Regular readers of my musings on this blog will be aware that about a month
ago I had an outreach visit that involved a human resources nightmare. I had
hoped that the whole thing had rather blown over and I wouldn’t need to
discuss it again. It didn’t so much blow over and blow up!
Our outreach clinics are overseen by a supervisor who has been given nine
months training in all things medical and sent out to run the clinic and
treat whatever falls though the door. The rest of the staff effectively
operate in support of him, doing malaria tests, giving out medicines,
fetching water etc etc. Anyway, to say this member is crucial to the clinics
survival is to say money is reasonably important to Donald Trump. Without
this health worker the clinic does not open. Full stop.
A short version (the long version might put me in therapy) is that the
supervisor of this particular clinic managed the following during the last
visit;
He picked an argument with us for absolutely no reason at all. Then, when
informed in the most reasonable voice I could muster, that this was
unacceptable and that he should consider his behaviour in future he walked
out in an overly dramatic, eye-rolling strop. Walked out, I might add
straight into the arms of another NGO and a near tripling of his salary.
Just be glad there weren’t any large or sharp objects in the immediate
vicinity. I was a tad peeved.
So this left two outreach nurses playing an increasingly frantic game of
spot the health worker. Initially we solved the problem by dragging a
substitute on from another clinic. The problems really started when he also
(for valid enough reasons) had to leave very quickly too.
We found ourselves hot footing it back from one outreach site and straight
onto a plane to rescue another. Things didn’t go quite according to plan
from the outset when the pilot keyed the wrong coordinates into his GPS and
flew us in totally the wrong direction. Thankfully Francis was much more
awake than I was and pointed this out. 12,000 feet is not the sort of
environment that facilitates easily stopping to ask for directions. After
scrambling around with maps we resorted to flying to somewhere near it
(which we had the coordinates for) and circling until we spotted the
village. This accomplished the plane was onto the dusty savannah in a matter
of minutes.
The first thing to do was to hold a staff meeting. We informed all the staff
that we would be seeing the patients ourselves for the week and sorting out
the health worker vacancy at the same time. In truth it had all gone (to use
the south London vernacular) pear shaped. We hadn’t a clue where we were
going to find someone. The situation was looking bleak. Clinic closure and
redundancy loomed large. I don’t think either of us slept very well.
Some very sick patients compounded this state of affairs. The worst was a
two-week-old baby who attended the clinic and had been seen by both of us.
He looked very well, he was feeding well and mother had few concerns. She
had actually attended with her other child, for her to be seen. The next day
the mother came back, this time with just the baby in a basket. As I took
the covering off the basket it was obvious that things were very serious. A
confirmatory listen with the stethoscope was the evidence. The babies’ heart
rate was extremely slow and the breathing was shallow and gasping. Fifteen
minutes of frantic efforts were not enough and, sadly, the baby passed away
as I held him.
There was no temperature and the child seemed well nourished and cared for,
I have absolutely no idea why the baby died. Infant mortality statistics
look a whole load different when you see them in flesh and blood. The
parents took the child home in the same basket that they brought him in.
Another Tuesday morning in Africa.
The people here accept child death as a norm, of course losing a child is
unimaginably painful, and I know they feel grief just as acutely as anyone,
but
children dying here is also greeted with a sad resignation, rather than
surprise.
A deeply depressing few days indeed, to depress myself further I looked
through the clinic records and found that many of the patients lived hours
walk away from the clinic and that its closure would cut a swathe of them
off from any healthcare at all. Furthermore the clinic was seeing patients
who were critically ill. I estimated that closure could cost 150 lives a
month.
