Working in the Hospital

First Impressions of the Hospital I work at in Stung Treng.

These views and impressions are my own and do not necessarily represent the views or opinions of VSO or of any of the management or staff of the Hospital.

My Hospital working day begins at 8am with a Management meeting where Ward Managers report on the activity over the last 24 hours and other likely and unlikely issues are discussed, for example:

-The Hospital has run out of strong painkillers and will not get any until the end of the week.

-A sick child needed a transfer to Phnom Penh but even though a Charity was found to pay for the transfer, the parents, who were poor village farmers, said they had no money to temporarily stay in Phnom Penh or to return afterwards, they therefore took the child back to the village untreated.

-The men: Doctors and Administrators, of the Hospital should not begin playing Boules in the Hospital grounds until the afternoon- in the morning they should work.

-Someone stole the pillows from the doctor’s overnight room so now he doesn’t have one!

By 8.30 I go to the Maternity ward, there are 10 beds on the main ward, two early labour beds and a room for births. One day there were as many as 22 patients lying on benches, on the floor or on mats with their babies etc.

The Maternity area is situated in a relatively new building built by Overseas aid.The Maternity ward is light and bright with white tiles everywhere but has no sinks in it at all. The birth room had 2 sinks both tied off with tape as the drains were blocked, all the toilets were also blocked- this lasted for 3 weeks and was blamed on relatives putting food waste and fish bones down the toilets.

Each woman/patient has relatives who stay with her (they sleep on the floor) as basic care and meals are not provided by the hospital to the patient.

Relatives bring food from home or buy it from the market nearby or give some money to a woman who has a basic kitchen under the Maternity Waiting House (a place where pregnant women who live a long way from the town can stay to await labour)

Photo of the Kitchen area under the Maternity Waiting House. There is no other kitchen in the hospital.

If the cleaner has just been the main areas look clean but on busy days especially if it is raining then the floors are very dirty even though people take their shoes off outside before entering.

The Patients are a very mixed group all bunched together- women who have miscarried, women with new born babies, women whose baby was stillborn, readmitted women who have hemorrhaged,women with eclampsia(fitting) also some older gynae. patients with cysts or bleeding etc.

The Labour ward bed looks very basic and is not very ergomomic.

Wood delivery bed with vinyl cloth. Every woman who gives birth in the hospital uses this bed. Also see basic wood trolley.

New birth beds came with the new building but they are more like large flat trolleys- no back rest and the Lithotomy poles are too wide apart .The new bed is rarely used for women and is used as a shelf to store things on.

The delivery instrument trolley is a basic  wood thing with dirty rusty wheels. Bits of vinyl tablecloth are put on the bed and trolley –these are wiped between patients.

So far staff have been mainly welcoming and friendly and there are some lovely 3^rd year student midwives who are intelligent and caring. There are no teaching aids in the hospital so after  a teaching session with me about cervical dilation,  one student made an excellent teaching aid using cardboard and paper  I was delighted by this and am hopeful that changes for the future of maternity care is in their hands.

Lovely student midwife with her home made teaching aid.

I will write more about the Midwives and the care they provide next time.