Scrubs and Chacos

Yes I wear Chacos with my scrubs. It is the best feeling ever. I can do this because the hospital has absolutely no rules governing sanitation. It is a weird set up. It looks more like a couple of run down houses in what used to be some pretty gardens, now run down as well into a tangle of weeds and even some crops. The pediatrics building looks ok on the outside, a rectangled mass of gray cement with occasional windows. But on the inside, you see that most of the square footage is taken by a courtyard and a roofed area surrounding it with benches and blankets where visitors sleep. The functional part of the hospital ends up being a hollow recantgle with three malaria rooms, a malnourishment room, and one miscellaneous room for things such as broken bones and snakebites. There are anywhere from six to twelve patients in a room, but the rooms would be considered singles or doubles in America.
The environment leaves the hospital very unsanitary, with the open air rooms, overcrowding, flies, and old food everywhere. The only things in the rooms besides the patients and their belongings are the bedframes and a mattress or foam to sleep on. They sleep on top of their mothers clothing wraps. There are also some back rooms that are the offices and the "operating room," although all they do is give injections and IV's. The only kind of diagnostic test they have is taking temperatures.

My biggest problem, however, is with the payment. The patients have to buy everything- medicine, thermometers, syringes, cotton- all before they are treated. And if they cannot afford it, they are not treated. Even those that are seen only after they have spent days scrounging up money, so the treatment is often too late. That is why the death rate is so high. And I am fairly condfident that Malarone, the malaria medicine I take, can not only prevent but treat it. It seems like it should be that easy.

Also, the doctors sit around so much. The daily routine goes like this. Work starts at seven; I show up before so I can change into my scrubs. Doctors stroll in around seven forty five. Around eight, the doctors do one round of all the patients. Two doctors and a nurse go to each patient, take his or her temp, and prescribe medicine. This takes two doctors, plus the nurse who pushes the cart, which the doctors refuse to touch. This takes two hours. Then they sit around till eleven, and then start treatment, giving shots and such. At twelve, they leave until three for lunch and a rest. Repeat rounds, while tzo additional doctors treat the patients. Home by five fifteen. I think an American doctor could do all of their wirk in three hours.

Now I am going to try to restrain myself from a William Schrieber esque rant about European/African works ethics (those who went on the missions trip tO Greece zith me have heard this rant), but it is ridiculous. They work short hours, take numerous breaks, are overstaffed, and complain about their job. Walking around town, people just sit around doing nothing. When David, who I will talk more about later, told me he wanted to go to America but coulndt afford the VISA and passport (his second time to ask for money) I told him to get a job. He cried. He is 18; and he cried over getting a job. That is why their country is so underdeveloped. Why the American embassy is the biggest building in Togo (it is- I love America). Because they just sit around. Yes I realize that there are not a multitude of open jobs, but still. I fully plan on spending as much time with my family as I can when I have a job, but when I am at work, I work. Kids should not have to suffer because their doctors are lazy. That turned into a slight rant. I am sorry.

TIA
Michael