Things have settled down into more of a routine now and I'm finally getting my head around the universe of ARVs and pharmacy and down referral and all the other stuff that I get to do as well.
Monday was a busy day of dispensing and last minute packing for Mapuzi clinic. I've now put a big poster up in the pharmacy with the master plan for down referral on it but there's so many different parts that I think it just ends up confusing me more...I've no idea how Monique managed to just do down referral as an aside to her job as an actual pharmacist! Sam and I spent a riveting evening with a book we found in the office filled with Would You Rather? Questions which ranged from 'Would you rather have one massive eye or four tiny eyes?' to 'Would you rather light a fire or put it out?' to 'would you rather watch a birth or an execution?’ You've got to wonder who writes these things. [But I won't lie; it is still keeping us entertained!]
Tuesday saw a frantic rush to complete the pharmacy order and fax it to the depot. It's technically meant to be done on a Thursday then faxed first thing on a Monday, but things are just a tad hectic [ha] around here so I ended up getting the list late on Monday then a whole load of additions at 8am on Tuesday. The order includes all of the drugs, medical and surgical supplies for the hospital so it's kind of important to get it out on time! After chasing down Drs Gatley and Gaunt to sign the thing [multiple times due to the constant additions that were handed to me each time I returned to the pharmacy, out of breath from running back from the ward], I finally was able to hand it to Siphokazi to fax it for me as it was now time to leave for Mapuzi clinic.
Tom, Sarah and I drove to Mapuzi in the torrential rain and I arrived looking pretty hot in pink wellies and long shorts, as always the picture of professional. The counsellors were efficient in getting everything set up and we were able to hand everything straight over without assisting with the dispensing which is a big step in the right direction. Sadly though, there was only one sister there and she was busy with other things so there was no one to take any of the twenty blood samples needing done. After ascertaining that no, I was not qualified to take the samples even if I wanted to, the ARV counsellors decided they would just have to make sure all the patients came back for their bloods on another day. [Note: I reckon about three of them actually did] We didn't really have much option but to leave and hope for the best – hooray for staffing shortages!
We journeyed to Ngcwanguba in the trusty/rusty JRHF Golf and as we pulled up to the clinic gate I got a call from Mapuzi saying four unexpected patients had arrived, just great. After sorting that out over the extremely shaky phone line, we had a meeting with Dr Meents [the one whose wedding we went to] then went to Ngcwanguba store to pick up gas to rectify our freezing cold shower situation. It's the coolest shop, I think it can be summarised by the fact it has a room that is only filled with crisps :D
In a miracle of modern times, I managed to finish work at 4.45pm, just in was time for a Coffee Bay pizza night with Sam, Anita, Etienne, Shannon, Jess and Ross (Jess' boyfriend).
On Wednesday I went to the maternity mortality and morbidity meeting where the medical team discuss the birth and death stats for the month. There were something like ninety births and three deaths in February and for each death the possible improvements to patient care that may have changed the outcome were discussed. After the meeting, Karl gave us a lecture on the new protocol for ARVs which is an exciting new development because it means that all the patients on a drug called Stavudine (D4T) will be changed to a better one called Tenofovir which doesn't have any of the terrible side effects like lipodystrophy and peripheral neuropathy (go look those words up...haha) [actually don't, they are probably the wrong ones and spelt wrong;)].
My morning in the ARV clinic was spent chasing after two problem patients who had been here, there and everywhere and had their files either lost or mixed up. This week I was shown how to find the blood results in the lab so now have to joyous task of doing that every now and again too. The hospital has just had a brand new lab built but it is sadly right at the other end of the site to the clinic so it’s a lengthy trek to get there. Karl is the most epic when he goes to get his blood results because he just jumps out the consulting room window to run down to the lab. I would love it so much if people did that in the UK!
Thursday was the day of one million patients flooding out the main dispensary. I came down from an empty clinic to see patients queuing all down the corridor. At one point during the afternoon, there were two doctors, Zandile and myself dispensing and it still took over half an hour to get the queue back down to a manageable size.
Apparently, every drug that is dispensed by the three pharmacists and I is done so illegally [not our fault, and there's nothing that can be done given that we have no pharmacist] because none of us have the training to do so. We are all able to hand out some pretty strong drugs like valium, ketamine, haloperidol, amitriptyilline etc. [One of the drawers is labelled cocaine, but I haven't looked in there...] I don't think I'll be allowed to dispense those sorts of drugs until a good few years of medical school are over!
Continuing on the theme of exciting work days, I'm sure you are bored sick of reading my blog by now, I spent all of Friday in the pharmacy prepacking drugs and doing paperwork, ably assisted at various points by Lisa and Sam :D After lunch courtesy of Lisa, thanks very much, I was back in on my own until Liz came by and lent a hand. She enlightened me to the genius idea that is 'taking your work home' so we took the files and pills and worked in front of the TV at the Gaunts all afternoon.
Dinner was macaroni cheese but we put it in a big pot and took our bowls down to a fire pit outside Roger's house and Sam, Megan, Joff, Liz, Lisa and I ate out dinners and chatted until quite late at night, good times :D:D
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| The women of Zithulele at the White House |
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guess i've got some of the stupid questions from the book to look forward to when you come back although gregor is managing to keep up your tradition of such questions!
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