Galmi

The hospital is literally overflowing. We have expanded the "120" beds into the hallway, into extra rooms, practically outside. More patients than anyone would think possible. and we only admit the very sickest. unfortunately these are usually the very young, and the pregnant women. there are a number of twins, too, and some premature. we have no NICU. we have one oxygen tank outside of the OR. and only one IN the OR, so when mom is receiving oxygen during her C-section, there is none for the babies after they are born. Orders are not carried out with any kind of purpose or sense of urgency, even in the sickest people. there seems to be a general acceptance of the suffering, of the condition of sickness and perhaps not enough experience with people actually getting "better" to see that hurrying would make a difference.
a wise OB doctor from the US, Lydia, said today, "Time at Galmi is like the Lord's time: a thousand hours in His sight are like a day gone by..." more true than you can imagine.

After 2 days of work, i have seen scores of patients. there are several common themes: malaria, malnutrition, severe anemia (Hematocrit of 5-10% is very common, when normal is 35-45%, and is due to malaria) barely compatible with life, malnutrition, malnutrition, measles (5 cases this week), pregnancy-related complications, more malaria, some TB, some HIV (probably underdiagnosed because we don't have enough test kits), diarrhea, pneumonia.

Yesterday we admitted 32 patients. Roughly 25 of them were pediatrics that J and I saw in and out of Room 1 in the outpatient clinic. Most were malnutrition and malaria with severe anemia.
The last patient i saw at 9pm (on my first call night) was a 45 y.o. woman with Tetanus. This is more reason than i will ever need to insist on vaccinations against Tetanus. She had a wound 10 days ago that had since become dirty and infected, and the day before she came to Galmi, her mouth became clenched, unable to open it. This is the way tetanus begins. The mortality is 50% even with good treatment. She did not get good treatment because the orders i wrote for her (to receive medicines to counteract the toxin, antibiotics for her wound) did not get carried out after i left the hospital. when i found her this morning, the spasm and tetany had spread so that she was arched back, more muscles involved, with intermittent spasms causing more pain and distress. The medicines started this morning. Why? i asked again and again... no one seemed to know, but could only guess - "the pharmacy was closed"... and no one called the person on call for the pharmacy to get the medicine that could have changed the course of this woman's life. We prayed desperate prayers (again) this morning - asking Jesus to heal her in spite of our care.