But is he right? I think it's too early to come to a definitive conclusion on this one but I thought I'd share some of my initial thoughts. In due course, I will extend it to how I think help should be provided to the hospital in order to maximise its impact - but for a number of reasons, including the forum in which I write, that shall be put aside for now.
So, am I? It really depends how you define voluntourist. Online you can find a number of positive definitions that equate the term to 'crowd-sourcing with an incentive'. You have a dull but earnest task that needs doing - like counting fish in a coral reef - and it would be helpful if 100 people came to do a couple of days' work each and then spent a few days just lying on the beach. As long as the quality was fine, everyone's happy.
For the Prof it has negative connotations. He is using it for people that come solely to make themselves feel better, almost to gloat. And whose contribution to the running of the hospital or the lives of the patients is so minimal as to be insignificant. He would rather have their airfare and foregone wages as cash so that he can make the changes he needs to in theatres. His number one aim at the moment is to make them insect and animal free!! And of course if you pay locals to do what voluntourists do, that money feeds into the local economy.
I can entirely see his point of view. If I am honest, I knew that I could not, under any circumstances, make a significant change here in 6 months. I'm not sure I could do it permanently (i.e. such that it would continue in my absence) in 6 years. But I would quibble with him about whether that means I should not have come. Much of my time over the last couple of weeks has been spent writing surgical protocols or, more recently, amending protocols that he has written. None of this would have happened without me being here - there is no one in the hospital with the time, the IT capability (why is it that Word randomly adds funny lines in the text every so often?) or the medical language understanding to do these. Yet they are required by the Government. And how long would the pharmacy have gone on thinking they couldn't add new products to their stock keeping software if I hadn't taken the time to read the manual and find the correct button?
Of course this all has to be balanced against the 'tourist' bit. Is it a coincidence that I love Africa and we are in Africa? No. Is it a coincidence that we are only 4 hours from a National Park? No. Do we intend to visit the park a few times? Yes, tomorrow being the first! So there is a definite upside to us being here that I would never attempt to deny. I am loving all the smaller animals around the hospital and being able to watch the sun setting in the massive sky. But we've been here 6 weeks now and, illness aside, Geoff has been in the hospital practically every day, with operating lists double the length of UK ones 3 days a week. So I think a short break is deserved in anyone's book.
Therefore, as I sit here right now, I think the answer is 'So what if I am a voluntourist? I am still helping at least as much as I am benefitting.'
Day to day in the hospital this week
For a little while now the hot topic at meal times has been the impending shortage of salt based IV fluids. Preferably those without dextrose (Dex) in. There was debate about whether best practice is to resuscitate with Ringer's Lactate or pure saline - it seems to vary by NHS hospital and department and internet source - but ultimately everyone agreed that they didn't want Dex-Saline or Dex.
I overheard the Acting Medical Superintendent asking the pharmacist about the fluids when he took me to pharmacy the first time last Tuesday. The response was that he had plenty of Dex-Saline. Quietly the AMS said 'but sometimes they can't use that.' Soon the wards ran out of saline, there were rumours of pockets of it - a nurse on the men's medical ward had 'found' a box of Ringer's Lactate that was being reserved for the really sick. Everyone else was getting Dex-Saline. The level of concern at meal times increased.
When I went to pharmacy this Tuesday I needed to ask when the delivery was expected this week. I have promised to help the stores boy with the data entry to make sure the prices are recorded correctly. The pharmacist's response surprised me a little "We aren't expecting a delivery from Medical Supplies [the Govt company] this week and I haven't placed the order for the other things we need yet." When do you think they will come? "I don't know, I will send word when I need you." The little voice in my head was screaming 'Why are you so calm? why haven't you placed the order? I was stood next to a trolley covered in fluid bags - all 10% Dex. The hospital has now run out of all saline IV.
And the Govt inspectors are here this week. In the weekly meeting the Acting Medical Superintendent let people know what they are checking for. 1) they are checking that protocols are being used correctly. A medic asked what protocols they should be using, she hasn't seen any. 'If you can find a hospital one, use that, else use a Zambian one, failing that a WHO one'. OK (but in fact there is a book full of hospital protocols which we use) ... 2) they are checking that staff are wearing their name tags. Same medic (she's persistent) states she doesn't have one. 'No, you don't. We haven't had any new ones printed for 2 years'. OK...
At dinner on Wednesday the Prof and his wife join us in the Mess. We talk about a lot of things and then I get in trouble for trying to organise/help (depending on your point of view) the Prof as he serves the pudding. His wife says 'do you think you would make a good Medical Superintendent?' I said that I thought I could make some positive changes. 'Yes' she says 'I told [the son of the English couple that used to run the hospital] that they should appoint you.' Whatever can she mean? She's only met me about 5 times!
No comments:
Post a Comment