September 15th 2016

       

Another productive day in Bjumba reviewing old patients and meeting new ones – The first lady who we mentioned on Tuesday was sitting up and smiling when we arrived, she is doing really well on morphine and wants to go home to be with her family, we are hoping this can be arranged for today to allow her some quality time with her loved ones. We couldn’t say goodbye without a group photo though.

We then went and saw a lady with a colostomy and awful wounds, we tried to advise as best we could, thankfully this lady had a small supply of colostomy bags (you can see Victoria washing one out in the picture) as they are not stocked at the hospital so when they are used up and cannot be washed anymore the nurses will have to fashion one out of either medical gloves or a plastic bag and tape – interestingly medical gloves are also used as conveens here! Another interesting blue peter creation was the fashioning of an incontinence pad out of gauze, cotton wool and cotton wool!

We paid another visit to the pharmacy today and we found a register of sorts, which allowed us to map the amount of morphine used over the last year – its not much but it’s a start and actually what is positive here is that it doesn’t appear that the team are fearful of using morphine, more that they lack the experience of when they should use it – hopefully we have helped with this during the week, we have already doubled their use since we’ve been here.

This afternoon we have reviewed 7 randomly selected palliative care notes, which was really interesting if not a little confusing at times – especially when they switch from English to French! – but again the outcomes from this will be positive and will hopefully aid the team in the future.

Finally, Victoria took one for the team and volunteered to go on a home visit with Anastasie, the social worker who has diligently looked after us whilst we’ve been here – I am therefore typing this in her absence – (she already told me she will edit later) – have to say though we're all feeling a bit guilty especially as after such a lovely warm day it is now the weather has changed and its looking decidedly stormy!

Tomorrow is our last day in Bjumba,  it has been an eye opener and an experience, it really does make you realise just how lucky we are to have the resources available to us that we do, and not to have to think that a patient may not survive just because they can’t afford the treatment they need.

I am back from visit and no need to edit !! washing out colostomy bag exhausted all my bon homie and ways of saying , 'its fine its no different from a babys nappy' (I lied of course) but the nurses here are not very hands on so one likes to be encouraging ! got caught in rain on walk back from visit but we about to order  for our meal which may arrive in under 2 hours but unlikely so all good !!