Wednesday, September 24, 2008

Rehabilitation at Rundu State Hospital

Three mornings a week I work in the Orthopaedic Rehabilitation ward at the hospital. I work with 3 others, a physical therapist and an occupational therapist (both from Zimbabwe), and a ‘rehab therapist’ who is Namibian and has been there for 10 years.

When I first arrived, I was very curious to see what my life as a therapist would look like in a hospital setting. My first morning I was welcomed and right off the bat was given my first patient without even having a tour of the facilities. I had to ask where the sheets were, was there lotion available, where the assessment sheets were (there are none), along with many questions as my patient stood beside me waiting. There is only one communal treatment room with no privacy, and I have found in general that patients here have a lot less privacy needs than back at home!

The OT and PT both watched as I did my assessment and they didn’t seem to have any patients, until around 10 am when all the patients showed up at the same time. I was confused by this and quickly figured out that the therapists don’t have a schedule (one reason I heard was because they didn’t think patients would show up for them so why bother). Well, I knew that system wasn’t going to work with me so I did some trial runs with a schedule and have been booked solid for 4 months, with my patients all showing up on time! Funny that even after 4 months, I am still the only one doing it. I think a big reason is because they tell their patients to show up sometime the next week, and usually the patient doesn’t show up, which means less work for them. So they sit around a lot and get paid for it while I work (happily) non-stop for no money at all!

My Namibian co-worker has been a particularly big challenge for our rehab team. In four months, I have only seen him treat a handful of patients. The OT and PT really struggle with it because he is constantly pushing his responsibilities on to them. He is suppose to be available to us to help translate, but most of the time he is not there, and when he is he asks other patients to do it for him!! When he is called on it he gets very upset and uses his authority as the Supervisor of the ward to get out of personal responsibility. I am fortunate that I only have one Namibian in my ward, compared to Daryl and my other AIM colleagues because sadly apathy runs rampant in the local work ethic here and has a poisonous effect in the work place.

One joy I have working here compared to the private setting at home, is that I don’t have to handle any money. Patients pay their small hospital fee and if they have been referred to our ward, I can treat them for however long, and however often I want without having to feel that money is a barrier to patients receiving treatment. It makes everything a whole lot less complicated. From what I can see, patients have been very appreciative for the time that I give.

The cases that I treat are mainly patients with chronic pain that have been coming for treatments at this hospital or others for some time with no resolve. It is especially challenging because there are literally no resources available for me to look things up and cross reference. I am in the process of trying to order some text books in order to help me, but also to help stimulate and challenge my co-workers. I have done a number of training sessions with my OT and PT colleagues but it hard when there is not even a muscle chart to refer them to and to teach from. I hope to see some change in this area before we leave.

So there is a basic review of what my hospital life looks like. I have many sad and interesting stories that I will have to post some other time, so stay tuned!


mbangungu said...

HI, I Recently returned from Rundu, doing my field work in one of the clinics. of course there are a number of challenges impacting health care delivery in the region. Nevertheless i find your paper very disturbing as it mostly tell the reader the negative aspect of the Hospital, such as lack of resources, poor planning, poor leadership skill etc. it is also unrealistic to compare Rundu Hospital with place of origin as this are two completely different space. for example in terms of availability of resources. finally why do you have a negative attitude toward Namibians?

Carlos BrĂ¡s Silva said...

Hi I´m Urologists interested in work in Rundu Hospital. Can you give me any contact for a job aplication? Thanks.

My e-mail: