First visit to Murchison Hospital
It is our second day. We are still recovering from jetlag but we are very excited to visit Murchison Hospital with the Johns Hopkins team. Murchison hospital is one of the satellite clinics that provides inpatient, outpatient medical and surgical cares as well as mother & child rehabilitation services for people with MDR-TB (multi-drug resistant tuberculosis) and those with HIV positive.
Murchison Hospital was established by Dr. Barton who used to ride a horse to visit patients in villages. The land was granted by the Chief and a wood and corrugated iron building was built to start Murchison Municipal Hospital. It became an MDR-TB/HIV satellite clinic in 2008. The initial year, they had about 40 MDR-TB patients. There were over 200 people who were treated in 2012 and that total has already been outnumbered in 2013. One of the reasons for this increase is that the clinic offers the rapid diagnostic testing called “Gene Expert”. This diagnostic testing (a PCR [polymerase chain reaction] sputum testing) has made it possible for patients to get their results in 7 days instead of 7 weeks and to be able to initiate the treatments much faster than before.
We looked around the buildings and noticed they are all well ventilated since good ventilation is one of the most efficient and the cost-effective ways to prevent the transmission of tuberculosis (transmitted through the air). We stopped at the Triage building where the pre-admission and evaluation processes such as vital sign check ups, patient interviews, and sputum collections are done. The HIV buildings are separated from TB buildings for the protocols, which makes it a little harder for patients. Patients who have both (60-70% of the patients are co-infected in South Africa) have to do the separate visits to the TB and HIV clinic buildings.
We visited a patient ward and met patients during the dinner hour. Some of them looked emaciated but many people in the room looked amazing. Dr. Jason Farley, the nursing professor from Johns Hopkins, told us that the patient we were talking to looked much better than the last time he visited him. When patients adhere to their drug regimens, they can completely be cured from tuberculosis. If not, they will develop drug resistant tuberculosis, which is harder and more expensive to cure.
We will start our observations on Monday and we are all excited about our future learning in South Africa!