1/12/12

Visiting or working in health facilities in other countries can be a very interesting experience. I have had a few brief visits so far in Liberia, but this week was by far the most interesting. One of other expat staff got several phone calls requesting her to give blood. There was a patient at the hospital needing her blood type and there was none available in the blood bank . She had given at a blood drive over the summer so she was on a list. Because it’s Liberia and the quality of medical care is rather low, she was a little hesitant, but she decided to go if one of us would accompany her.

Being the nurse, of course I volunteered. It was late by the time we left, around 7pm. We drove to the biggest hospital in the country. Neither of us had been there, so we drove in the front entrance, found a parking area, then called her contact person. He was not there yet but would meet us at the front entrance. We couldn’t figure out where the front entrance was, so we asked two people and they pointed us to the emergency entrance.

We walked in the door and told the nurse we were supposed to meet this person to donate blood. She gave us a clueless look, so we said we would wait outside and call him again. We sat on the curb to wait. The nurse came out and said “I hope he comes soon, you are not allowed to sit on the curb, a car might come and hit you.” Luckily we saw a man walking purposefully towards us so we figured that was him and got off the dangerous curb.

We had thought this man was from the blood bank, since that is where the list is, but after a minute or two of conversation it became clear that he is the son of the man needing blood. He had somehow gotten the list and was calling the six people on it to try and find blood for his father. Crazy that 1) the family member has to do all the work to get the blood and 2) he somehow got the list.

The three of us walked down the empty, dark corridors to find the lab. Once there, my colleague had her blood tested to make sure she was eligible and was indeed the correct blood type. The blood was drawn right in the lab – with all the lab equipment and other samples lying around. We then had to wait about 10 minutes for the results so we chatted with the son. His father had already received blood just before Christmas but his count was low again. They do not know what was causing this drop, but needed to stabilize him for more testing. He had been waiting already for about a day, in the emergency room of the hospital, for the blood.

The lab technician came out with the lab result slip and motioned for the son to talk to him, they started whispering in the corner. My colleague looked at me and said – “Shouldn’t I be getting my own test results!” Yeah, definitely no such thing as HIPAA here. So we got up and walked over, all he said was – no problem – you can give blood. All the hepatitis and HIV tests are negative and your hemoglobin is above the cut-off. No confidentiality at all!

So then we moved into the next room where there was a place to lie to give the blood. The son then had to go purchase the supplies from the cashier before we could begin the process. So we waited, and while we did the lab technician took off, saying there was an emergency and he would come back. So the two of us were sitting there, just waiting, in the dark, empty basement of JFK hospital. The son came back with the supplies, but of course the lab tech was not back yet, so he went off again to find him. Eventually the son, a couple lab techs, and several observers were there and ready to start.

The other lab tech was the one who was to draw the blood. We made sure he had all new supplies, and he started to clean the area. However he was not wearing gloves. My colleague asked where his gloves were. His response – “We already tested your blood, it is negative so I don’t need gloves” – universal precautions???? I told him he should wear gloves anyways – to treat any blood as if it could be infected. He just kept smiling and looking at us and preparing. So my friend tried again – “I would feel more comfortable if you were wearing gloves.” He still just kept staring and smiling and working so I tried again “She would feel more comfortable, we would both feel more comfortable, if you wore gloves.” By now he had the tubing and bag out, so I reached out to hold the supplies for him to put gloves on. He says “You want to help me?” “No, I am going to hold this while you get your gloves on.” He finally got a pair of gloves and started.

The blood draw went fine and as my friend was resting before leaving, more family came in - another son and the wife. Both sons were so grateful and really wanted to do something – “what can we get you to build the blood back, candy bar, water?” So while they went to find some good blood building food, we chatted with the wife. Such a nice family! It had been a rough few days for her. Waiting in the emergency room was overwhelming . She explained how so much was going on around them, including the birth of a baby!

Eventually the two sons came back with chocolate and water. On the way out we stopped to say hi to the patient. He was grateful and we let them know we would be praying for them. What an interesting experience between the craziness of the medical system in Liberia and meeting the recipient. At home when you give blood you never get to see the person it is helping, so that was cool and it was a good reminder of the human face on the other side. Please pray for this man and his family as they try to solve his medical problems in a country where medical care is much more limited.