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Barbara M wrote concerning the 3rd World practice of family
involvement in nursing hospitalised patients.  Until 2 weeks
ago I would happily have joined her in praising such a practice.

2 weeks ago I saw, on Australia's excellent SBS channel, a
documentry on the Central Hospital, which is in Conakry, the
capital city of the west african nation of Guinea.  The hospital
was described as being the main medical centre of both the city
and the nation.  Poverty (an average annual income of US$510)
has resulted in a horrifying situation.  Families provide not only the
nursing service but also have to provide the drugs, in the sense
that once the doctors have written the procription, it must be collect
and paid for from the hospital pharmacy by family members who then
hand it over to the medically trained staff to administer.  NO FAMILY
MEMBER TO COLLECT AND PAY FOR THE DRUGS - NO DRUGS
ARE GIVEN.  NO MONEY TO PAY FOR THE DRUGS - NO DRUGS
ARE GIVEN.  If, as apparently often happens, the hospital pharmacy is
unable to fill the perscription, the family member or friend has to try and
get it filled by an external, private pharmacy.  In one instance a man
brought to the ER with menengitis (sp?) died after 8 hrs unattended
other than being diagnosed.  He died because he had no family or
friend to help him and because the ER had only 2 overworked doctors
on duty, no nursing staff, no drugs other than those purchased for other
patients. The ER itself is located in a seperate building to the main
hospital
and is the only part of the complex that a patient can enter without paying
in advance.

The Intensive care unit comprises a ward with beds only. One nurse
attends 8 patients.  The mortality rate is 70%.

What staff the hospital has are well qualified and as dedicated as any -
where else in the world.  They know the limitations of their system and
do what they can to minimise its difficiencies.

None of this invalidates the love and caring of the family members
who, often at great sacrifice to themselves, try to fill the gaps.  But
it is an indictment on us all that their sacrifice is necessary.

I was left with a profound sense of shame.  I live in a country with one
of the finest medical services in the world.  We have an oversupply of
doctors,  free hospitalisation in world class hospitals equiped with every-
thing money can buy and staffed by highly trained professionals.  Yet
we want more.  We complain if we have to wait 30 mins past our
appointment time,  we object at length if we have to wait for surgery,
we protest at delays in getting the latest 'wonder drug'.

WE DON'T KNOW WHEN WE'RE LUCKY

Dennis.

++++++++++++++++++++
Dennis Greene 47/10
[log in to unmask]
http://members.networx.net.au/~dennisg/
++++++++++++++++++++

Barbara wrote:

> Maybe there's something to be said for those "unsophistocated" third world
> countries where it's normal for family members to remain "camped out" by
the
> bedside of a hospitalized loved one, performing not only as kind of
"relief
> nursing staff," but also preparing meals, feeding, and bathing, etc. the
> hospitalized family member.
>
> And I can just imagine the
> reaction of the nursing staff if assorted family members were always "on
duty"
> by the bedside of a loved one, watching, and judging the them and the
medical
> staff.
>
>
> ----------
> From:   Parkinson's Information Exchange on behalf of BMIS08
> Sent:   Monday, August 11, 1997 9:30 PM
> To:     Multiple recipients of list PARKINSN
> Subject:        drug problems
>
> Lucy and anyone having or watching this hallucination problem:
>   I can only relate my uncle's problems.  He had only an internist and the
> drugs often got to him; the balance with eating and sleeping and drugs is
> SO tricky.  My uncle would get hallucinatory and see monsters and people.
> The only thing we could do was give him a total pill holiday until his
system
> was clear.  It seems to me that drinking water (and most other liquids)
is a
> problem for pwp.  Since water is necessary for flushing medical waste the
> problem gets serious at times of crisis.  He would clear up and be his
normal
> self, then we would start again.  We also began to recognize signs of
other
> medical problems as the irritants - he had prostate problems and got
infec-
> tions easily.  Once we began to pay attention, we also noticed that change
> in schedule caused problems.  He would go into the hospital fine and
after a
> week become a maniac.  At 81, in what most of us would see as frail
condition
> in the hospital, he punched a male nurse in the face.  It took 4 of the
staff
> to hold him.  We learned to get him OUT of the hospital inside a week
when-
> ever humanly possible.
>   Hospitals and doctors are one of the big problems in medicine today.  We
> had to fire more than one doctor and verbally thrash more than one
hospital
> employee, including the administrator, to stop them from driving my uncle
> crazy.  They insisted on calling him the wrong name, yelling as if he were
> deaf, ignoring him because he was old, and oon and on.  It is a disgrace
> to this country that older people are treated as if they are in the way,
as
> if their lives are not meaningful anymore, as if they should ALL be in
nursing
> homes waiting to die, and on and on.  Our family motto now is not to ever
> have anyone in a hospital who is not monitored by family on a random
schedule.
> Sad to say, hospital personnel watch very carefully to see when visitors
come.
>    Of course, this is not ALL hospitals.  It is, however, more the norm
than
> not.  Doctors are the same - overbooked and too busy to care.  They book
> patients every 10 or 15 minutes here.  Who can even get a story from the
aver-
> age 80-year old in 10 minutes.  The theory seems to be that your time is
not
> worth anything - but the doctors' and medical staffs' is priceless.  If
the
> doctors refuse to talk, fire them both.  Threaten the hospital - use
whatever
> is available - local tv if necessary.  Fight for your parents.  Make your
> moves count.  Find doctors who care and will fight with you - they CAN
keep
> people in hospitals when they want to, despite drg's.
>    My thoughts and prayers are with you and all in your plight where I
shall
> soon be with my own parents.  It is heart-rending enough to see parents in
> such difficult circumstances.  Not to be able to help is unbearable.
>
> JH
>