Day 2

We started off today by meeting with Zinhle, one of two pharmacists at Raleigh Fitkin Memorial hospital.  We did an overview of some of the patients in the women's public medical ward and then began rounds with Zinhle as well as two pharmacy technician students from SANU.  We went through four different patient charts before visiting the ward and observing their status.  Some of the disease states we observed included common things in America such as diabetes, anemia, dehydration, and electrolyte distubances.  We also observed some less common ailments such as tuberculosis, HIV/AIDS, malnutrition, and opportunistic infections.  The ward is one room and usually holds around 34 people.  The Swazi people must provided their own bedding and food while hospitalized.  The average stay is around 5 days and costs about 60 cents (USD) per day to stay there.  The protocol for tuberculosis is very different in Swaziland due to limited space and funding.  All the tuberculosis patients are stationed in the back of the room, although not isolated; whereas tuberculosis patients in the US follow very strict protocol with negative pressure rooms and complete isolation.  This is troublesome for the hospital as disease can be easily spread to other patients or healthcare workers.  We were required to wear fitted N95 masks while in the ward to help protect us from tuberculosis. 

Next, we visited the ICU, which was more similar to an ICU you may see in a developed country.  In contrast, however, it was still one large room, but the facility and equipment were more up to date and less crowded than the medical wards.  The ICU isn’t used as frequently and there was only one woman staying in the ICU at the time we visited.  She was brought in and diagnosed with Type I diabetes and symptomatic diabetic ketoacidosis.  We were able to observe kussmaul respirations for the first time, which was visibly evident by her quick and heavy breathing.  We were given a chance to look at some of her labs and evaluate her current therapy. 

Our last stop on rounds was to the renal dialysis unit.  Similar to the ICU, it is a newer donated facility with very nice equipment.  A very nice Swazi man allowed us to observe his dialysis and ask questions.  We then proceeded to do clinical research on topics we encountered during rounds and met with Zinhle for discussion.  We finished our day by meeting with Sarah, the director of the pharmacy technician program at SANU to provide her with materials for her upcoming school year.  There was discussion for rotation opportunities for upcoming 6^th year STLCOP students to teach at the university next year.