This past week we have been in the Worcester hospital where
we were given a ward to screen and follow-up throughout the week. My ward
contained a lot of chronically ill patients including diabetics, renal patients
and COPD. It also included TB patients, these patients were all malnourished
and required supplemental drinks.
Being in hospital is
really a life changing experience where there is no monotony and the difference
you make to each individual can be so rewarding, even if it's simply giving
them a warm smile and asking them how they are(asking like you really care and
you really want to know the answer) you can see that they appreciate it. I'm
not just talking about the patients here, because obviously we have to go into
much more detail with them, but I'm talking about the nurses, the cleaners and
the security. These people spend a lot of time looking after others and making
sure they are alright, but does anyone ever ask if they are ok and give them
some attention? So for me treating my patients and the people that work in the
ward with the same warmth and care is so important, because then I know even if
I can't make a huge difference in their lives nutritionally wise I have at
least made a difference in the way they feel that day.
There were a few
incidents this past week that truly touched me in my ward, I would love to go
into detail about every single one but I feel like that would take a bit long. Briefly
though I counselled a few patients on Diabetes and also a weight loss
patient and I could see how much they
appreciated what I had taught them(they also thanked me many times, so I know
they appreciated it) and that they truly were going to make a change to their
diets when they returned home. From this I realized that half the problem or
even more than half the problem in our country is that people do not have the
knowledge to make a change in their lives, they don't know any better, which
enforced my belief in that Community Nutrition plays such an important role as
that is where health promotion can occur and with health promotion comes
prevention which would basically mean that less people would be in hospital
from eg hyper/hypoglycemia because they would know how to manage their
Diabetes better , if they even had it(wishful thinking to completely prevent
diabetes from occurring).
Teaching the moms how to cup feed and express breast milk when
we had never done it before was quite a daunting experience, but educating the
moms on breastfeeding and positioning and latching was incredibly rewarding and
I really enjoyed it. I think that one needs to be careful with how much
information you give in one go as they are very overwhelmed , especially if
they have just had their first child. With that in mind I it is also very
important to not just criticize the moms but to encourage them on what they are
doing right as well, it is important that breastfeeding remains a positive
activity not one where you are worried you are doing something wrong in. So
remain calm, patient and positive when you are educating moms would be my
number one tip.
Being able to cup
feed a KMC baby was incredible exposure that I am very grateful now, because
now I know how difficult it is, but only if you don't know your child. I say
this because I think you learn the different mannerisms and the best position
to cup feed your child so the more you cup feed the easier it gets and the more
the baby gets use to it. The experiences with the mothers and the tut we had the
previous week will definitely better further consultations with future mothers.
Suggestions to use our time more effectively during Ukwanda:
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To have ward rounds every day in hospital, even
if they are very brief, as it allows us to learn from the other Dietitians patients
and not just our own. Which obviously means we have greater exposure, which
will hopefully allow us to be able to know how to handle different patients in
the future.
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I think it is very important to do health
promotion in the clinics and day hospital specifically focusing on Diabetes and
Hypertension as these are too very common ailments in the community and they
can easily be managed with help from the diet.
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With this being said I think that Health
Promotion aimed at care givers for their children is essential:
o
This would include educating them on correct
complementary feeding guidelines, so basically healthy eating and the portion
sizes for their children.
o
As well as teaching the Mom's in the birthing
wards about the RtHB and going through it step by step. This is very important,
and I strongly recommend it, as there is no one else who will take the time to
give such a detailed explanation to them. With that explanation they should
know the importance of breastfeeding, how to complementary feed as well as the
importance of going to the clinic. And with just that we can change so many
lives.
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I realize we have to make the most of our time
here and that a day only ends at 4pm, like any other working day would, but
finishing at 4pm on a Friday in Worcester and still having to drive back to
Cape Town is very tiring and not very enjoyable. I also know that we are
encouraged to stay in Worcester over weekends, but when you are in private accommodation
in Cape Town(which is generally quite expensive), have a gym membership and
friends there it is unlikely that we won't return every weekend. It would be
fantastic if we were refunded for every weekend. But I wouldn't not want to
come here, I think that the opportunities we receive in Worcester are incredible
and we are blessed to have such different learning opportunities.
To summarize what made my week.
A patient said to me when talking about where I was going
for Community Service next year(casual conversation):
" Ah , so you want o go back to your home so you can
help your people".
I was blown away, that is the exact reason I am returning
home, to give back to the people who gave to me. What an incredible individual,
and even though she was severely ill, her soul and mind were not. They were fill
of energy and passion for life! Which just shows, you are as strong or weak as you
believe yourself to be.
"Are you finished weighing me?" "Yes I
am" " Ok good, cause I want to go for a walk now" "Where
are you going to go?" " Oh I don't know, I just don't want to lie in
bed anymore it makes me feel useless and tired".
