Water, Pus and Medical Records

I spent the day at one of the district hospitals today. It's a seventh day adventist hospital, which means that any time you eat there, it's vegetarian. They actually have this lentil/quiche thing that I really like. The food is all really heavy with butter and oil, so you can only eat there sparingly unless you want to constantly be in a food coma. But food is not why I went there.

I'm working with the statistician to help refine the why data is recorded and reported, both for the hospital itself and for the Ministry. All data (for things like: number of pts seen in the outpatient department, types of diagnoses, length of stay, number of pregnant mother on PMTCT, etc) is sent to the Ministry each month. The Ministry compiles this data then (as is my understanding) for the Annual Joint Review each February. (That was the big meeting I missed when I first got here because of the GI thing.)

Oh, I should add here since it's probably an underlying assumption you may have.....everything is written in these huge books. There are no computers. So the challenge of keeping track of patients, particularly outpatients, is great.

Anyway, I was walking around the hospital with the statistician, assessing each ward and how they keep track of their data. And instead of waiting until a nursing sister was finished seeing a patient, we would just walk in the room, sometimes mid-exam and start looking at the record books. And often the nursing sister would stop what she was doing to talk to me. I was pretty uncomfortable with it, especially seeing a patient sitting there waiting for me.

The two worst situations were:

We went into the dentist and she was drilling some guys mouth. The statistician just pushed past the procedure, pulled me along with her, and starting flipping through the book. Meanwhile, the guy in the chair was drooling bloody saliva into a pan (there's no suction here) and all I can think about is infectious diseases. Needless to say, I got out of there as fast as I could.

Then we went to the HIV/TB clinic in the hospital, and barged in on someone's "confidential" counseling session. He just sat there looking at me, and I shrugged as if to say "Sorry, she made me come in here." The we talked so long to the counselor that the guy started to get faint sitting in his chair, and had to lay on the floor waiting for us to finish.

There's just such a different sense of privacy here, and patient centered care. Or, I guess you could say there isn't any. I did learn a ton, though, and I think we may even have gotten an implementation plan started for some of the outpatient record keeping. I'll be going back weekly, but hopefully it won't be anywhere near patients having procedures.

In other news, I found out today that the water in the gym water bubblers, is not, in fact, fresh spring water. Nope. It's straight from the tap. And I've been drinking it for the past two months. I can't decide whether to be disgusted or encouraged that I've been drinking tap water for 2 months with no consequences. I sort of wish I hadn't found out because now I'm going to stop drinking it, which means I have to carry my water to the gym each day. Bummer.

And I just wanted to mention that Sarah for the past several hours, and over the next several days, has been doing research on where pus samples are sent for lab analysis. Yeah, pus. And there are a lot of different kinds.

Tomorrow is an office day for me. Oh, actually, we moved to a new office on Monday, but we don't have internet or phone yet, so by office day, I mean I'll be working from home.