Today was what you might say is the first “official” day of my tenure here at Malamulo. Mrs Magumbo is the administrative secretary and yesterday I asked her what I need to do and where I need to be and she informed me of worship at 7am each morning. So this morning I was amongst the business office workers for worship. We sang a few songs and then studied today’s lesson in the adult quarterly. I was out of the loop on the lesson – I need to work on that.
My first order of business is to get an understanding of the entire revenue cycle for the hospital which will really give me a good understanding of the entire operations of the hospital as well. I spoke with the accountant this morning and asked him many questions. Then we went to each ward and department and asked them how they process patients. It was good – I met quite a few people and understand the workings of the hospital better – although I have a ways to go. I will say though – there are SO MANY benefits to an automated system. We even do not have email or a phone system within the hospital!! Everything is manual and the patient’s account is not connected in any way to their medical record. If we want to be sure people are paying for their outpatient surgery and not just tearing up the charge sheet they are given before getting to the cashier we need to escort them to the cashier! If they could even make a phone call to let the cashier know the patient is coming… can you imagine?
Later in the afternoon Alison, who is a British nurse here with VSO (volunteering) and teaching in the school, took me around for a more clinical perspective of the wards. When we got to the maternity ward we wandered over near the labor room (just off the nurses’ station by the door) and realized someone was in labor. She said, “oh you can watch if you want”. I glanced in the large picture windows and saw several people worriedly working on a lady giving birth. I saw the head of the baby but it seemed like they were having a hard time. After standing there talking for a few minutes I asked Alison if she should maybe check on things because I wasn’t hearing the baby or hearing them progress at all. Just then a nurse came out hurrying to get an IV. Alison went in to help and after a few minutes came back to tell me things were not looking good. I went back to my office wishing there was something I could do. Instead I said a prayer for the baby, the mom, and the clinicians. After a short time Alison came to get me and reported that the baby had not survived. It appeared it had been dead for quite some time and had a distended belly – that was why it was not coming out of the mom easily. It was a sad report and I guess made me feel sad for the people in general. Death is such a “normal” part of life and that is part of the struggle that the western doctors and nurses face because there is very little urgency in any situation here – either by the patient or the caregivers.
The matron of the hospital (i.e. “director of nursing”) came to see me today. She told me about the staff – the nurses – and how they are not well trained nor do they do a good job. I guess many nurses don’t want to work at Malamulo because they’ve heard the struggles that we have and how hard it is so they go to work for the government hospitals or other places. I asked her if there was anything I could do for her and she asked that I come to a meeting with the nurses and meet them. I am happy to do that so we’ll see how that goes.
I think after this week things are going to be quite different since Ryan, Jonathan, and the 8 engineers are all leaving. Tomorrow night we are having a dinner for their going away. I’m not sure who will come by to do random projects or accompany me to the market when Ryan leaves. Even though it isn’t a week yet he has done a good job at helping me feel at home here. He makes me laugh too which is nice. But alas his Phd in Chemisty is calling him and since he says it will take 5 years to finish, I guess he should go. He has been here for two months essentially keeping this place running but specifically focused on some maintenance and general “face-lift” to the buildings as well as coordinating all visitors and housing. A big thank you goes to him for all that he has done!
So I don’t think I have any major analysis or revelations in the first few days of being here. I feel overwhelmed with the enormous amount of need at the hospital – supplies, equipment, money, money, good staff, supplies, equipment (that works), & money. If that sounds a little redundant you might catch a taste of what I’ve been hearing. I wish there was more I could do and that there was some way I could snap my fingers and have things sorted out and set up perfectly. But I don’t so tomorrow I will go again and attempt to continue my quest of understanding something foreign in more ways than one!
My first order of business is to get an understanding of the entire revenue cycle for the hospital which will really give me a good understanding of the entire operations of the hospital as well. I spoke with the accountant this morning and asked him many questions. Then we went to each ward and department and asked them how they process patients. It was good – I met quite a few people and understand the workings of the hospital better – although I have a ways to go. I will say though – there are SO MANY benefits to an automated system. We even do not have email or a phone system within the hospital!! Everything is manual and the patient’s account is not connected in any way to their medical record. If we want to be sure people are paying for their outpatient surgery and not just tearing up the charge sheet they are given before getting to the cashier we need to escort them to the cashier! If they could even make a phone call to let the cashier know the patient is coming… can you imagine?
Later in the afternoon Alison, who is a British nurse here with VSO (volunteering) and teaching in the school, took me around for a more clinical perspective of the wards. When we got to the maternity ward we wandered over near the labor room (just off the nurses’ station by the door) and realized someone was in labor. She said, “oh you can watch if you want”. I glanced in the large picture windows and saw several people worriedly working on a lady giving birth. I saw the head of the baby but it seemed like they were having a hard time. After standing there talking for a few minutes I asked Alison if she should maybe check on things because I wasn’t hearing the baby or hearing them progress at all. Just then a nurse came out hurrying to get an IV. Alison went in to help and after a few minutes came back to tell me things were not looking good. I went back to my office wishing there was something I could do. Instead I said a prayer for the baby, the mom, and the clinicians. After a short time Alison came to get me and reported that the baby had not survived. It appeared it had been dead for quite some time and had a distended belly – that was why it was not coming out of the mom easily. It was a sad report and I guess made me feel sad for the people in general. Death is such a “normal” part of life and that is part of the struggle that the western doctors and nurses face because there is very little urgency in any situation here – either by the patient or the caregivers.
The matron of the hospital (i.e. “director of nursing”) came to see me today. She told me about the staff – the nurses – and how they are not well trained nor do they do a good job. I guess many nurses don’t want to work at Malamulo because they’ve heard the struggles that we have and how hard it is so they go to work for the government hospitals or other places. I asked her if there was anything I could do for her and she asked that I come to a meeting with the nurses and meet them. I am happy to do that so we’ll see how that goes.
I think after this week things are going to be quite different since Ryan, Jonathan, and the 8 engineers are all leaving. Tomorrow night we are having a dinner for their going away. I’m not sure who will come by to do random projects or accompany me to the market when Ryan leaves. Even though it isn’t a week yet he has done a good job at helping me feel at home here. He makes me laugh too which is nice. But alas his Phd in Chemisty is calling him and since he says it will take 5 years to finish, I guess he should go. He has been here for two months essentially keeping this place running but specifically focused on some maintenance and general “face-lift” to the buildings as well as coordinating all visitors and housing. A big thank you goes to him for all that he has done!
So I don’t think I have any major analysis or revelations in the first few days of being here. I feel overwhelmed with the enormous amount of need at the hospital – supplies, equipment, money, money, good staff, supplies, equipment (that works), & money. If that sounds a little redundant you might catch a taste of what I’ve been hearing. I wish there was more I could do and that there was some way I could snap my fingers and have things sorted out and set up perfectly. But I don’t so tomorrow I will go again and attempt to continue my quest of understanding something foreign in more ways than one!
