As we came out we saw a woman being carried across the yard between two buildings
Cheryl is volunteering at Brikama Health Centre for 4 weeks, assisting Alice Clack & Gemma Sheridan with systems management.
So, I’ve just finished my first week out here. First of all, nothing really prepared me for how hot the middle of the day is! I thought having worked on construction sites and in factories in India and China nothing would surprise me but the middle of the day here, say 12pm to 3pm isn’t just hot in the sun, it’s hot everywhere! Sometimes, when there are fans or there is a bit of a breeze you get a few seconds respite but honestly, half of what I brought to wear isn’t really suitable. Luckily half is and washed clothes dry quickly in the sun!
So, how did I spend my week? Well Week One in the plan was always about assessing the current state so quite a bit of surveying and taking inventory. But as you’ll see below, I did get an opportunity for some hands-on organisation by the Friday.
My first visit to the maternity unit was on Tuesday. I am staying in a house on the other side of the town’s market – it’s about a five minute walk into the medical centre along two streets that are lined with stalls selling everything you can imagine (more on that another time). When we arrived, we put our things in the doctor’s ‘on-call’ room (a place where the doctors can rest when they are on 24hour shift cover). As we came out we saw a woman being carried across the yard between two buildings. Gemma immediately went over to see what was going on whilst I waited just outside the unit. A little later I learned that the woman had been very poorly and would need an operation. Thanks to the quick work of the shift team the problem was diagnosed rapidly and a successful operation was carried within a matter of a few hours. The woman was well enough to leave two days later.
On Wednesday I spent most of the time surveying the physical layout of the unit. One of the things that the team have asked me to look at is the system for managing the stocks of different things. Due to the layout of the unit, things are stored in different places and I need to get a map of this written down so that, in conjunction with the staff, we can design the optimum layout and stock check system for the team to work with.
Thursday was an interesting day. One of the things that the team would like to do is have a sort of gantry in each bay in the labour ward to hang bags of blood and saline from when treating patients. One idea was to put a rod across the top of the bay and fashion a ‘hook and chain’ type attachment to hold the bags. I spent the morning with the unit’s maintenance officer looking for possible materials in the local market. In particular, we had an idea to use a hook a bit like something from my toiletries bag (the sort you hang up in the bathroom) and tried to find a local fabricator that could make them. We visited a few and then found one that said he would try to make it.
See the photo for what he made!
The amazing thing is, he made it with a hammer, chisel and a large stone with various holes in it to enable him to hammer out the curved hook. It was really craftsmanship at work and something quite special to have seen. The design for the gantry is something we will work on this week.
So Friday was the day that I got really hands-on. There are a series of six part-built rooms to one side of the health centre and the plan was always to create clean and comfortable rooms for the different staff to use when they are ‘on-call.’ The funding to complete the job hasn’t been found yet so over time the rooms filled with various things, including some old equipment that wasn’t in use, such as an old pair of scales and an air filter, and some things like dressings and gloves that could be used but were mixed up with things that couldn’t be, such as out of date medicines. So, on Friday, a very enthusiastic team of four from the theatre staff joined me and, after a short safety discussion, we spent the morning in one of the rooms sorting through each box and packet to find the things that could be used and move them to a cataloguing room, and to safely dispose of the things that couldn’t be. See the pictures below for our ‘before’ and ‘after.’ I have to pay credit to the team, they worked incredibly hard and somehow I didn’t notice the heat half as much when we were working. Lots of materials were found that could be used in some way. The next step is finishing off the list of what we found and transferring it to the main store and well, there are two more rooms to be tackled next week!
I was lucky to get some time off on Saturday and visited the more tourist area about 40minutes from Brikama. I managed to get a great vegetarian meal, we visited a large pharmacy that is helping to supply some of the medicines that the maternity unit needs, and I got to see the local beach. It’s beautiful and it’s easy to see why people like to visit.
Today (Sunday) was world blood donor day and there was a national event held in Brikama to encourage people to donate blood. The tv and newspapers were there and there was lots of entertainment by local groups, including schools (a marching band) and some local singers and dancers. It was an impressive event and we heard afterwards that the event was successful in directly recruiting blood donors as well as raising awareness of the need for blood to help save the lives of many people in emergency situations.
An interesting fact to finish - did you know that the stuff in blood that helps it to clot degrades after 24 hours? In Europe we overcome this by separating out the red blood cells from the plasma and freezing the bags to prevent the degradation. Over here, fresh blood donations are critical in many areas because they don’t always have the facilities to do this separation and freezing process. Often relatives of patients will donate blood to try and ensure a match of blood type and that fresh blood is available.
This week I will be looking again at the stock systems, particularly the way orders are managed and audits are carried out, taking on another ‘on-call’ room and looking at how we might introduce some sort of dashboard for the unit.