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MADIBA
United Kingdom
1275 Posts |
 Posted - 26 Mar 2007 : 22:24:51
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Reports reaching us say the death rate amongst women who underwent caesarian births at the RVTH is on the increase. Fingers are pointing at the cubans on technical assistance. Whatever the case, the concerned authorities should not shy away from the problem. Let them investigate and find a lasting solution to this problem.
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madiss |
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sab
United Kingdom
912 Posts |
Posted - 26 Mar 2007 : 23:34:41
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Infection control must be at the highest standard, otherwise septicaemia will follow quickly after caesarean. Septicaemia/Septic shock will cause complete organ failure. Does RVH have kidney dialysis machine & the huge amount of expensive drugs to combat such blood poisoning?
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The world would be a poorer place if it was peopled by children whose parents risked nothing in the cause of social justice, for fear of personal loss. (Joe Slovo - African revolutionary) |
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salimina
253 Posts |
Posted - 27 Mar 2007 : 00:03:25
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| If that is the case then there should be a lot of investigations. Because caesarean is one of easiest jobs in an operating theatre.No qualified doctor should have a problem with. |
Edited by salimina |
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gambiabev
United Kingdom
3091 Posts |
Posted - 27 Mar 2007 : 08:48:29
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Its easy to blame outsiders, such as Cubans. WHat racism!!
The Cubans come to Gambia and work very hard in the Gambian health service for very little reward and often as volunteers.
IF the unit is not following careful hygiene rules and if appropriate drugs are not available perhaps that is more of a reason than the fact the workers are cuban!!!
IF this is an ongoing problem then clearly there needs to be a full investigation. Otherwise these women might be better to take their chances at home and not risk an infection in hospital. |
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MADIBA
United Kingdom
1275 Posts |
Posted - 27 Mar 2007 : 10:12:19
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| GambiaBev, come on ! Wat racism? The cubans are not the only non-Gambians wrking in the health system. The bottomline is let the authorities investigate, let the truth emerge no matter whose cow is gored. |
madiss |
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sab
United Kingdom
912 Posts |
Posted - 28 Mar 2007 : 00:52:55
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Gambiabev, there is very much more to it than Cuban's helping or working voluntary in The Gambia. As you know 'voluntary' does not necessarily mean working without payment.
Take at look at the monthly salary for the VSO worker below. £120per month plus expenses. - in The Gambia! VSO are generally known to be voluntary.
Medicine & Health Services to other countries earn Cuba near on £1bn annually.
There are 'Government Agreements' going back about twelve years - on Cuban health programmes and in recent years Gambian's in very small numbers have visited to Cuba for training.
I still suspect that the problem at RVH is septaceamia, or newly trained staff with not enough 'hands on' experience, left to there own devise (as is the case in the UK also)
http://www.medicc.org/publications/medicc_review/0805/cuban-medical-literature.html
http://www.medicc.org/publications/cuba_health_reports/005.php#1
Clare Hamer, working with VSO - specialist registrar in paediatrics, gives an account of her experiences as one of the first doctors to be involved in this innovative scheme
After our morning meeting we disperse to our workstations around the hospital. I am working in the acute and main sections, which are supposedly for more stable patients. The ward is still being cleaned, and so it is impossible to get into it. I visit the procedure room first, where I find three extremely sick patients who have not managed to find a portion of a bed. Since I cannot find a nurse I struggle to take a history in broken Wollof. The nurse arrives and we sort the three out in 15 minutes. I eventually start the ward round at 10 am.
I sit in the middle of the ward and the patients come to me unless they are too ill or too big to be carried. The round is interrupted only three times today: to deal with patients in status epilepticus and one child who has just died. In total we see 40 patients in three hours.
Working in the Gambia is very different from any job that I have done. We are under-resourced in every way. Staffing is inadequate; the medical supplies are erratic; and the ability to do investigations is extremely limited. Seven junior doctors and two consultants (including me) see between 150 and 350 admissions per week. We see the same number again in the outpatients and the specialist clinics. During the height of the malaria season it is not unusual for one nurse to be looking after 80 patients. The net result is a high level of mortality and morbidity. The figures are depressing. In the peak of the malaria season over 20% of patients admitted were dying. The figures have now dropped marginally, but
they still reach 12-15%. This is my first experience of working in a tropical setting and so it is difficult to know how these numbers compare with other countries.
The frustrations are enormous. Children often die for no obvious reason. I may have seen a child a few hours earlier, and, although unwell, he or she had not looked on the verge of death. Because of the difficulty in monitoring and doing investigations I am often left guessing the cause: electrolyte disturbance may have contributed or maybe the child had aspirated; alternatively, the treatment we gave or failed to give may be responsible.
I have been assigned to the cardiology clinic. Since there is no echocardiography available in the country my clinical skills have been tested and improved. I work with some extremely good nurses who site all the Venflons, identify and correct hypoglycaemia, treat convulsions, and ensure that at least some of the anaemic children receive lifesaving transfusions. Sometimes children get better against all odds.
Every morning before work there is a handover meeting for the doctors in which we discuss one or two cases. Weekly events include reviewing the mortality statistics in a joint meeting with the nurses and the pharmacy staff, presentations by medical officers on topics of interest, and a teaching ward round with paediatricians from the Medical Research Council.
Clare is extending her stay at the hospital as she is currently the only paediatrician there.
http://careerfocus.bmj.com/cgi/content/full/323/7303/S2a-7303
Regards,
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The world would be a poorer place if it was peopled by children whose parents risked nothing in the cause of social justice, for fear of personal loss. (Joe Slovo - African revolutionary) |
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gambiabev
United Kingdom
3091 Posts |
Posted - 28 Mar 2007 : 18:13:08
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| I was not the person that blamed the cubans! I fully understand it is a very complex issue. |
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