On Thursday, Aakash and I attended a morning meeting of the hospital staff, where they talked about what had happened the previous day around the hospital. A lot of their conversation centered around the mortality in the pediatric wards, and what could have been done to prevent some of those deaths. Many of the problems were identified to be systemic; it was not a matter of negligence or malpractice by one ward or one physician, but rather a series of smaller errors that were exacerbated instead of rectified as the patient continued to receive care. For instance, many patients are transferred to multiple wards during their stay at the hospital. If one ward sends a patient in critical care to a low-risk ward, and then that ward doesn’t check in on the patient often enough to fully monitor the condition, it is not the fault of any specific caregiver but rather the fault of the caregiving system itself as applied in that instance. In a hospital as big and multi-faceted as QECH, I imagine that it is hard to keep such a large network with such widespread responsibility running flawlessly.

 After the meeting we shadowed Dominic on his rounds. Dominic is the attending physician at the low-risk pediatric ward. In his ward we got to witness the use of the CPAP machines, as well as some other technology that I was familiar with. Dominic explained that most of the infants under his care were hospitalized because they had some sort of infection, and they were often septic. He and his colleagues informed us that the largest technical obstacles encountered in the ward were mostly centered around the ability to deliver fluids through an IV drip, and the lack of oxygen concentrators and phototherapy devices available. Aakash and I got a lot of specifics on what exactly wasn’t working with administering IV fluids and a few other problems, and we look forward to bringing that information back with us to the US so that BTB can do as much as possible to resolve the issues.

On Thursday afternoon and Friday I spent most of my time in the BTB office. Shannon helped me get started on a couple projects related to CPAP training in different hospitals. Now that I’m more settled in, I have also been getting a much better idea of what our specific goals are going to be for the next two months, and how much potential Carissa, Jacinta, Caleb, Aakash and I have to really help out in the time that we have. I look forward to starting on some bigger projects next week!