Time for some obstetrics! I am working at
Mbarara National Referral Hospital
in south-western
Uganda.
The 600-bed facility is one of four teaching hospitals nationwide and is affiliated
to the
Mbarara University of Science and Technology. It has a large obstetrics
and gynaecology department with 24 doctors and 20 midwives, and is the first
place I've worked where the former outnumber the latter. The hospital has
approximately 8000 births a year (a similar number to
Liverpool Women’s Hospital, my former workplace) but has only three beds on the ‘labour ward’. The
literacy rate in
Uganda
is improving at
73%, but for the less fortunate there is a handy clue at the
entrance to the department that they are heading in the right direction for
their obstetric and gynaecological services (see photo below).
 |
| Dr Kim outside the Obs and Gynae ward |
The first few days were certainly eye-opening. There is a
general air of chaos on the wards which takes a little getting used to, but I’m
beginning to acclimatise to the mayhem. I delivered someone at the foot of a
tree on the way to work one morning which is not something I’d experienced in
the UK!
Quite why the patient was not occupying their bed that was only 50 yards away
is anyone’s guess, but I have never left the house without a pair of latex
gloves since that occasion.
The staff are incredibly friendly and helpful and I’m
getting used to ‘Ugandan Time’. If you add at least an hour to the length of
time within which something might be expected to occur, then you’ll be well on
your way to getting to grips with the local timekeeping. Unfortunately ‘Ugandan
Time' also applies to emergency situations, which has led to some hairy moments.
The patients themselves tend to be extremely appreciative of
any treatment provided, however minor, although this sometimes becomes
embarrassing as they try to give you money following their Caesarean section.
I’m beginning to formulate tentative plans of what I’m
hoping to achieve here. It remains a challenge to work in a clinical
environment devoid of guidelines and information whiteboards so I’m hoping to be
able to introduce these soon.
The Royal College of Obstetrics and Gynaecology in
London
have raised charitable donations for Mbarara which I am helping to allocate, so I’m hopeful that basic facilities can be improved. I’m hoping
to install curtains around the beds on the antenatal ward to give the women
some much needed privacy. We also need a
better way of transferring patients from the operating table to the trolley
following surgery as a patient recently fell after her Caesarean section. We
use
PatSlides routinely in
UK
and they could be something we could consider introducing here.
Outside of the hospital I’m pleased to report I’ve just
attended my first Ugandan aerobics class, which takes place in a
nightclub,
bizarrely. My anxiety levels were raised as we assembled in the middle of a
male sauna, prior to the session, but fortunately this was the place of payment
rather than exercise and we were soon able to flee to the dance floor for the
exercises to begin. Working out beside fridges full of
beer and with people
playing pool in the background may seem distracting but it was most enjoyable
and I’m guessing this will turn into a regular Wednesday night trip, though
whether
Dave decides to dig out his sweatbands remains a moot point.
