| | Recently we have had a long period of time without any doctor consistently in Greenville again. One of the reasons we got involved in this project was to reduce the number of women who had to travel to Buchanan or Monrovia by road for "emergency" C-sections. In the dry season, when the road was pretty good, the fastest I have ever gotten from Greenville to Buchanan was about 5 1/2 hours. Anyway, our goal is to always have a doctor on the ground in Greenville. And if we don't, we do our best to make sure that we are prepared to make timely referrals.
So, anytime there is no doctor in Greenville, part of my job is arranging referrals for patients. Normally the process should be pretty simple:
1. Hospital calls me and explains the situation; we determine how urgent the referral is.
2. I contact our driver (if our vehicle is available)
3. I contact our logistics guys to fuel the vehicle
4. We go to the hospital, get the patient and one family member and one nurse or midwife and send them on their way.
Easy, right?
Well, recently it hasn't been so easy. Sometimes our vehicle is not in town. Then we contact our partner organization who are implementing the clinic portion of our project, and usually they are able to help us, especially since they also support the hospital in Buchanan where we send our referrals. But even that is just more phone calls, not too difficult.
Sunday this was a whole new game, or so it seemed. Here's how my Sunday morning went:
5:50 AM - First phone call from the hospital about a woman who was bleeding in late pregnancy. I knew a little bit about her, as she had been in the hospital the previous week, at which time we were just monitoring her and planning to send her with any vehicle that was travelling, as it did not yet seem urgent to send her to Buchanan. Overnight her bleeding had increased, so the PA who was in charge at the hospital contacted me to refer her that day.
As of Saturday, we had received word that one of the bridges on the road from Greenville to Buchanan that had a hole in it was not safe to cross with vehicles anymore. This had been a bridge we had been concerned about, but Saturday we had gotten instruction not to cross with any of our vehicles again. So we knew that rather than simply arranging for our vehicle to go to Buchanan, we needed to make a swap - send our vehicle to the bridge and get Buchanan to send a vehicle to the bridge, and transfer the patient from one vehicle to another at the bridge. Again, it's a good thing our partner organization is supporting the hospital in Buchanan, because they are able to help facilitate these kind of swaps.
So it's Sunday morning. My first calls were to the project coordinator for our partner organization's office in Greenville, asking her to help arrange the Buchanan side of the swap. And then a few phone calls back to the hospital, updating them on what we thought was going to be pretty quick progress.
The first phone calls resulted in getting phone numbers of people at the Buchanan hospital, as they have an ambulance that would potentially be available to do the swap. And from that point on, the major cell phone network (Lonestar) dropped in Buchanan. Which wouldn't be a big deal, except that all the numbers we had for people in Buchanan were Lonestar numbers.
When we realized we couldn't get through on the phone, we thought maybe the radio would work. But there was a storm, so we couldn't reach Buchanan by radio. The Project Coordinator for our partner organization tried things like calling Monrovia and asking them to radio, all unsuccessfully. Finally I remembered that someone I know used to live and work in Buchanan, with the organization supporting the hospital there. So it was worth a shot to try and see if he knew anyone with any other cell phone company - and guess what? He did! The one Cellcom number he had was for the hospital administrator in Buchanan, which was perfect!
Finally, at 10:45 our car was on its way to the bridge for the swap, patient on board and all. They had to wait for some time for the ambulance to get there, apparently our driver drives faster than the ambulance driver! But the ambulance picked up the patient, and took her to Monrovia (because there was no doctor in Buchanan at the time, either), where she finally had a C-section.
The lesson? Don't have an obstetric emergency in Sinoe County! Seriously, this is the thing that's the toughest. I have so many friends who have recently had kids in the States or Canada, and at least half of them have had C-sections. I am so happy that they were able to have safe and timely C-sections - but I hate the fact that despite our work in Sinoe, we still have women travelling over the road for hours when they need an emergency surgery. So many of these women do not seek medical attention until it is already late... but even then, it seems like they shouldn't have to wait a whole day before they can get the care they really need!
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| | Posted 10/23/2008 11:21 AM - 39 Views - 2 eProps - 1 Comment
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