On my own again

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So after an uneventful weekend last week, Monday came, and Rebecca and Amanda said their goodbyes to everyone at Bwafwano. I mostly spent my day doing data entry, trying to get my malnutrition program spreadsheet finished. I ended up getting the last bits done at home Monday night. The day was largely uneventful. The three of us, plus David ( a Swedish economics student we met here) had a great dinner at the Indian restaurant as a send-off.

Tuesday morning, Rebecca and Amanda headed to the airport early, and I went in to Bwafwano. I showed the clinic monitoring spreadsheet to the nurses, and they requested a few changes, all of which I put in place. And just like that, it was done! The MCH clinic now has a way to keep track of enrollment, RUTF daily needs, and monthly ordering requirements just by keeping the records they're supposed to do anyway. I was pretty happy with the results. I cleaned it up a bit, made it more readable, and finally put some protections on it so that the functioning parts can't be changed accidentally. Hopefully, it'll help the program run smoothly once I leave (which is coming soon!).

Wednesday was the big IMCI and CTC clinic day at Bwafwano. I've managed to miss the last couple of these, but I was quickly reminded of how busy and crazy it can get there. We had a couple admissions and a couple discharges, and I think we're working on settling into an enrollment plateau of about 25 malnourished kids. One highlight was that Anna, the girl we saw my first day, came back. As you may recall, she was admitted to UTH, and discharged early to go into our program. Unfortunately, she disappeared off the radar for a few weeks, and Wednesday we found out why. Originally, it had been her paternal grandmother taking care of her at UTH and the clinic. Dad was incapacitated (TB and HIV), and mom was in the hospital (TB and HIV). As it turns out, things have been shaken up at home. Her father died just two weeks ago, and mom started taking care of her again after she herself was discharged from the hospital. The disappearance happened in the transition of care from the paternal grandmother to the mother, with the father's death thrown in for more confusion.

Happily, though, she's back. She looks very sick-- weighing only as much as she did when she was enrolled initially, over a month ago-- but she was clearly VERY hungry, eating very happily off my finger in the clinic. We're putting the family on close monitoring to make sure we don't lose track of her again; I am really not interested in making the same mistake twice.

Yesterday was a day at Chikumbi, and while there were no snakes (apparently there was ANOTHER one last week, which I missed), we did have a bustling clinic, with two new admissions to the malnourished program. It was likely my last day there at Chikumbi, and so I had to say my farewells to the HBC workers there. Despite the little episode of gastro I came down with there, the food has really been best at that site, in part thanks to the little chili peppers growing at Midnight's house.

Today was more of a day to make sure I'm tying up my loose ends before I leave. In the morning, I went to collect our RUTF order. On the way, I borrowed the Ubuntu laptop, because I'm going to be making a valiant effort to learn Microsoft Access and create a client database for them. Yes, I'm going to try to teach myself a new program and create a full database for them in a week, in my free time. Piece of cake, right?

This afternoon, I headed over to UTH to visit a patient that the Ottawa students had admitted the day before. It was a sad case (as many are here, it seems): a two month old who's severely malnourished and dehydrated, more or less because his parents are too drunk most of the time to remember to feed him. Thankfully, he's doing OK at the malnourished ward. Also at UTH, I was fortunate enough to run into Dr. Somwe, and we're going to try to get all the paperwork done for the physician exchange before I leave. He was a joy to meet with, as always. The only down-note was that a patient I referred from the day before wasn't there, which was particularly frustrating because I had given the mother money for transportation, and she swore up and down that she would be there by this afternoon. She hadn't arrived by 4 pm, when I was there.

Planning to be fairly busy this weekend, but I'll see if I do anything worth an update. More likely, I'll just tell the tale of it on Monday.

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