Tuesday, December 29, 2009

Bangil in 7 days (Part I)

I was distraught when I first arrived in RSUD Bangil (Rumah Sakit Umum Daerah). It looks rather like the haunted abandon hospital in typical horror movies. Ah, right! They've shifted to a new hospital, phew~

About 500 meters away is the new RSUD. Wow! Besarnya! Well, not that very big though, but for a general hospital in Indonesia, it is considered as big. I can say that it's about the size of Pantai Hospital in Ampang. In spite of the size, the hospital was pretty calm, unlike our teaching hospital back in Malang – chaos! maybe it was Sundayy… We (me and my partner, Roula) was brought up to our room which is on the first floor just above the ward we're in charged to. We stayed in a modified 1st class patients' room into intern students' room with air condition, tv and a double decker (which then both mattress were laid down on the floor before the tv).

First day in Bangil – nothing much about the work. We went around the hospital but got quite lost inside, so we got out of the building, walked from the outside and find our way back where it then rained. I was flattered that we were provided with meals three times a day. A complete healthy meal in mangkuk tingkat, but one thing I've learned is that Malang's tempe is the best!

One new patient, and one death case.

Second day in Bangil – it was Monday. We started our day with ground ward round with the resident, which was Dr. A, a petite woman, quick and savvy! Went around 8 wards, covered about 40 patients, in about 1 hour – crazy? Exhausted!

Then we were called for a consultation at the Obgyn department. I had to go alone. So I drag along the ECG machine (on a trolley) all the way up to the obgyn ward. Damn, why don't they have elevator? The infrastructure of the hospital is considerably funny, I am not going to elaborate more on it.

The slightest amenities yet has made me learn better in observing patients. For instance, they don't have the facilities to check the serum electrolyte in blood, therefore one of the ways to identify patients with hyperkalemia is by observing their breath and confirmed with a sign of Kussmaul. Therefore with the slightest indication, KSR and Kayexalate are the two safest therapy we could give (the correction of potassium is supposed with Calcium gluconas + D40% + insulin). Meanwhile to counterpart an unconfirmed hypokalemia state, we only suggest the patient to consume bananas and tomatoes.

However I'm glad I went through it, the challenge of working in a place where facilities are at the least you can get. Like… dragging the ECG machine is something I know I won't have to do later back in Malaysia, it may be one of the funniest memory.

So, that day, I had 6 new patients and no death case!

Third day in Bangil – That morning, we put on our guiltiest-most-pitiful faces while walking into the office. The nurses gave us their thwarted faces instead. We were sorry that we didn't hear the phone ring, we got 4 missed calls, and sorry we didn't hear them knocking on our door when they were to informed us that there were 2 new patients came in (that was around 12am). Thank God they were all fine…

That day, we had Nasi Punel for lunch. It was Bangil's specialty and was recommended by our seniors who were there previously. I must say that… tak sedap pon!

Fourth day in Bangil – I met with countless patients with several of complains and still so hilarious. Since majority (almost all) my patients there at the 3rd class are all came from the rural area. They hardly speak Bhs Indonesia, they speak Jowo instead. Somehow I did comprehend with some of their sentences but I always have Roula with me (my partner, my translator).

Came a patient with a history of Diabetes, and I asked for how long has she been suffering from it. The answer was very subjective…

"Lupa tahunne piro, pas arekne eki sak umure telo"

(forgot exactly what year (she was diagnosed with Diabetes), but it was since her daughter was three)

And the daughter is now 15 years old.

So then you see the importance of having a lot of kids. You may not remember the year, but as mothers, you'll have the vivid memory of how old your child was back in the days. That is how you keep track of your life… your children – the memory of bringing them up!

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