The hospital

The hospital

To give you an impression of where we are working here is a brief description of Kibogora hospital:

It rises about 1000ft above the expansive Lake Kivu (and 4500ft above sea level), in a beautiful tropical setting. The hospital is built into a very steep hillside and sprawls over three levels. It is a district general hospital which receives patients from 10 community health centres which range from 30 mins to 4-5 hours away. It has 252 beds in total, though this doesn’t dictate the number of patients that it cares for as there are often 2 in a bed. Its services include, maternity, paediatrics, internal medicine, surgery, nutritional rehabilitation and neonatology. These are staffed by 13 doctors , including Dr Tim (the American surgeon who has been here with his family for a year http://www.bergfamilyafrica.com/) and many nurses, technicians and admin staff that keep it running.

 

The most striking difference compared to healthcare in the UK is the omnipresence of the patient’s family who remain with them throughout their stay – they are expected to provide all their meals, wash the patients and do their laundry. This often leads to the whole family being present at the hospital resulting in a constant hum of colourful activity with the women milling about the hospital, cooking, washing, cleaning, chatting and also many children running about the place.

 

The other notable difference is how empty the wards are despite each bed being occupied (sometimes twice) as outside of the doctors’ ward rounds, the patients and their families congregate outside where the air is fresher and they can sit in the sun. This also helps to clearly highlight the sickest patients who are unable to leave their beds.

 

This has led us to wonder whether the general absence of families in UK hospitals due to strict visiting hours and the subsequent tendency of patients to remain in their beds could learn from this model of inpatient stay. (We appreciate this is somewhat of a generalisation-there are many places and people in the UK work hard to get patients from their beds).

 

Despite all the services provided, they are limited by lack of equipment, for example; there is no CT scanner, there is an ultrasound but no trained ultrasonographer, some blood tests are unavailable (for all the medics out there – no Electrolytes!!) – this means that you have to rely less on tests an more on clinical signs.