Waste not, want not. It is amazing how little is wasted here, in the hospital particularly. At home, when we do a procedure on a patient we grab extra supplies (needles, syringes, gauze, gloves, IV cannulas, etc) and whatever remains is more often than not just thrown away. Because our sterility and cleanliness is scrutinized. We are so afraid to risk contamination of another patient that we don't want to use supplies that have potentially touched another person. We repeat the mantra "foam in, foam out" so often that I find myself washing my hands with sanitizer or soap and water nearly every 5 minutes, sometimes if I am just talking about something that seems dirty or if I feel like it has been too long since my last dose of sanitizer. I frequently don gloves at home to examine patients, even if I will not be touching body fluids or a wound. All of this has gone out the window in Ethiopia. We brought with us one box of small gloves and 3 small bottles of hand sanitizer. Our first day in the ER/ICU, we shoved a handful of gloves in each of our white coats. We were examining patients and using the ultrasound and Auna used about 2 pair of gloves within 15 minutes. We quickly realized we would not have enough gloves for the month if we continued to use them like we do in America. We were also using hand sanitizer after touching patients, doors, dialysis solutions, charts, etc on the first day. There is hand sanitizer on the walls in the hospital, but when Auna used it initially, the smell was pungent and irritating. By halfway through the first day in the ER, we realized our sanitizer from home was not going to last. Yesterday, I reached in my pocket for the hand sanitizer when Auna said "Stop! You haven't touched anyone, you aren't dirty! Save the sanitizer!" It is just habitual. I had touched a door and elbowed through the busy hallway outside the ER, and I felt dirty. The smell of the local sanitizer is now comforting in its cleanness. When patients buy medication from the pharmacy and it comes in a vial, they buy the entire vial not just their dose. At home, we throw away nearly full bottles of lidocaine and other medications in glass bottles that are now deemed "single use." Here, we put a piece of tape over the top and hand the vial back to the patient or family to keep for when they are due for another dose, if it is a medication that will be repeated. Patients also have to buy each syringe, IV cannula, and even sterile gloves for procedures. Not just pay for the materials we use, but actually physically walk to the pharmacy to purchase the supplies. There is no room for careless use of supplies. There is no waste here because our patients, and the hospital, cannot afford it. While our hands our tied by CMS and hospital standards at home, and we cannot reuse or recycle much, working and living in this environment will change how we use medications, supplies, and materials at home.
Random photos...
Macchiatos in Soddo
Neighbor dog, Peanut
Lawn trimmer, blood agar supplier, and Peanut-chaser. There are three sheep, we call them all Dexter.
Pretty flowers outside our house
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