As I prepare to go out for my usual daily visits planning to pass through the hospital wards and then proceeding to the patient’s homes, the phone rings. A relative of my four patients who all live together in the same house urgently requests me to come and review one of the patients who had deteriorated. I do a quick mental prioritization of where to go first because I have to cover a distance of 30km from the office. I settle on seeing the urgent request and doing a hospital ward visit later. Going out to the car park to pick my car, I am greeted with two flat tyres on the car.
I attend to the flat tyres only to realize that one of the tyres needs more than just inflating with air it needs mending. I rush to the garage for the tyres to be fixed. After a good 30 minutes of patiently waiting the wheels are finally fixed and I proceed to the patients’ home.
On arrival, one of the patients is in severe pain and has not had his last three morphine doses as the carer says the morphine is causing the patient to deteriorate. Further investigations reveal that, the other patient in the same household had died the previous night and this is when the morphine administration was stopped by the carer. The other two patients, who are the in-laws to the deceased are crying and can’t handle it. It is initially difficult to tell whether it was due to grief or to pain.
I explained the processes for the arrangement of ferrying the body to the mortuary. I do pain control management on the patient in pain and some supportive counselling to the other two patients and the affected relative, thereafter I asked to be excused.
I rushed back to the hospital for the ward rounds but in the end I ferry a patient who was due for radiotherapy treatment at one of the only two radiotherapy centres in the country, the hospital ambulance could not escort her due to fuel shortage. On arrival at the radiotherapy unit we are greeted with the news that the machine had just broken down.
I took advantage of this misfortune to drop some morphine tablets for a patient of mine who is under hospital admission at the same hospital. The other patient had to wait in the car.
I finally drove the patient back home without having received the radiotherapy treatment. From the patient’s home l reckon l should visit this sick child who had chemotherapy a few days ago. This is one of my lighter visits as the child is happy, smiling and able to crack a joke and not in any pain.
Just after 1600 hours, I park my car at the office. While retracing the day’s happenings, l glanced at the fuel gauge. It’s slightly below quarter tank, phew! I have to remind myself to start the following day in a queue at the Service/Filling Station. I quickly rash to the office and do the documentation of the day’s events followed by planning for the following day! As I leave the office premises I realize I did not manage to do the hospital ward visits!
Island Hospice Service: Harare, Zimbabwe
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