On Monday night, Liz and I kept Comfort company during the first few hours of her night shift.

A few things are different at night:

– Thanks to the new solar panels, there’s almost always power at night. However, there are some issues switching back and forth in the evening and morning.

– All patients who come must be admitted. As Liz blogged about, this can create some problems. Apparently some patients know this and, because they want to be admitted, come in at night and then can’t be seen until the following afternoon due to backlog.

– In the pediatrics ward, medications that are supposed to be given at midnight are given at 9PM so that the mothers can sleep. Many mothers sleep on a chitenje under their child’s bed.

– If there are too few nurses during the day, there are even less at night. Roughly 7-8 nurses and 2 clinical officers run the hospital.

– Doctors are “on call” with walkie-talkies. Since all of the doctors are provided housing next to the hospital, range isn’t an issue.

– Female and Labor wards can be significantly busier at night, because women come in from botched abortions (St. Gabriel’s doesn’t do them) or want to come in without their husbands knowing. Something like the SAPHE pad would probably see a significant portion of its use at night here.

From a technological perspective, the shortages and general added confusion in the nighttime reinforce the need for easy-to-use and quick devices. Nurses don’t have the time, particularly for potential-emergency patients who come in at night and need to be diagnosed quickly.

From an observational perspective, we had an exciting night, and I’m glad Comfort invited us!