Hospital Experiences

Mulago PICU

Along with conducting my research, I have also been able to shadow doctors and nurses in the Mulago Hospital. Most of my time there has been spent in the Pediatric Acute Ward or the Pediatric Intensive Care Unit. In the states, patient care areas are usually called “Units,” but in Uganda they are called “Wards.” This was tricky for me are first because “Ward” spoken by a Ugandan can often sound like “World.” Being told to go to the “Acute World” made me a bit confused the first day. The Female Ward, the Male Ward, Operating Theaters, the terms and organization are a bit different, but not difficult to get used to after being here a few days.

Direction signs at Tororo.

This acute ward has a triage waiting area, a resuscitation room, the floor (where less acute children go), a small neonatal intensive care unit and a small pediatric intensive care unit. Every morning the children on the floor are determined to be stable enough to move to a specialized ward, such as cardiac or GI, or they stay with us a bit longer.

Mulago Pediatric Triage

I spend most of my time in the resuscitation room, which functions most like an American emergency room. We see many children come in with respiratory distress from bronchial pneumonia, malnutrition, and suspected malaria. The room has 5 beds, between 2-5 residents, usually one nurse, and anywhere from 2-10 patients (the little ones share beds). It is interesting to see that the residents conduct many of the assessments and interventions done by nurses in the states and the nurses either focus on stocking the room or telling the doctors what to do.

Mulago Peds Resuscitation Room

Family and friends of the patients perform all the personal patient care, such as feeding, bathing, washing the linens (if they have them), and even purchasing medications when the hospital does not have them available. Though it’s hard to know there is limited available to offer our patients in need, there is some comfort in the fact that there are many well stocked and accessible pharmacies nearby. Slightly less comforting is that there are no prescriptions required, but at least meds can be accessed when they’re needed. 

Laundry being done by family of patients at the Tororo Hospital.

I’ve been able to experience quite a few hospital environments: Tororo District Hospital, Cure Hospial, Kanginima Hospital, Benedictine Eye Hospital and Mulago. My first real exposure to health care systems in a developing country has been truly eye-opening. At first it is heartbreaking to see how little doctors and nurses have to work with, the environment they have to work in, and how hardened they’ve become to losing their patients. But those feelings are quickly replaced with awe and encouragement when you see what all they CAN do with how little they have, what all they CAN do in less than ideal environments, and how hard they DO work to provide life saving measures to their patients. I think westerners sometimes come with the thought that we will bring our skills and technology to make it better here, but in the end, we are usually the ones who come away learning skills we carry throughout our life.

Tororo consultation room.