The Patient Journey

My father-in-law has been for a check-up a year after his knee replacement. He sent me this email and kindly allowed me to share his thoughts.

“Shona, I got thinking yesterday about the differences in what we take for granted here and where you are regarding hospitals. I got a paper form, paid £10 and flew to Glasgow, met by an NHS minibus, was seen by the X-ray people in about 15 minutes of checking in at reception, was seen by the nurse about ten minutes later who had my case history and x-rays, did a few checks of my knee, and that was me done, very slick and professional, oh just by chance I met Mr Picard who did my op and thanked him for making my life easier. I stayed in a 4* hotel, ate lots of good food at cheap prices, in a room that was big by any standard, en-suite, 21” applemac with digital freeview TV channels, all for the sum of £10. This morning I had a full breakfast before being driven in the same NHS minibus to the airport for the flight home, it made me think of you in SL and I admit I felt almost ashamed of what I just accepted as the norm.”

In the UK, this is known as The Patient Journey. The NHS making sure that not only do you receive good care, but that it is as slick and efficient as it can be.

Here’s how it works in ODCH: When the child arrives (probably having travelled by poda poda), they register and get seen by the triage nurses. If they are triaged as “emergency” they get sent straight to the emergency where (hopefully) they are seen and treatment administered straight away. That’s provided that the doctors and nurses are available. If they are triaged as “priority” they get seen in our out-patients department. There they wait a variable amount of time before being seen. No one complains about waiting. If they are “routine” they get sent to the Under-5s clinic about a mile away (another poda poda journey for the family to pay for).

If the child needs an x-ray they go to another hospital, about 2 miles away very early one morning. Not in an ambulance, but in another poda poda. The x-ray department can only take 10 x-rays per day. If they run out, the patient needs to go another day. The family return to the other hospital to pick up the x-ray the following day (more poda poda journeys….) There is an ambulance – but usually it’s used for transporting staff around instead of patients.

The wards are often more than full. It’s not unusual to have two children to a bed. The mothers sleep on the bed with them, or underneath. There are no single rooms. The children do get provided with three meals a day (rice and cassava leaf). I’ll not go into details of the patient toilets… but they’re not en suite anyway! Wards 1 and 3 and the play room do all have TVs, which the patients, parents and nurses all crowd around in the afternoons.

But I don’t want people reading this to feel guilty or ashamed about what we have at home. I often feel that way even with the things I have here compared to my colleagues and neighbours. I’m trying to learn to stop feeling guilty, and to feel thankful for all the things we do have and have the luxury to take for granted, and to try my best to help those that I can. If I felt guilty all the time there’s no way I could enjoy going to beaches or to IMATT parties…! I would like people to think about it as my father-in-law did, and to be grateful for what we have at home. Or to use what we do have to help others. If you want to help the children in Sierra Leone – donate money to the Welbodi Partnership (www.welbodipartnership.org) who I work alongside in the hospital. You can also donate money to VSO although the money doesn’t go direct to the children – it would go towards sending more people like me out to other places to share their skills.