Day 8

Day 8, The working day here starts with a prayer. The medical manager here came in a missionary capacity in the 1980s and set up a church in the locality. Some of the senior doctors have a literal pastoral role at Mseleni. A passage was read from The Bible, and then a prayer was said for the working day. In some ways it makes perfect sense that only people of faith would be able to work here day in day out with everything they have to witness, but perhaps that would also be reason to question faith.

Today I did my first cannula and lumbar puncture here. Not a big deal in most settings but I was slightly anxious about the LP as I had only done one in the last 2yrs, and even then I had help for that. No such luxury here. Of course the real worry about needle procedures were that both patients were inevitably HIV positive. In the UK I would almost certainly take extra precautions; double glove, have a sharps bin within reach, mark the bottles high risk. Yet again, no such luxury, you just to have to crack on. There is one sharps bin on the ward, nowhere near the patient bay. To those who were wondering, the indication was possible cryptococcal meningitis in a guy with widespread and likely visceral Kaposi’s, it was a champagne tap.

http://www.youtube.com/watch?v=HKnxmkOAj88