A Final Project

  As my time at Karanda is finishing up, I was thinking about what I might be able to do to leave things here a little better than when I found them.  First I decided to clean the drain in my shower, which had never drained well since I moved in.  One very large slimy hairball later, that problem was solved, and I felt empowered to take on another project.

  During my time here, one of the things that has caught my attention is the difficulty encountered in resuscitating newborns.  There are many times that despite attempts being made, the newborn resuscitation fails.  Sometimes this seems to be related to baby being born far too early or having severe problems during the delivery or even having severe birth defects.  Other times infants who could survive seem to die because the attempted resuscitation is incomplete, haphazard, or completely neglected.  So as a last minute attempt to make things better, I asked permission to try and address this issue.

  With the help of a girl here who is an artist, I created a large (~3ft x 2ft) poster designed to take the guesswork out of resuscitation and give those attempting it a easy and visible algorithm to follow.  There were already a couple papers on the wall with neonatal resuscitation information, but they were too small and complex to be referenced during a resuscitation.

  Here was the result of our attempts...

 
In case you are wondering about Step 9, Chiremba is the Shona word for doctor, which is to say that steps 1-8 don't require a doctor and can be done by the midwives, nurses, and even nursing students.

  I was really proud of the aforementioned poster, but the sad truth is that after I handed the poster to one of the midwives to put up on the wall last Thursday afternoon, the poster hasn't been seen since.  Not quite sure what happened.  Several people have searched for the poster to no avail.  Now I don't know whether to spend a couple hours making another poster, or not.  The culture here is such that perhaps someone thought the poster was wrong or inappropriate or even offensive in some way, but since it would be too confrontational to tell me, they instead "lost" it.  Hmmm... I wonder.

  With the help of one of our anaesthetists and my friend, Rejoice, who is a midwife, I also made a chart of commonly used supplies and medicines for newborns with their sizes and doses, so that there will be an easy quick reference for treating these babies.  This I will print out and put up on the wall in the hopes that even if my other poster is never found or recreated, it will help some anyway.

  I also sorted through the resuscitation supplies to determine what items were missing.  In the process I fixed the pediatric pulse oximeter (checks oxygen levels) which hadn't worked for a long time.  I also found a small IV pump that would allow us to accurately give the fluids needed by our newborns (currently a real challenge).

 I would love to see more results like the ones below...