Diary of a Tsunami Doctor |
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January 30th, 2005 - 07:17AM |
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Photo: The IRC Hilarie Cranmer, M.D., is a physician at Brigham and Women’s Hospital Department of Emergency Medicine in Boston. On only a day’s notice, Dr. Cranmer departed for Banda Aceh, Indonesia, on January 7 to join the IRC’s tsunami relief teams there. Cranmer has been sharing highlights of her travels and observations in an e-mail diary. Today is Sunday, and it's a day off—at least as far as clinical duties. We’re to write a ton of reports including inventories, contact information lists and a summary, both from team and individual perspective on our time here. So we've been spending our morning "off" at the internet cafe, the fastest one in town, where they have broadband, not dial-up. Of course, right next door is a souvenir shop. Business thrives when not devastated by a tsunami. Billboards in town let you know how to dress and how to ask forgiveness from God because of the tsunami. Yesterday everyone on our team was sick, so it was only a half day that started at 7am and ended at 4 pm. We drove out to Seunuddon, the region I’m working in, and saw all the patients in the observation unit. My special boy, the one with pus in all his muscles, still had a bit of a fever, probably for two reasons: one was that none of the nurses on really knew how to give antibiotics by intravenous, and so he hadn't got any in about 12 hours; and second because I needed to irrigate out his other abscesses. So he got some more ketamine for an anesthetic, some more antibiotics, some Tylenol, some fluids, some vigorous irrigation, and when he woke up he was without fever, his heart rate was down and he was happy as a clam. And, at least 5 more nurses know all about IV benzyl penicillin. Then one of the midwives found me because she was concerned about a postoperative patient, one who had a cesarean section about 10 days ago. So we all jumped in the car, and headed to her hut and found her and her baby to be nearly completely healthy. I had the ultrasound, so could see there were no pus pockets, and she was without fever. Her baby however was only 4.5 pounds, and she was having a lot of difficulty with breast-feeding. So we worked on that, and the midwife promised to visit her every day to help her. We’ll likely bring out some vitamins for the baby as well and enroll her in a directly observed feeding program, using expressed breast milk. There is so much need for continuity of care, with such a big population, and limited and unpaid staff. It seems as soon as you uncover some small thing, the hole is getting bigger and bigger. The senior staff is overwhelmed with things from supplies to morale to accountability, but eager all the same. From the health perspective, measles vaccinations are still a priority. Our camp across the street from us is probably still only 67% vaccinated, despite our aggressiveness of setting up in the camp itself, recruiting kids from tent to tent, and using the mosque loudspeaker to make the announcements. One possibility is that the population has been so mobile, moving between camps and villages where relatives are. Another is that we haven't been able to truly "mark" the kids to somehow show they have had vaccinations, since registration cards have been intermittent in supply and difficult to give/hold for the family. We’ve tried nail polish, magic markers, and using the teachers known as “police forces,” whom the kids are deathly afraid of lying to. But, it's a goal this last week to get as many as possible.... Okay, getting the evil eye to get going on reports and such. Talk to you soon, Hilarie Posted By: Dr. Hilarie Cranmer | Asia, Diaries & Journals, Health, Tsunami Relief Permalink |
