Northdale Hospital

    Before going on with today's blog, I would like to conduct some business.  First, a retraction.  Last night I was very tired and beside several major typos, I got the name of the hospital wrong.  It is "Greytown'" not "Greyswtone."  Also, it has been hard to send the notification emails from here.  They do not seem to go through.  Please checkfor the blogs each weekday, and I will try not to disappoint.
     Today began early for Jamil and me.  We attended the Greys Hospital version of our mortality conference, where they discuss deaths on the service and how they might be avoided in the future, without laying blame.  In Kwazulunatal they take our version further in that they  not only look for mistakes within the hospital and doctors, but, also, within the system.  This is so important here, as they can determine where best to apply their limited resources to avoid deaths.
     We then headed to Northdale Hospital, the former Indian Hospital under apartheid.  This is classified as a community hospital which implies that there are no certified pediatricians or other specialists.  This does not prevent huge numbers of patients from showing up in the outpatient department.  There is a significant emphasis on "kangaroo" care for small birth weight neonates.  This involves comfort and support for the mothers of premature babies to have the babies supported against their chests for feeding, comfort and control of body temperature.  This conserves resources and nursing in these high risk children.
     We then moved back to Greys, where we rounded with th echief of service for 2 1/2 hours.  It has been a long time since I did this, and it is hard on the legs and backs.  The cases were by and large very ill and quite interesting.  The recurrent theme of HIV/Aids, TB, and malnutrition was very evident.  Here, there was much brain involvement and other severe consequences.  Most sobering was that there were several children who did not satisfy the criteria for admission to the ICU because there chance of survival was minimal, and there were limited spots in the ICU.Dadah, who was brilliant by any international standard.  He discussed his choice of going into the public sector and passing up the riches of the private sector.  He was inspiring, and we are all fortunate that there are people like him.
     Hennie and Bill continued their work and even had a solid lead.  Each day brings some good hope and we wish for that one break.
     Larissa spent a successful day at Edendale Hospital working on the pediatric wards with the children and mothers.  She got to interview some mothers and got to work on a photography project in which she had children use photography to express some of their feelings about themselves and their condition.
     Another successful and inspiring day.
Marty