Day 7

13 February 2009

It's our last day of running two hospitals. Activity at Solidarité has now surpassed activity at Jude Anne. We rounded on eleven inpatients at Solidarité this morning. There were three babies in Pediatrics. Jude Anne held only two patients, of which one was to be discharged after normal delivery, and the other, I decided to transfer to Solidarité. (She was the one operated for ruptured ectopic pregnancy the other day.) The registers said, 11 consultations yesterday at Jude Anne, and 25 at Solidarité.

It's a bit of a miracle to me that our planned "cross-taper" of activity has worked.

And, the biggest improvement, now that rounds are at Solidarité: it's quiet. Our discussion doesn't have to compete with trucks in the intersection, or the generator of the bank next door.

They unpacked and installed the second OR today. Niveau 2, normally our post-op and post-partum (of complicated pregnancies) service, started settling in this afternoon. The idea is to separate our mixed inpatient service back into its component parts, i.e. antenatal, post-op, post-partum. Triage and accouchement will similarly be again distinct services. The lab moved the rest of the stock from the blood bank over to Solidarité, too.

Logistics moved the main generator today. It requires a crane. Electrical wires are in the way. Traffic continues on a busy road beneath. I wasn't there for that – and I'm sort of glad – but I apparently did manage to call the logistician at a particularly awkward moment. I needed waterproof mattress covers for the foam mattress pieces, so that post-partum could accept patients. He was looking at the generator suspended mid-air, while a demonstration swarmed past, and the midwives were attending to a patient who had delivered in the back of a tap-tap (modified pick-up truck turned commuter bus). Jude Anne has always been an exciting place, even to the last moment.

Now the sign has been painted over. A banner says in Creole that we've moved. There are staff there tonight (one triage bed, three inpatient beds, no operating theatre, a lab that can measure hemoglobin – had I known that they were taking the triage beds, I would have asked to leave at least two!). As of tomorrow morning, there will only be a guard.

The work is not done, of course. The remaining furniture and equipment will be moved tomorrow, perhaps into next week. We need to organize and open all the departments properly. Then we start work on what the Czech logistician calls "The List of 1000." It is a list of all the things, small and large, that will still need to be done to make the hospital function better. The essential has been done (water, electricity, medications). Now we worry about having enough chairs, shelves in appropriate locations, curtains to control radiant heat, etc. The List of 1000 will keep us busy for months.