I've been sick for like a week now, and yesterday I visited my grandpa Chuong's doctor's office to get some meds. He's known for handling flu and the like very fast but it's no surprise since he always immediately uses antibiotics and applies them i.v. (intravenous).
Funny thing was that I was allergic to the antibiotic I received. At first my skin became red but I wasn't really alarmed, then it began to itch and a nurse called my grandpa then. He gave me something to inject intramuscular. The nurse wanted to do it ventrogluteal but because I've heard too many things about it being done wrong resulting in the injury of the superior gluteal or ischiadic nerve, I convinced her to inject it into my arm. She was all like, "But if we do it there it will hurt a lot!" but I didn't think so, sis. I'm no sissy, thank you~ [-X
Talking about luck that I stayed after the antibiotic injection and my allergy was immediately treated, though. As crazy as I may sound right now, it was interesting to experience an allergic attack, hehe. When the itching became quite uncomfortable, I really did get those symptoms of feeling really hot, especially in my hands and feet. Had I waited longer, I would've probably gotten an anaphylactic shock. At least then I wouldn't be laughing as much anymore, lol.
I'm probably getting a drip today. Grandpa says he'll heal my allergy too, since I do get those random skin rashes quite often.
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But yeah, what today's post is actually for is the further introduction of what I've seen at the Children's hospital. First of all, a picture of the main building:
The quality of the facilities is one thing, the quality of equipment and health care in general is another thing that is very, VERY different from what I'm used to in Germany.
As I already said in the previous post, I'm working in the neonatal department. There was this case one day, a premature baby with kidney failure had a rock-hard ascites belly and needed an abdominal puncture. A surgeon of some sort came to the neonatal ICU that day to do the job. The seemingly easy task failed on the first try, however, because the scalpel he used was too... blunt. He pressed and sawed on the infant's stomach for about five minutes before the nurse came in with another set of surgical instruments. Thank God it worked then. The whole time I was feeling so, so sorry for the baby. I can't imagine the pain it has to endure when it wakes up, the result of a mini surgery that was not supposed to hurt much. Sigh...
Then the other day, I witnessed an intubation. It was an orotracheal intubation without any form of anesthesia (it wasn't an emergency, so I didn't really understand...) What was worst was that day, the doc in charge let some interns try and while I was standing next to them watching, my heart was seriously breaking. Unskilled docs need practice, that's for sure, but maybe not on a kid that isn't in the least unconscious, please? I could see how hurt it was >"< In the end the interns had to give up (after blood started to bubble out from the baby's mouth and they couldn't see anything anymore), and the more skilled doctor had to do it. When I asked her why we didn't sedate the kid, she shrugged and smiled sadly at me, saying forlornly, "Tại vì mình không có đủ tiền để gây mê tất cả các em, Phương ạ. (Because we don't have enough money to sedate every single one of them)"...
Oh and did I mention they didn't even check if the tube went into the trachea or accidentally in the esophagus? Either the docs are way too skilled and don't need assurance, or they's just careless... (I'm leaning towards the latter :-<)
But yes, money is the main problem. Had we had enough money, we wouldn't have kept blunt scalpels. Had we had enough money, we wouldn't have intubated awake infants. Had we had enough money, we wouldn't have put 20 patients in a room with only 10 beds... (10 beds, I repeat, a room with 10 beds!)
Here's a picture of the neonatal ICU:
Another thing I'm quite shocked about was how freely the kids here receive oxygen therapy. It's always said that you should only give enough as needed, since too much oxygen will definitely become toxic. When I did my checking round one morning, I had a kid with 7 liters oxygen. 7 freaking liters! And no nurse really noticed... I mean in Germany during my internships in the internistic heart and lung department, I have barely seen any grandma or grandpa with more than 5l oxygen, and here, infants get 7l... I cut it to 5l at first, then 3l, then when I end up with 0,5l, the saturation was still at 98%. I observed the kid for another ten minutes just to be sure, feeling sorrier and sorrier with every second passing by... I just don't get it. Half the kids are not monitored because we don't have enough machines, but then two third of the kids that are monitored have a saturation of constant 100% and no nurse, no doc actually come up with the idea to check the oxygen administration.
As a contrary example, I saw an intubated baby with 40% SpO2, the monitor was beeping like cray cray but no one heard it. I checked the tube and the connections and stuff, but couldn't do anything, so I quickly called a doctor. A doc came, fumbled there for another minute without any effect and ordered a nurse to come suctioning the baby. After suctioning the baby could breathe again, the saturation went up to 95%. The whole chaos took about 4 minutes to handle, I don't know how long the baby's been at 40% before I came, I don't know how much longer the baby would've had to stay like that if I hadn't come, but either way, I'm pretty sure some brain neurons of said baby was damaged. So maybe the doc will heal its pneumonia, but how are they gonna explain the neurological deficits the baby will probably have to endure for the rest of its life?
I honestly don't know who I should blame more, the docs or the nurses. Or the hospital managers. Or the politicians, for pouring all the money into shopping malls and other shit. Because well, the medical professionals do the rest of their job quite well.
They do heal pneumonia and other infections no matter how bad. (For some weird reason neonatal pneumonia is really, really common here. We have a whole ward for little pneumonia patients).
They have enough surgeons who can do successful surgeries for infants with congenital heart diseases. (The main problem is usually that the parents don't have enough money for those costly operations...)
They heal pathological icterus / hyperbilirubinemia with photo-therapy very effectively (though I'm not sure how that will affect the infant's eyesight later... probably not very positively).
The two wards for premature babies are managed quite carefully too, except for that oxygen therapy problem I mentioned above (almost every premature infant has an insufficient gas exchange due to unripe lungs... so oxygen therapy is always involved). What I kinda find interesting is that they use caffeine for those kids with asphyxia on birth and those with a lot of dyspnea attacks. Apparently caffeine is used a lot in Germany too, I just haven't heard of it.
Well yeah. Thanks to this internship, I definitely got a lot more insight of what goes on behind the scenes in Vietnamese hospitals. To think that the National Hospital of Pediatrics is Vietnam's hugest children's hospital... I seriously have to reconsider working in Vietnam later. Not because I don't love my country as much anymore, but rather because I could probably do more if I work in Germany and regularly come back to Vietnam to volunteer, donate, support, help out with advanced training for docs and nurses, etc.
I really don't know... It's still a long way to go, self, you have a lot of time left to decide. :)
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