Thursday, September 8, 2011

Medical Care in the Third World.

My sister-in-law had surgery today, and I am appalled at what I observed.  I am so mad I don't know whether to scream or sit on the floor and cry, or both.  I never want to hear another person from an industrialized country bitch and moan about how long they waited in the ER.  Don't tell me how the nurse was mean, or the doctor was rude.  Just shut up and sit down and be thankful for the advantages you have.

Yesterday we were talking to Sis and she told us that she had been scheduled for admission last evening, but had been asked to come in this morning.  There were so many peopled admitted they were putting two patients per bed.  Juan thought she was joking.  I thought he misunderstood her, so I just told him that if they tried to put her in a bed with another patient we would just bundle her up and take her home.  After all, I may not be working, but I am still a nurse.  Just in case, I took my BP cuff and stethoscope with me this morning.

Everything was going well until a nurse came out of the OR with a uterus in a jar the family provided.  I couldn't believe what I was seeing.  It seems they have no way of doing the pathology in Tocoa, so my nephew will take it to La Ceiba.  It will take a week or more to get the report.  Oh well, at least it was in formaldehyde.

The doctor did not come out and speak to the family.  Neither did the surgical or the recovery room nurse.  My BIL says it is not normal for anyone to come and speak with the family.  We were lucky because there were enough nurses/friends coming and going to keep us informed.

About 2:00 PM the nurses wheeled Sis out of Recovery and to her room.  Let me stop a second, and add some background.  Sis has been a nurse in this hospital for all her adult life, 34 years.  Usually nurses and hospitals take care of their own and make room for a co-worker.  Evidently not here; or maybe they did and that's why she wasn't sharing a bed.

Anyway, when we got to the room I looked inside and I almost fainted.  There were two ladies and their newborns on beds up against one wall, and both babies were screaming.  There was another woman on a bed under the windows who was obviously a fresh post-op and on the other long wall was a second fresh post-op and then Sis's bed.

This was not a big room.  This room was designed to be a semi-private room and it is a five bed ward. You never put pediatric patients, especially newborns, with adult patients, especially surgical patients.  That is a disaster waiting to happen.  This, along with the overcrowding, sets the stage for cross contamination.

The gurney being used was probably last used in the industrial world about 1930-40.  The bed was so old that I don't remember ever seeing one like it.  It was the size of an old gurney, about 25-30" wide.  Forget automatic controls; this one didn't even have the old crank at the foot to raise and lower the head.  You have to stand at the head and manually lift it.  Okay, Okay, call me a spoiled American Gringa.  After all, that is just the gurney and the bed.

When the nurses transferred Sis to the bed, they left her flat on her back.  Most surgical patient are left with the head of the bed raised at least to about 15 degrees, if not higher.  This helps keep fluids from collecting in the lungs and makes it easier to breathe.  Not one of the nurses checked for bleeding or even looked at the bandage.  No one checked to see if the Foley was draining, which is just as well, cause I didn't see one.  No vital signs were taken.  No pillows were put behind her to ease the pressure on her back.  She wasn't propped on her side in case she vomited.  I could go on, but I won't.

While I was building up to throwing my hissy fit Macho Man decided it was time to get me out of the hospital, so he said we needed to go to the hardware store and then home and hustled me out the door.  On the way out I was frantically trying to explain to my niece how to get her mother to deep breathe and cough; how to turn her from side-to-side; how to prop her up, etc.  I was also begging her to take Mami home and I would come and stay for a couple of days.

It is a shame when a medical system has a mission to provide good care to its users but does not have the equipment or the personnel to carry out that mission. It is a shame that many countries have no set standards of care and no way to enforce higher standards.  It is a shame good medical care is not a right of every human being.

Sis is okay for now.  I have no doubt she will fully recover and the pathology will be all right.

We are blessed.  If we have good medical care, we are doubly blessed.

1 comment:

  1. Actually Patty, I'm very surprised you weren't aware of this issue before. You've been married to a Honduran longer than I have. My wife is from Choloma just outside of SPS and she once told me how nice the hospitals are in the U.S. I didn't think anything of it until I saw some photos in La Prensa Honduras of a hospital. She told me that was how it was for the public hospitals which of course the majority of Hondurans visit. Unfortunately, you won't get close to U.S. standards without paying some bucks.