Bwelani

I spend my mornings doing a ward round on St Augustine’s the male medical ward. There can be anything from twenty to forty patients to be seen there many with complex medical problems. In the afternoon I go to St Luke’s, our outpatient department. This is where patients have their first contact with the hospital. The HIV clinic is run from here as are the specialist Surgery and Gynaecology clinics. Room 15 is where the doctors from the medical department work.

I feel more at home here, its more like General Practice what I am used to, mixed in with a good bit of A&E and a general medical outpatients. Patients seen in room 15 are a mix of those for review post discharge, reviews of chronic illnesses such as asthma, high blood pressure and diabetes as well as those first presenting be it with chest pain, fractures, miscarriage, anxiety or to have a police report filled.

I sit at a desk like at home and see patient after patient. Bwelani (l is pronounced r) means come ahead (it’s the closest I know to next). One afternoon I see a 50 year old man presenting for admission for chemotherapy for Kaposi’s sarcoma. Bwelani – a 29 year old lady with an ectopic kidney and hypertension for review. Bwelani – a 78 year old man complaining of chest pain who has chronic obstructive airways disease.

Bwelani – a 63 year old man who has TB symptoms, sputums are negative, X-ray looks suggestive, start TB treatment. Bwelani – a 30 year old man with an acute exacerbation of asthma. Bwelani – a 20 year old student who has malaria. Bwelani – a 30 year old man new diagnosis Hepatitis B positive.

Bwelani – a 38 year old man new diagnosis of HIV positive, symptoms suggestive of TB, quite unwell and admit to the ward. Bwelani – a 24 year old lady with congestive cardiac failure secondary to rheumatic heart disease for review. Bwelani – a 7 year old girl with cough fever and constipation, admit to paediatrics (transpires has ileus secondary to pneumonia). Bwelani – a 69 year old lady with anaemia probably secondary to peptic ulcer disease.

Bwelani – a 19 year old girl previous Caesarean section in Mozambique at term, send to ‘waiters’ via maternity (waiters is a house in the grounds where women who should deliver in hospital wait). Bwelani – a 55 year old HIV negative man with sputum positive pulmonary TB, start TB treatment.

Bwelani – a 46 year old man with type 2 diabetes for review. Bwelani – a 36 year old HIV positive lady with pulmonary TB for review. Bwelani – a 3 year old boy with malaria. The afternoon concludes and its back to the still rather unfamiliar territory of the evening round on the medical ward.