First Clinical Day (06/03)
Monday was our first full day at Murchison Hospital. We arrived at the hospital in the morning to learn about the national data collection and structure of patient care. The first part of the day was spent learning about the process of data capturing at the hospital. The data is extremely important; without it, South Africa nationally cannot critically analyze how well DR-TB treatment is working, overall patient outcomes, and a variety of other information from a public health and health care standpoint. The registers (the manual book that contains a summary of patient treatment and outcomes) ask for DR-TB information because they want to capture MDR-TB (multi-drug resistant), XDR-TB (extremely drug resistant) data, and TDR-TB (totally resistant) data, although the hospital does not treat anything but TB and MDR-TB patients. The data in the register must then be entered into the Electronic Drug Register (EDR).
The second part of our day was spent in ward rounds and in discussion with one of the sisters (South Africans refer to nurses as sisters), the matron of the male MDR-TB ward. Dr. Farley (the head of the Johns Hopkins University group with us) took us to see our first MDR-TB patient in the men’s ward. There we learned how the initial patient assessments were taken on admission, got familiar with the charts, and learned how to properly interpret a patient’s chest x-ray. It was an incredible learning experience and (as you can see in the picture) the Murchison Hospital nurses were extremely friendly and ready to aid in our understanding of the healthcare system with all of its rewards and challenges. We finished the evening by ordering pizza and chicken take-out and dined in bliss with all of our delicious meals before sauntering off to bed tired but excited for the upcoming week.