It’s Been A Hard Day’s Night……Week
Maybe we should have taken heed of the portents.
The weekly morning meeting started out with the news that the river would probably be completely dry by mid week and the bores were over taxed and could be tapped out by about the same time.
The work day started started with the chaos of the “head count”. Well let’s say the day to day tumult was added to by the head count. Someone somewhere in government (I was never truly able to ascertain whom), had determined that, on the busiest day of the week, every staff member at the hospital had to progress through several different desks and produce several different documents to prove they in fact existed and worked at the hospital. One staff member wryly observed that they wanted her birth certificate, passport, degree, licence to practice and her kindergarten report card. Ok the last bit was made up. It’s not that they didn’t actually have all this information already.
So while all the patients were making their now even slower progressions through their various queues , the staff were queuing up to prove they all existed. All this queueing was happening in the very small corridor outside the administrative office where the photocopier was going overtime making copies of all this stuff.
Fortunately no-one cared if we counted or not.
On the very same day it had been determined (again I’m not sure by whom) that the floors in Maternity, Female Ward and the Family Health Clinic had to be resurfaced. The decree was that these areas needed to be closed and the patients moved out for the alleged three days it would take. Umm where? Certainly not to the corridor outside the admin office. So, amidst the chaos of the staff not being able to do their jobs because they needed to be tapped on the head, all the patients and hospital equipment had to be moved to somewhere. The female patients were squeezed (even further) into a section of the Male Ward and into the newly built Central Sterilizing Room. Fortunately the sterilizing equipment had not been moved in yet. However, while there were basins in there for washing there was of course no toilet.
FCH was squeezed into a sweaty shoebox that was the patient Chapel, with the pregnant moms having to sit outside on a bench, inhaling the fumes of the solvent being used to prep the floors. The same fumes that caused the nurse to have an asthma attack and end up in Outpatients. Meanwhile the poor labourers were toiling away in the increasing heat. The move meant the nurses had no access to their computer (or the network) so we quickly had to rig a wireless piggyback to the room, dodging amongst the floor work in Female Ward (as that was where we had to position the extender) and then actually make some space so they could do their job.
On Wednesday there was a regularly scheduled visit from a Harare Orthopedic surgeon. In the middle of the working and operating day the power went out as per usual. More a hassle for them than for me across the hall trying to fix another computer. The complicating factor this time was that the generator quickly overheated from the load (the radiator was low on water) and shut down too. So everything (except for the computer system protected by the impressive back up battery array) ground to a halt until the generator could cool down and be restarted.
So, maybe we should have paused for a second and thought that, just maybe, the planets were not aligned for attempting a major overnight upgrade of the computer software. However, the narrow window provided by the tick over into November (and therefore increased internet bandwidth) was at hand. I stayed up until midnight on Wed night in case I needed to be available to any prep work. The support staff in Canada let me go to bed while the download happened and then I got up at 4 to be on hand while the update progressed. All progressed reasonably fluently while most others were in bed but, as the sun and everyone else started to rise and started to get on the internet, the internet speed progressively degraded and made it increasingly hard for the support team to do the necessary things via remote control. Increasingly we had to resort to them texting me with step-by-step instructions. I think you can imagine how tricky it would be to make sure cryptic command line instructions get relayed 100% accurately (is that meant to be a space there?), especially to a Mac user.
I didn’t share with the team back in Canada that, all through this, the computers and the hospital had been running on back-up battery all night because the generator was having a rest from the toils of the previous day.
All too quickly the start of the work day approached and then passed with the update still not completed. So I also had to run around to various departments telling people to not turn on the computers. Of course, in all the additional chaos on top of the usual tumult, just because you tell one person it did not mean the message got relayed to the next. So I had to go around more than once when we discovered folks trying to log in and thus interrupting the process. I then ticked off more people by deliberately disconnecting them all from the internet so as to free up bandwidth.
Eventually the main update completed but all was not finished. It was then I discovered that each individual Virtual Machine had to be updated in order for them to “see” the update. Remember this is a Mac user trying to divine a path through the idiosyncrasies of Windows Networking and VMWare. So picture me banging away, swearing repeatedly under my breath (to be polite) while taking longer than was probably necessary because I didn’t really know what I was doing, to update each VM then saying to the receptionist “Go” every time I would get a machine done so she could call each department and let them know. All the while I was cognizant of the dozens of patients waiting in ever lengthening queues.
This already laborious process worked for those machines I could convince it to work on from the central console. There were just some that wouldn’t behave so, in addition, I had to run to various departments to physically assault, sorry update, the computer there.
All through this the staff and the patients were their pleasant, accommodating, unflappable selves. We never cease to be amazed by the locals’ ability to not be phased by all that is going on. Despite the massive interruption, everyone was still very kind and ridiculously grateful, sometimes for the smallest things (like the update enabling the chart number to be printed on the receipt!) By the end of the (very long) day all the patients had been registered, seen, and attended to with the same minimum of fuss and not a single person expressed any hard feelings. Remarkable.
As of Friday the floors were still not finished………..
A special thanks needs to be said to the staff at Applied Informatics in Health Society (AIHS.ca) which supports MOIS. For the last three weeks they have been graciously replying to the bombardment of emails I have been sending and then pulled out all stops to tweak the update to suit some specific Karanda requests as the Nov 1 deadline approached. They then worked many long, frustrating hours getting the update done over a very slow connection. An impressive feat given the time difference, distance and poor infrastructure. All of this for free as they have donated the software and their time to support this project in Karanda. Can’t express how important that is and how grateful the hospital and community are.
7 thoughts on “It’s Been a Hard Day’s Night…Week”
……and I thought that it was busy in Fort St John!
Well done, Paul. Great pictures.
Makes my day in Haiti seem a breeze. We did however get the Dhaihatsu truck stuck in a riverbed “road” made impassable after the hurricane and had to walk and ferry supplies up the mountain to our clinic in the church in Lavanj starting 3 hours late. Likewise the patients waited patiently and with good humour for their brief moment with the blanc nurse and doctor to get their pittance. At least we had no computer problems as our mobile clinics have no electricity and no one in the government knows we are here so no admin nightmares. Keep soldiering on Paul. What doesn’t kill you….
This makes me appreciate the fact that the BC not-for-profit I work for still uses paper charts at its 58 part-time clinics.
Thanks for what you, Paul, and Cam are doing.
Gives me pause for the fact that the BC not-for-profit org I work for still uses paper charts.
Sending appreciation to you, Paul, and to Cam.
Suggest a warm Karanda beer.
It was the beer in Kenya that was always warm. The one, no two, I had in Harare were perfectly chilled:)
Good work, Paul, you geek! I see by the stethoscope draped over your neck that you still call upon your medical skills there…or were you just checking the computers for vital signs?
I hope the water situation improves soon!