Halfway Point--going fast!

By Sara Brown

I have been in the ICU’s and in the general ward at Nakasero hospital this past week with Prosperity. There is a 4 bed ICU for critically ill patients who require intensive monitoring. The step-down unit is called the HDU, which also holds 4 patients. These are some of the cases we encountered while rounding in the ICU’s: CNS lymphoma, gunshot wound, severe dehydration, hypertensive emergency, DVT’s in a thrombocytopenic patient, among other interesting cases. 

The general ward also had interesting cases: refractory hypertension, newly diagnosed Type 1 diabetes, DVT’s, S. aureus hip abscess, kidney stones, severe itching from intrathecal morphine and more. This floor was interesting because the care was managed between a medical officer who saw everyone and a primary specialist. I crafted an information sheet with 2 options for initiating insulin therapy, so the general doctor could discuss changing the insulin dosing frequency with the specialist. It got placed in the patient’s chart!

Upon reflection, I realized that pharmacists are situated perfectly to ensure patient care while on rounds. We helped bridge communication gaps between different doctors and created discussions about patient’s therapy. We rounded with very receptive physicians who took our recommendations on drug dosing, renal adjustment dosing and discontinuation/initiation/adjustment of therapy.

It was fun looking up the different drugs we do not have in the US and comparing treatment strategies. Oftentimes, a medication cocktail was prescribed instead of maximizing the dose of one drug before adding on another. This difference may have to do with limited follow-up care after discharge. In the US, a patient will get plugged into a clinic and go for regular blood pressure checks until a therapeutic dose is achieved. Here, I’m not entirely sure what happens. I will have to ask a medical officer tomorrow!

And a food update: I ate West-African food yesterday twice (!) from the restaurant Mama Ashanti. It was very good! Fried plantains are becoming my favorite snack. I will for sure attempt to make them when I get back to the US 😊 Prosperity highly recommends getting plantain chips from Trader Joe's, too. 

Tonight, we had a farewell dinner to Dr. Nicol, who is going back to Minnesota tomorrow. The Welo Inn staff prepared a ton of traditional Ugandan food to feed 15 people! They had: matoke, boiled sweet potatoes, fried yellow potatoes, chicken, beef, peanut sauce, cooked greens, beans and rice. It was delicious! Following dinner, we had a dance party so people could dance to music belonging to their country/region/state. Crazy to think I'll be going back to the US in about 2 more weeks! Time sure does fly.