The government hospital in this region is the safety net for those who cannot afford health care. It is so crowded that beds are being placed in hallways. And although this is the referral center for the whole region, there are many things that seem to be missing. And since they do not have the proper equipment, they have to be creative.
- Incubator: An ex-30 week premie was referred from a private hospital because the parents could not afford the down payment for an ICU hospitalization. Since this institution does not have an incubator, they made one from a regular crib, light and a sheet.
- Chest tube: There are no chest tube kits, they come up with their own DIY chest tube kit from a sterile bottle, saline and tubes meant for other use (such as a NG tube).
- Intubation: Sometimes the Mac does not have a functioning light because there is no battery or it broke. I was told that immediately after Yolanda (aka Haiyan), they held a penlight with their teeth during intubations. The pediatric department still does not have a stylet for intubation. The internal department only has 2 that are reused. In the pediatric department, they cut and use a 14-gauge NG tube if there is no intubation tube. And they do not sedate because they do not have midazolam or mechanical ventilators. This means that whenever a patient is intubated, the family member or caretaker is there manually bagging the patient 24/7.
Even for something as simple as IV line insertion, there are many components that are not provided by the hospital.
- Purell: There is no alcohol at the bedside or at the entrance of a room. Patients must provide alcohol for the medical personnel to wash their hands. They must also bring their own cotton swabs for cleaning before injection or IV insertion. Some interns and clerks will carry their own set.
- Heplock: The patients are required to buy their own heplock for the IV lines. Before an IV line is put in, the parents/patients must go and buy the yellow cap. And it is used over and over again, even if there is old blood.
- Tape: Tape is in constant demand and frequently not available. They use tape to secure the IV lines, even though they have Tegaderm. The interns will often bring their own roll.