He was cold, like a corpse. He was depressed and wanted to die and would try to throw himself on the floor to kill himself several times a day. Rose and I would go and pick him up, put him back on the bed and pray for him. His twin brother tried to care for him but there wasn't much that he could do. One week after I met Ben and began caring for him, he died. 8 others died that same week. Many of them from preventable causes. What do you do when you know what needs to be done, but have none of the necessary resources? Overwhelmed.
Last week I began my rotation in Ward 9. Everyone who knows anything about this hospital knows that Ward 9 is the worst of the worst. It's a surgical/orthopedic/burn unit. It's dark. It's dank. It's dirty. So dirty. There are exposed bones, bones in archaic traction devices, people with burns on over 50% of their body, severely malnourished children with gaping wounds. During dressing changes and treatment time, there is literally screaming and gnashing of teeth. Hell on Earth. And it's completely overwhelming.
But as overwhelming as all of that is, I have also been overwhelmed by God's goodness. He has given me favor with the nurses and doctors that I have met so far (this is a huge blessing as Ugandan doctors are notoriously mean and defensive toward outsiders...anyone really). He has shown me the kindness of certain nurses who, though they haven't been paid in over 6 months, continue to care for and buy food for indigent patients. He has shown me that even in the pain and suffering and severe lack of resources, there are glimmers of hope. I see it in the resilience of some of my patients. I see it in Sister (nurse) Molly's concern for the patients even after dealing with such horrible conditions for so many years, day after day. In some strange way, I'm actually 'happy' to be there. I find satisfaction in teaching the nursing students and Medical Officer students (like physician's assistants). I have quickly grown to love certain patients and am very attached to them. At first, I thought I wouldn't be able to wait until this 8 week internship was over. Now I can't imagine how I'm going to stop going there. I need to know that Francis will heal from his burns, and I need to see little Ryan (2 years old) gain weight and come back from severe malnutrition and heal the huge abscess on the lower half of his body. How do you just walk away from people like this after you've met them and loved them? You don't. I won't. And I'm not even half way through.
And just in case you were wondering...yes, I do in fact have to wear a uniform which is an antiquated white dress. It's stunning.
Community Health Initiative Director
Fount of Mercy