Bombo Experience
Last week, I went to Bombo Hospital to help one of the Norwegian nursing students with an interview for her final research paper for her Bachelor’s degree. I hadn’t been required to wear a white student nurse’s uniform like the one I was given in about 7 years! The only pair of closed-toed shoes I brought with me was pink, so I wore bright white & pink to the hospital:)
As we pulled into the hospital compound, I saw many buildings…eye clinic, tooth clinic, lab, etc. The oldest building, with a sign on it called ‘Cliff Block’, had an old-building, unique architecture feel to it that I like.
We entered the building next to Cliff Block…a more modern looking building, but run down by Western standards. We walked up a couple flights of stairs until we reached the maternity ward. Antenatal patients at less than 7 months were in a room off to the left, antenatal greater than 7 months & postpartum were in a room off to the right, & in the middle was the delivery room & Low-Birth-Weight Unit (LBW) (their NICU). The rooms were crowded…most of the beds had at least 2 women sharing them. Some had brought their own sheets of plastic to lie underneath themselves to protect the mattress from their blood. Some new mothers were resting, some were breastfeeding. The beds looked like they were decades old. Hospital personnel walked in & out of the room, but we were told there were only 2 nurses for around 60 patients! Despite the overcrowding & seemingly run down conditions, there was beauty in that room…beautiful new mothers with their precious babies, both wrapped in beautifully colored kangas.
I was able to go into the LBW unit. I kind of felt at home around those tiny babies I’m used to caring for. The room was as big as one of the NICU storage rooms at home. The incubators were made of wood with a plexiglass tops. Two new babies with retractions were in there being observed. Another tiny one was being cup fed by her mother…a method I’ve only read about in books. Another baby that looked to be about 30-32 weeks had her nasal cannula, which was hooked up to an oxygen concentrator, lying on top of her nose. I wanted to help, but wouldn’t even know where to start. Are there even the resources & knowledge here to help these sick & premature babies?
The nurse who we were going to interview was busy helping with sutures when we first arrived, but we didn’t have to wait long. She had been a nurse for 1 year – 7 months in this unit. She was so insightful, telling us about how things should be done in comparison to how they really are done. Tea (the nursing student) is writing about the effects of hygiene on maternal & infant mortality & infections, including sepsis. The nurse agreed that they’re connected & knew the importance of hygiene, but said the lack of resources, like clean equipment, lack of staff, lack of time to teach patients, & lack of general hygiene knowledge in patients are all obstacles. She seemed to have the knowledge, but is limited on her ability to implement it. She explained that they work 12+ hour shifts with little to no breaks, caring for up to 30 patients a piece, while also cleaning the ward. It sounded like nursing in the States 100 years ago. They don’t have time to teach. They don’t’ have time to assess the patients like they know they need to. They rely on the mothers to tell them if the baby isn’t acting right. They do their best, but know it’s not enough. They try to encourage breastfeeding, but have no time to teach, so the mother’s give up easily & give formula. They try to tell them to be clean, especially the breasts while breastfeeding, & the umbilical cord, but don’t’ know if they mothers really do it because they’re unable to reinforce it. Nursing as a profession isn’t respected highly in the community, so it’s not desirable to stay at a challenging job like this nurse has.
I’m glad I got to visit Bombo. The medical system here faces many challenges, but so did the Western world many years ago. They continue on here, & will also succeed.
Ujuzi wa Bombo
Wiki ijayo, nilikwenda Hospitali ya Bombo kusaidia mwanafunzi Mnorwei mmoja wa uguzi. Na mahojiano kwa mwisho karatasi yake ya uchunguzi kwa digrii yake ya Bachelor’s. Sijahitaji kuvaa nguo nyeupe ya kazi hospitali kama miaka saba! Nilileta jozi ya viatu moja tu kwamba siyo ndara, ambavyo la pinki, kwa hiyo nilivaa rangi ya nyeupe sana na la pinki kwenda hospitali. Tukiingia kiwanja cha hospitalini, niliona majengo mengi…kliniki kwa macho, kliniki kwa meno, lebu, kwk. Jengo kuukuu kabisa, liliyokuwa na alama ambayo ilisema “Cliff Block”, jina usanifu majengo ya Ulaya na wakati uliopita ninayependa.
Tuliingia jengo kondo ya Cliff Block…jengo jilifanana la kisasa zaidi, lakini kupotewa na nguvu na sanifu ya magharibi. Tulikwea ngazi mpaka tukafika wardi ya wakina mama. Wagonjwa hawajaofika mwezi saba kabla ya kuzaa, walikuwamo chumbani cha koshoto, na wale wameofika mwezi saba au zaidi, na wale wamezaa walikuwamo chumbani cha kulia. Katika katikati, palikuwa chumba cha kujifungua na wardi ya watoto wachanga waliozaliwa wenye uzito udogo au kabla ya wakati wao. Vyamba vilikuwa kusongana…vitanda karibu vyote vilikuwa na wanawake wawili au zaidi kushiriki. Wanawake wengine wameleta vipande vya plastiki wao wenyewe kupata chini ya wao wenyewe kulinda magodoro kwa damu wao. Mama wapya wengine walipumzika, wengine walinyonyesha. Vitanda vilifanana na vilikuwa vya kuukuu sana. Wafanya kazi wengi wa hospitali waliingia na waliondoka chumba, lakini tuliambia kulikuwa waguzi wawili tu kutunza kama wagonjwa sitini. Hata kama kusongana sana na kwamba wardi kulifanana na hali ya kupotewa na nguvu, kulikuwa uzuri katika chumba kile…
mama wapya wazuri na watoto wachanga wao, wote wamevaa kanga yenye rangi nzuri.
Niliweza kwenda ndani ya wardi ya watoto wachanga waliozaliwa wenye uzito udogo. Nilisikia kama nyumbani kuzunguza watoto wachanga wale wadogo sana kama wale nilizoea kutunza. Chumba kilikuwa ukubwa cha chumba ya akiba nyumbani. Incubata walitengeza mbao na plexiglasi juu ya upande wa juu. Watoto wachanga wapya wenye ‘retractions’ walikuwepo kuangaliwa. Mwengine mdogo sana aliliwa kwa kikombe na mama yake…njia nimesoma kuhusu tu vitabuni cha kiada. Mwengine aliyefanana amefika wiki thelathini au thelathini na mbili, alikuwa na kitendea kazi changu ya oksijeni juu ya pua yake. Nilitaka kusaidia, lakini sikujua kukoanza. Kweli…wana vifaa vya kutosha hapa kwa kuwasaidia wale watoto wachanga wagonjwa na wale kabla ya wakati wao?
Mwuguzi tuliyekuwa kuhoji alishughulika kusaidia kushona tukifika, lakini hatuikuwa na muda mrefu siku hii. Amekuwa mguguzi kwa miaka moja - miezi saba katika wardi hii. Alikuwa na ufahamu sana, kutuambia kuhusu jinsi ya vitu vifanye kufananisha jinsi ya vyao vinafanywa. Tea (mwanafunzi wa uguzi) anaandika kuhusu jinsi ya elimu ya afya kugeuza mauti ya mama na watoto wachanga na maambukizi, hasa septicemia. Mwuguzi alikubali kwamba vitu hivi vinashirikiana na alijua maana ya elimu ya afya, lakini utovu ya vitu vinavyosaidia kama vifaa maalum safi, wanafany kazi, wakati kufundisha wagonjwa, na maarifa ya kawaida wa wagonjwa kuhusu elimu ya afya. Alionekana ana maarifa, lakini ni kuwekwa mpaka katika kuwezwa kuyafikiliza. Alieleza kwamba walifanya kazi zamu ya kazi ya saa kumi na mbili au zaidi na mapumziko ya dogo au hata moja. Walitunza mpaka wagonjwa thelathini maadamu pia kusafisha wardi. Hii ilinikumbushe ya uguzi katika Umerika miaka mia moja uliopita. Hawana wakati wao kufundisha. Hawana wakati kuwapima wagonjwa wao kama wanajua wanahitaji kufanya. Wanawategemea mama kuwaambia kama mtoto mchanga hatendi sahaki. Wanafanya kazi yao bora kabisa, lakini wanajua wanajaribu kutia moyo kunyonyesha, lakini hawana haitoshi wakati kufundisha, kwa hiyo mama wanacha rahisi na kuwalisha na unga ya maziwa. Wanajaribu kuwaambia waki mama kuwa na usafi, hasa maziwa zao maadamu kunyonyesha na chango la uzazi, lakini hawajui kama mama kuifanya atafanye kwa sababu hawawezi kujimarisha. Mwuguzi pia alituambia kwamba ubingwa wa uguzi haukustahi sana kwa jamii, kwa hiyo hakuna motisha kubaki katika kazi ambaye inakuwa ngumu kama hii.
Mimi ninafurahi niliweza kutembelea Bombo. Pana mazingira ya kazi magumu hapa, lakini mazingira haya, sisi pia tulikuwa nao Ulaya na Amerika. Wanaendelea mbele hapa na wao pia watafika.
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Nurses’ Duties in the US 100 Years Ago
The following job description was given to floor nurses in institutions similar to Athens’ Lunatic Asylum (circa 1887).
In addition to caring for your 50 patients, each nurse will follow these regulations:
1. Daily sweep and mop the floors of your ward, dust the patient’s furniture and windowsills.
2. Maintain an even temperature in your ward by bringing in a scuttle of coal for the day’s business.
3. Light is important to observe the patient’s condition. Therefore, each day fill kerosene lamps, clean chimneys and trim wicks. Wash the windows once a week.
4. The nurse’s notes are important in aiding the physician’s work. Make your pens carefully you may whittle nibs to your individual taste.
5. Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m. except on the Sabbath on which day you will be off from 12 Noon to 2 p.m.
6. Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes or two evenings a week if you go regularly to church.
7. Each nurse should lay aside from each payday a godly sum of her earnings for her benefits during her declining years so that she will not become a burden. For example, if you earn $30 a month you should set aside $15.
8. Any nurse who smokes, uses liquor in any form, gets her hair done at a beauty shop, or frequents dance halls will give the director of nurses good reason to suspect her worth, intention and integrity.
9. The nurse who performs her labors and serves her patients and doctors without fault for five years will be given an increase of five cents a day, providing there are no hospital debts outstanding.
http://www.toddlertime.com/advocacy/hospitals/Asylum/ridges-staff.htm
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