Friday, 6 January 2012

Working In the Hospital

An Update of Angela’s work at the Hospital.
 All views expressed in the following article are our own and do not necessarily reflect the views of VSO or Stung Treng Hospital. Angela writes:
I was informed by the Doctor that babies born weighing less than 2 kg in Stung Treng will die within a week. I observed that there is no extra care or advice given to these babies or their mothers. They are just encouraged to breast feed on demand by the mother. Small babies of this weight are not strong enough to maintain their own body temperature or to demand enough food; they need a basic level of extra help.
A very poor women came into the Hospital maternity unit to deliver twins. Due to complications she had a caesarian section and then went to the mixed surgical ward for care which is where I found her two days later, not having been aware of her admittance or the birth of the twins. The ward was very crowded and the babies were asleep on the floor between two beds, a man with an infected foot was in the nearest bed. The woman and babies had received no care from a midwife although her wound had been redressed by the nurses. The baby boys were 1.9kg and 2kg at birth both looked dehydrated and were underfeeding. With the third year student midwives we discussed a plan of care including two hourly breast feeds (helped by the student midwives) and daily check and weighing of the babies. We also discussed Kangaroo care but that is difficult with twins after a caesarean section.

Mother Breastfeeding Twins in the surgical ward
Another VSO Volunteer and I gave the Grandmother some of our own money to buy food from the market so that they could all stay in a few more days. The hospital does not provide food or meals for the patients, food has to be prepared and brought in by the family if this is not possible due to no family present or ready money then it is a real problem for the patient to stay and pressures them to discharge from the Hospital early.
At five days old when the family went home the babies were gaining weight and appeared alert and healthy. They have a hard life ahead and I hope they will survive.
With the midwives and another VSO Volunteer we have developed a daily Baby check sheet for all babies along with a basic instruction sheet. This was accepted by the Chief midwife and Doctor so now in theory all babies get a daily basic check up; colour, feeding, bowels, urine, tone, breathing etc. The intention is that the situation regarding the twins not receiving attention should not happen again.

Breastfeeding Supported by Student Midwife
The students and some midwives do the check daily but I know that other midwives are maybe less diligent- but Rome wasn’t built in a Day!