We have been here a bit over a week now. I feel as though I am finding my way around
and able to contribute to the health and well-being of the patients.
Last night, we had dinner with the hospital management
team. It was interesting to hear how the
relationship with Ilula hospital developed.
Randy, Gary, John and Ken don't just "talk the talk" but also
"walk the walk" They work
tirelessly to continue the relationships that are built here as well as improve
patient care and provide sustainable economic development.
I have seen my first ever cases of Kwashiorkor (protein
deficiency and Marasmus (protein and calorie deficiency). It seems that many of these cases are
overlooked. Understandably, because
there is little to treat the malnutrition and the concurrent diseases are first
and foremost in the clinicians' mind.
Malaria, HIV, pneumonia, to name a few.
We just received 50 cases of Plumpy'Nut, which is a high
calorie, high protein paste that comes in a foil packet. The supply of this supplement is not
consistent, but now that we have it, we are using it!
The packets contain about 500 calories and 13 g of
protein. It also has some Vitamin A and
Vitamin C. The nursing staff and
clinicians have been very supportive and the patients are receiving and
consuming the correct dose.
Many procedures are different here, not the least is the
language. As allied health
professionals, Mark and I have been at a bit of a disadvantage, because we need
to interview the patients to determine the correct treatment. We often use the clinician as an interpreter,
and that slows them down,
For example, this morning on rounds, I spoke with a newly
delivered mom of a small weight for gestational age baby. The baby was nursing well, the mom's diet
contained sufficient protein and calories, therefore, no intervention
needed. Yippee!
For another case, I had an interpreter. The mom was HIV positive and looked malnourished. The baby was small, and not feeding as well
as we would like. I prescribed 3 packets
of Plumpy'Nut for the mom. This way, she
will have sufficient protein and calories to produce high quality breast milk
in sufficient quantities. It was a great
experience to be able to counsel patients about their diet and feel like I
wasn't rushed. I felt like the patient
received good info and I was able to assess their compliance.
Tomorrow I will give a short inservice to the medical
staff on how and when to prescribe Plumpy'Nut.
I know the staff were stunned when I prescribed Plumpy'Nut for a mom,
and not the baby!
Just a few more days before we leave the hospital and go
on another safari.
Then back to the US for Mark and I on the 29th.
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