Saturday, May 19, 2012

May 19th, 2012

I'm sitting in the airport terminal at the Juba airport, preparing to return to the US after my first stint working as a teacher of junior doctors at Juba Teaching Hospital. As I watch expatriate aid workers arrive on the incoming flight from Nairobi, I feel like a seasoned veteran. And yet I've only spent two months here. Sixty days. Barely any time to even get acquainted with a place. Eight short weeks. In some ways, though, it certainly seems like it's been longer.

Working at the Juba Teaching Hospital has been challenging. Lack of essential medications, equipment, and skilled manpower makes taking care of very sick patients even harder than it should be. Certainly, some patients present too late to be saved, even if they were cared for in a first-class institution like Massachusetts General Hospital. But many patients present very sick, yet early enough that they have a chance. Unfortunately, many that should make it do not.

Our goal is not to bring MGH to Juba. That is neither possible nor a good use of time or funds. With diligence, patience, and a cooperative attitude, we hope to raise the level of care to one that is expected of a national referral hospital in Africa. This is feasible. This is necessary. But it won't be easy.

There is so much work to be done. When an elderly patient admitted tp our ward with diarrhea and weakness, unable to care for herself, receives no nursing care for 24 hours, or when a lecture I worked on for several hours is attended by less than half of the junior doctors expected, I feel disheartened. When a patient dies because there is no IV tubing to give medications and fluid, or when a patient with severe anemia fails to get the prescribed blood transfusion because no one walked the 25 meters to the lab and brought the blood to the patient, I feel like the challenges here might be too great after all.

Yet we get up the next morning, and we try again. We encourage the nurses again to clean the patient in need. We work with visiting pharmacists to address the myriad of medication issues plaguing the hospital. We bring in expert nurse instructors to coordinate between the ministry, hospital, and the school of nursing to improve nursing care. And we work side by side with the young physicians that are charged with caring for one of the most impoverished and traumatized people of the world.

Jeff Pierce, MD

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