Day 10: Teja's Perspective

We were back at Jinja Hospital. Having been here for a few days already, we now feel pretty familiar with the hospital. The first thing on our agenda was to check back in with Head nurse Sister Susan Alero, who introduced us to the hospital on Day 1. We provided her with the feedback that she had asked for at Jinja. She did not seem surprised by any of the observations and gaps that we found.

We made it known to her that we were interested in visiting the antenatal clinic. Sister Susan was very helpful - she whipped out her phone effortlessly, made a call, and told us to head across the quad to the newer building at the back of the hospital to meet Sister Silvia.

The antenatal clinic was a squarish building with two rows of benches in the middle and several examination rooms that lined each side. The office sits in front of the rows of benches where mothers would sit. On the right, a table is set up outside the windows of an examination room. Mothers stack their A5 book with doctor’s notes on the table as they come in. Nursing students go through the books one-by-one, calling up the patients and begin triaging them.

Sister Silvia welcomed us into the antenatal ward and introduced us to her assistants. She explained to us what was about to happen for the day and showed us into the different examination rooms. Monday was a doctor's clinic at the antenatal ward. This means that on top of the normal antenatal services offered to mothers, mothers who have other complications and want a second look by doctors would come in on Mondays. On other days, only nurses and midwives would be present to give mothers normal examinations.

We spent the rest of the day with Sister Justine, sister Silvia’s colleague, as Silvia had to head out to take care of her son with a medical emergency. Kim Hwang also got an opportunity to shadow the doctors as they took a look at some of the more complicated cases. Nursing students would come in with a patient's booklet - a thin A5 notebook that reminds me of the ones I had used in kindergarten. The quality of the paper was slightly yellowed and one would be concerned that they would easily tear or get wet. The notebooks soon stacked up. More than once, Sister Justine would walk in and berate the nursing student for indiscriminately bringing notebooks from the general examination room into the doctor’s office-for-the-day.

Some of these patients presented their ultrasound scans - usually from private clinics. We discovered from talking with these mothers that these scans go for around 20,000 UGX. One of the mothers came in with a distended abdomen. The doctor had difficulty finding the heartrate of the fetus with a fetoscope and eventually gave up. Multiple mothers were scheduled for a C-section, mostly for presenting a previous scar. Mothers requiring an ultrasound scan would be advised to get one from a private clinic before coming back – none of the ultrasound scanners are working at the moment. Only a single working ultrasound unit sits in the private ward for paying patients.