First day, losses and urine dipstick

It would have been nice to go 24 hours without my first patient dying. But that is not how this game goes. It was less avoidable than many deaths here, but nonetheless, still avoidable.

I debrief with the team, lessons are learnt. I locate a smaller face mask for next time and we talk about how we can communicate with each other and families navigating the 3 languages we are working in (English, Arabic and Tigarian).

And we carry on; the hospital flows remarkably well considering it has been constructed, staffed and stocked in only the past 3 months. I see a 7 month old with malnutrition and gastroenteritis, a baby with intractable seizure, malaria, HIV related gastritis, radial arm fractures and lower back pain.

All treated and diagnosed without tests (other than rapid malaria test). It is medicine at it’s purest. All types of presentation, of all ages. Short histories and through examinations leading to long thinks about which in out tiny but potent arsenal of medications could possible help with the more complex of problems.

I love it. I was worried, after years of work, months of admin and weeks of long sweaty journeys what if it wasn’t what I thought it would be? But after a day of constant sweat in 45 degree heat, struggling to communicate and sleeping on a camp bed in a dorm I couldn’t be happier.

I am still the new boy, thrust into a job role slightly above my station and trying to learn fast. But I see the improvements in myself and in the hospital by the hour. At the end of my first day the urine dipsticks arrived. I never thought a urine test would make me so happy but with such limited resources simple tests can go a long way.