Male Ward

I have now been the doctor in charge of male ward for three weeks. We have twenty five beds and after my first three days on the ward, the ward has been full and remained full. Last Friday, the ward was so overfull that I had eight men waiting outside on chairs. I was a bit overwhelmed but managed to

o transfer two to bigger hospitals (one had large bowel obstruction which is a surgical emergency and another one had not been able to walk for six weeks and was awaiting an MRI scan),
o discharge three
o give two pass outs (which means they go home to take care of things for a few days)

Unfortunately one patient died (my first death on the ward and completely inevitable). This movement freed up sufficient beds to empty the hall way.

So far, my patients on Male ward are a huge mix – neurology problems (a few unable to walk), severe gastroenteritis (usually Stage 4 AIDS and therefore very close to death), surgical problems (two men with the worst smelling feet I have ever experienced – one waiting for a below the knee amputation and one with gas gangrene), orthopaedic injuries (lots of people chasing cows and fracturing bones) and young HIV men with bacterial meningitis.

I am really enjoying the ward. My nursing colleagues are great and the work itself is very challenging. Everyday, I find myself laughing about something. Here are just two examples:

When I took over the ward, I also took over the care of a psychiatric patient. As a doctor working in Africa (both South Africa and Ghana), I have encountered far fewer patients suffering from mental illness. This is partly explained by the link between affluent societies and increased stress levels. However it is also because of the limited medical resources in Africa. Here, very few patients with invisible illness/injuries are admitted.

Anyhow, back to my story, which is that my patient was admitted due to an episode of acute psychosis (he is a known schizophrenic who is not on any treatment). He smokes too much dagga (marijuana) and drinks too much alcohol. He is a very intelligent man who is quite bored with life. I kept him in as a patient until last Wednesday (I was waiting for the Psychiatric Nurse to see him). During this time, he explained that he was using the time wisely. To find a wife. Predictably he quickly became a menace. Anything female was a target. Except for me. Thankfully I was exempt from his charm. For I was his doctor. What a relief!

2) One of my young men with bacterial meningitis was desperate to go home having received only one day of IV antibiotics. I told him, very assertively, that he would be staying for minimum seven days. Immediately he looked very upset. Now there is no such thing as confidentiality on wards in Mosvold. Everyone gets to listen in as a patient is spoken to by the doctor. On this occasion, the Umkulu (old man) who was on the opposite side of the ward and seven patients away, shouted out that ‘Even though she is a woman, you must listen to her.’ Feeling greatly respected, I looked back at the patient. With back up from an elderly male, the patient acceded.