Lisa's adventures

Joined September 2015
  • Day90

    Back to work

    December 25, 2016 in Central African Republic ⋅ ⛅ 26 °C

    We finally went back to work at the complex pediatrique at the end of November.

    I started in the urgence medical: medical emergency department. It was going ok until we had two very I'll patients at the same time, one resus after the other. The doctor was writing notes and the nurse was trying to put in an iv line when I noticed he had stopped breathing. I grabbed the mask and bag to start resus. But the mask was too big, I couldn't find the baby one ( later I found someone had disconnected the rubber from the plastic- Abd that's why I couldn't see it ) so we called icu and the nurse helped. Thank God she came, she us a very good nurse, although she is a bitch. They didn't have any suction catheters in their draw ( the nurse) so I grabbed my box which was fine. But I was really condemned for it. The national nurses give me their list of stock needs and I replace them twice a day. It was my third day and I overestimated their abilities. Anyways, basically local staff mostly stuck in emergencies and in the end the room was full (it's a small room, so maybe 4) of international staff with the national staff at the edges. It was a shame because we are supposed to be teaching them what to do. One died but one is still in intensive care. I had a big cry to the head nurse about it. I've never worked in the emergency department or with kids. I've never ventilated someone before either, so I'm really not a great fit for the area. Especially as the doctors don't take charge! I saw the nurse taking blood on a red code while the doctor was seeing another patient, it's ridiculous. Still trying to cannulate when the oxygen is 85%. The department is defiantly the hardest, the staff area really hard to manage, always late, really stubborn and no skills.

    In general it was also a hard first week back as I'm still new here ( to the work) so I'd ask a question about a drug or what we do for a certain illness and the reply is often common Lisa you should know this! Ffs I've worked in tropical medicine for 2 weeks- and most of the drugs are in Italian or have other brand names. The office said take it easy on yourself for the first month/ 2 months. It takes time to get used to it etc. Very nice. They should say that to all the other staff, rather than have a bit because I almost ran out of stock on my second time ever ordering.

    So after a week I went back to my old ward soins continue. I really like being back, my nurses are nice and I can really teach them stuff. They still miss obs and some drugs but are getting there.

    Now we have two new staff they are really nice and one old one came back- another English/ non-Italian speaker! She is really nice and is in urgence medical. Two mean nurse have left. So the team is improving.

    Yesterday was Xmas eve. They had some sort of ceremony in front if the hospital then the presidents wife came in to meet the kids and give them presents. Nice gesture, I got to shake her hand. Bit intimidating with all the soldiers with massive guns around though.

    My mum sent me a package. I told the logistician that if it was going to cost too much money to pay taxes and bribery that they can keep it. He was negotiation/ waiting for how much. Then he have it to me and said I didn't have to pay anything! Then today the invoice arrived for 287 Euro. Wtf . I was very clear that if it's ridiculous they can keep it. Total contents is only worth 100AUD. Merry Christmas Lisa. Fu Emergency.
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  • Day66

    The health education book

    December 1, 2016 in Central African Republic ⋅ ⛅ 24 °C

    This is my book, it's the basic story, the real one is in French and has questions for the nurse to ask the mothers. The book is about traditional medicine. Here they crush herbs and plants into a paste. They administer it orally, rectal, bathing the child with it or putting it in the skin. Sometimes they inject it which often results in an abscess. Usually the side affects are intoxication, enlarged liver and spleen and sepsis.

    Pg 1: this is Marie and her son God bless, he is two years old. God bless is sick so Marie's neighbours advise her to visit the traditional doctor.

    Pg 2: Marie takes their advice, the traditional doctor gives him something to drink and cuts his arms and puts a paste on them. It really hurts him.

    Pg 3: the next day God bless has a lot of pain in his abdomen, it's very swollen and his arms are also red and sore. Marie is really worried so she takes him to the hospital

    Pg 4: at the hospital the doctor does some tests and finds that God bless has malaria. He need to stay in hospital for a few days to treat his swollen abdomen caused by the traditional medicine

    Pg 5: Marie's younger child is now sick. Her neighbours give her the same advice: to visit the traditional doctor. Marie does not listen

    Pg 6: Marie takes her baby straight to the hospital. She sees the doctor who does some tests. Because Marie came to the hospital quickly Marie can do the treatment at home. It was also free.
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  • Day64

    Return to work!

    November 29, 2016 in Central African Republic ⋅ 🌙 27 °C

    After six and a half weeks stuck at home we will finally return to work. On Monday i did a quick orientation to the urgence médicale- my new department. The doctor has already made a comprehensive list of problems and solutions, so that makes it easy. For the first week I need to concentrate on hygiene., and getting back to the way it was before we left. The two trolleys were filthy, the floors under the beds/desks/trolleys are also really dirty. It's gotten pretty clusters and unorganized, so I'll focus on that while the doctor does the medical side.

    Sometime soon we will do renovations to my ward. Currently there are about 7 small rooms, we will knock down the walls between the rooms on one Side, joining three together to make the code rouge room and the observation room, with a curtain seperating them. It will be awesome! Then the other side will remain with two consultation rooms and a blood collection room.

    Today I went to the clinic ( a proper emergency project-small 12 bed hospital with triage) to observe the flow of patients and how it is supposed to work. It was really interesting, I saw malaria, scabies, sickle cell disease ( about 50% of the population have it) and mild pneumonia. Two patients were admitted.

    Then after lunch I went to the complex ( complexe paediatrique- hospital) to clean the two trolleys with draws- then it's ready for the drugs and consumable to arrive tomorrow. The nurses open the glass vials ( like frusamide, not amixicillin) by smashing the top against the trolley, I guess they are scared it will break in their fingers. So the trolley was full of tiny pieces of glass! And all over the floor around it. It's a four bed observation room but we had 10 patients being monitored. When we renovate we will have 6 bed. We are also trying to get a blood transfusion room approved as there are a lot of malaria with anaemia and after a transfusion they are better and can leave, but we don't have room In urgence medical and if we admit them we get bed blocked for other kids and if we admit them to a section of the hospital that is not operated by emergency it's unlikely any vital signs will be done. So many things to consider. Ideally it will have about six beds, 1/1.5 national nurses and I will educate them and monitor them too.

    We have another meeting today to discuss tomorrow. Exciting! It's also my birthday I Friday so on Saturday we will go to balafon to do dancing - well until 9pm as that's the curfew. :)
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  • Day51

    A Bangui story and the plan

    November 16, 2016 in Central African Republic ⋅ ☀️ 29 °C

    At our meeting last night we were told a very interesting story. This start is likely not a true story, just like our surgeon is not a witch who stole a heart for voodoo. So a teenage girl hitch hiked hike from school the other day. The guy that picked her up had a kitten in the car and said that his kitten is hungry; and asked if she could breastfeed the kitten, and he would give her some money. She agreed, and as a result got an absess on her breast and died. This resulted people teasing all of the girls at the school by saying "meow!" When they walk past. Yesterday the girls protested against this bullying, so the police threw tear gas in the crowd of girls. About 35 came to the hospital for care - although nothing serious was wrong; just fainting and hysteria.

    We just had another meeting about how to restart activities! It will be sometime next week. There was a lot of talk about surgical side, which I'm not a part of and also reorganisation. We are limited with nurses, so I will be changing departments from a medical ward- which was previously managed by the icu nurse; to the medical emergency department. I'm quite excited actually. But I've got a lot of reading to do! I need to mesmerize the criteria for admission, protocols and the handover left by the previous nurse. I'll work with an international doctor who is lovely and had heaps of experience with MSF. They triage the kids outside (under a gazebo) then kids go to either surgical or medical emergency with a green, orange or red card.

    The pictures for my education book are finally finished. I'm going to put it together today with the head nurse and do more of a handover of my ward and the new one.
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  • Day48

    4 weeks at home

    November 13, 2016 in Central African Republic ⋅ ☀️ 29 °C

    The last week has been really fun.

    We are allowed to go out more, so I've been swimming a bit, and we went out for lunch last week. I was a logistician on Friday, there is a 19 year old logistician assistant too, so it was three of us. It was really interesting hearing the stories and how his job works. He gets to drive around a lot, which is always fun. The young guy talks and sings a lot, he has taught the national staff a soccer cheer. He also loves telling me how weird/ stupid my accent is - both French and English. He is also constantly amazed about how little I know about Italy, prime minister? This famous Italian writer? Book? No I'm not Italian. But it's famous! I ask the same questions about famous Australian things and he has no idea, but why would he? It's just Australia *sigh*

    Two shipping containers had arrived at the hospital so we went to organise getting them unloaded from the truck, they had my generator inside! (My ward does not have aircon, so its literally a sauna. I was told I would get aircon once we get another generator). They had already made a platform for both containers. We were waiting for a fork lift to come to take them off the truck and leave them just outside the hospItal gate, then the crane would come in a few days to put them in place. Unfortunately the fork lift never arrived, so now the truck with our containers (and my generator) are headed back to the port in Cameroon; and will hopefully return in a week or two. Another favorite saying here is 'welcome to Africa'.

    When we were leaving a super market the other day the driver of another xpat car started saying emergency! Emergency! They killed the baby! It was all in sango, and our driver was yelling something back. It was really confusing, but no one was listening to the other driver so that's a good sign.

    We have not had as many meeting as before, which is actully nice; so we don't here we are waiting. ..slowly slowly. ....we did get some great news though. The police file for the surgeon is finally closed! He has a fight home, business class, on Tuesday! Everyone is really happy for him. Poor guy was already so sick of this mission and wanted to leave, then his room catches on fire and he gets arrested in one week.

    Last night we had mexican night that me and the head nurse organised. It was sooooo tasty! Unfortunately we could not find any tequila so I shared a bottle of gin with the logistician. Gin and pomplemousse is a great combo! (Pomplemousse is a fizzy grapefruit drink).

    Now it's lazy Sunday! Although every day is pretty lazy these days. I spent most of my days drawing the health education books and watching friends.
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  • Day42

    3 weeks at home

    November 7, 2016 in Central African Republic ⋅ ☀️ 31 °C

    I can't believe it's been three weeks already.

    There is still uncertainty. The surgeon's file should be closed soon, and someone from the main office in Milan will visit us on the 21st November to discuss with the relevant local authorities about our continued collaboration, then we should be able to open.

    The security is much better, we can go to the proper swimming pool and to lunch. It's so nice to be outside. I love driving around and looking out the window. Once I saw a guy wearing a beanie! Ridiculous.

    I have a new job now. I'm creating some public health promotion books. I just started today. I sat with two nurse and discussed which diseases they need, and they told me all about them. The first one will be about the use of traditional medicine, it's herbs and plants crushed into a powder or paste, then they either inject it into the muscle, mouth, bum, or cut the child to put it under the skin. This results in pain, enlarged liver and spleen, and sometimes death. I'll take pictures when it's finished. I like drawing and public health so it's a good job for me.

    I decided I'll stick it out. I said I would commit for six months, so I'm going to. Being able to go out makes it so much better, and I'm busy doing other work. I also found two people who like games!! Winning :)

    Mum sent a birthday present with me. .. so tempting to open in. It's a daily challenge to not touch it....
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  • Day27

    One week trapped at home

    October 23, 2016 in Central African Republic ⋅ ☀️ 25 °C

    I'm so bored.

    We get daily updates about the situation and the security. We are allowed to walk between the two house with a guard, it's only 50m maybe. The community were furious, thinking we practice witchcraft or voodoo. The negative attitudes have also been felt with other NGO's and they have also reduced their curfew.

    It's weird for me as I have not seen much at all. I just get updates of what is going on, but am left in this little bubble of maison B, so its pretty surreal. While walking to the other house one day I heard a passer by say ' je deteste les gens des emergency' which means I hate the people of emergency.

    We have stopped all operations for 1 week now. After about 2 days all the drugs and medical supplies were gone, which means the mums need to go to an external pharmacy to buy everything, and it's not cheap. Imagine if your kid was on amoxicilline IV 4 times a day. You need 4 vials, 4 syringes, 4 diluents, 4 needles. That's just one drug for one day, and assuming the kid already has a cannula. It's challenging for me as more kids might unnecessarily die due to our absence and lack of free supplies. But we can't give them our keys to the cupboard where a few more supplies are because we don't just give out drugs we educate and empower local staff. It's also a method to get the government to appreciate our presence more. - it is also unsafe.

    We had almost all the national staff visit us which was lovely but tiring. They miss us and it was a great show of solidarity. They did almost drink all our beer though :)

    Apparently on Monday the community are having a protest against the U.N. blue helmets. So we are hoping to recommence activities on Wednesday if it calms down back to the general level of dislike.

    At home I have drawn, played guitar, watched movies, hung out with my team, we did a mini salsa night which was fun. Made cakes. But it's also really hard. I feel trapped. The Italians are lovely but rarely switch to English or French when I'm there, so I don't understand anything most of the time. I feel bad asking them to switch, they seem like they are having a great time and I don't like forcing people to speak English when I'm there. Although I need to.

    Also everyone here smokes, I did not expect that at all. So after three weeks now my throat kills this morning. I'm pretty sensitive to it so can't hang out too long. And there are also a few people that smoke weed. I used to be fine being around people smoking weed but now I can't stand it and go to room straight away. I think i partially blame it for turning my lovely caring boyfriend into a selfish arrogant one that came home at 4am every night. Too many bad memories with it. And actually, I've never had a good experience with it.

    Now I have so much time I'm also starting to get a bit stressed again about finding a job after this.

    To top it of the internet is even worse with everyone using it and this morning we don't have any water.

    Please tell me about your lives and the outside world! And if you write a comment, don't forget your name :)
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  • Day20

    Drama drama

    October 16, 2016 in Central African Republic ⋅ 🌙 21 °C

    There is always something happening here. First a possible safety issue and we were evacuated. Then I got sick and fainted, along with 8 other international staff. The other day I was going to brush my teeth and smelt something funny, I saw smoke coming our of someone's room so had a look to find an electrical fire. I ran inside to tell everyone FIRE! Lucky we had an extinguisher, but the poor guy has all his stuff covered in the extinguisher dust. And just now ( Sunday night) the project manager and surgeon have been 'arrested' by the police! A child died today soon after surgery, so the parents called the police. The parents believe we took out the child's heart during surgery! Crazy crazy!

    Apart from the drama it's been a good long week. 7 days. This week my goals were to educate the nurses on how to do a urinalysis , how to give metronidazole properly (i caught one nurse guessing the dose! - but after i trainer her it was all done correctly!) And change the doctors round, and give night shift more tasks such as restocking and cleaning to make the days easier. I would say I got about 50% done so will continue for the next week.

    A cleaner asked me if I could adopt her daughter this week. She was dead serious, it was really sad, I said no I can't but kids really need their parents and love which she obviously has if she is willing to give up her daughter to a stranger at the hope of a better life.

    This week I also had two infants with respiratory distress, which I transferred to ICU (they are fine, but we don't give oxygen on my ward) and one poor 4 year old boy who has steven Johnson's syndrome or lyons syndrome, I can't remember which one. But the result is his lips are a wound, we are unable to clean them because he is in so much pain and suffering. They have been stuck together for two days. Another nurse gave oil to put on them and they have begun to open. He may need surgery this week to open them fully, and clean his mouth properly. The poor mum is really upset but grateful we are trying to help.

    Last thing. 2 nurses are leaving soon so
    we threw a party for all national and international staff at a local club. It was awesome and just what I needed after a long week. Almost all the men at work told me they were going to dance with me. Africans are great dancers! Two of my favourite nurses were there, we danced together. It was really nice to see them out side of work. Everyone danced a lot! One guy who also proposed and said he was willing to move to Australia with me danced with me a lot, I tried to get away without being rude! They dance really really close! !! Or just grab your wrists and start dancing. Either way it was still awesome finally seeing a slice of the real bangui, rather than just the xpat one.

    UPDATE: we had a meeting about today's events. There was a lot of yelling, anger and some violence at the hospital by the relatives of the dead child and the police who took the surgeon to a room to interrogate him. It was really unsafe and luckily the national staff and guard came to help the project manager. Both are home now but all emergency activities are suspended until the government offer an apology and publicly acknowledge that we had no part in the child's death. The national staff are supportive but the local population can be very against white people. So everyone has to stay home until further notice.
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  • Day14

    week 2

    October 10, 2016 in Central African Republic ⋅ 🌙 25 °C

    I'm finally getting the hang of it. But it's still challenging. We had a meeting today to reorganize the wards, and I need to change the way we give coartem (malaria med) and reorganize the doctors round, make sure the ward is clean. But I'm not supposed to do anything but tell the nurses what to do, which is hard when I see them already super busy.

    Today was exceptionally busy because the doctors round takes forever but I need 5 free beds. And one patient was imposible to canulate, so I had to ask everyone to try and in the end the orthopaedic surgeon put one in the bone. The kid really needed a blood transfusion. After my meeting I returned to a messy ward . Meds all over the table, beds not clean. And busy nurses. I also need to teach them when I have time. This morning I was able to show someone how to do a v loos pressure so that was good. And other I explained why we threw away the blood that had been out for hours and opened to infection. So small steps.

    I left a list of things to do to the night a
    Shift, it is a nice team on so I have hope that tomorrow i will arrive to a clean ward with clean patients.
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  • Day10

    sickness and embarrassment

    October 6, 2016 in Central African Republic ⋅ ⛅ 23 °C

    Yesterday I woke up and ran to the toilet, diarrhoea had arrived. It was inevitable, but earlier than I anticipated. At breakfast I was feeling really nauseous so decided to spent the morning at home. By lunch time I had a fever, headache, fatigue. So I went to the Emergency clinic with the international nurse Stephan. I have a urine sample and the guy who took my blood sample tied the glove so tight on my arm that I could not feel my arm anymore, I started to cry as it was so painful, especially with my headache and general shittyness. Then Stephan came to take me to the consultant room , and saw I was crying. 27 year old nurse crying over a simple needle, good one.

    Urine and blood tests were negative, I still needed to give a stool sample. They started me on an antibiotic and paracetamol. I slept most of the afternoon, and woke up around 6:30 when i decided to have some dinner. I quickly went to the toilet again, managed to perfectly capture my stool sample. Then another wave of nausea hit, this time it felt like it was actually going to turn into vomit. I grabbed the bin, but then I realised I'm not going to vomit, I'm going to faint. I was not going to pass out in a locked bathroom, so I semi-conciously got of the toilet and tried to go outside to get some help. I stacked it on the stairs, apparently i managed to let out a 'help me'. The logistician saw me and asked if I wanted help, I said yes and then fainted.

    I woke up in my bed, with my room full of people. It's a good thing living with doctors, nurses and anaesthetists! They put in a cannula, damn they hurt! It's still in and still hurts! I received 500ml of Hartmanns, for dehydration. They were all really lovely. I told them I managed to get a stool sample, that it was in the bathroom, but apparently it ended up in the garden. A quick test later and I have no parasites, but heaps of bacteria.

    I also stacked it pretty bad so my knee really hurts :( I'm having another day of today. Generally feel better, still have diarrhoea and nausea so I'm trying to eat and drink more.
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