1) Patient Beds
2) Hospital Compound where families clean clothes and make food for patients
3) Ingredients for Hand Sanitizer
It has been one month since I arrived in Rwanda and I am continually amazed at the obstacles my patients and coworkers face. The work can be very frustrating. Everyday I see ways to keep people alive and reduce the severity of illnesses, but implementing change is never easy, especially when resources are extremely limited.
One particular frustration is the lack of hand washing by the medical staff. An estimated 60,000 in Rwanda are infected with illnesses in hospital, which are called nosocomial infections. Nosocomial infections are often caused by health providers not having properly washed their hands. They significantly increase patient death rates as well as costs to the patient and hospital. I have seen diseases being spread in our hospital and the staff seems to accept it as normal.
All the nurses and physicians know they are supposed to wash their hands between patients, but it just is not practical. There are no sinks in the patient rooms and the nurses have to move quickly from one patient to the next to provide care for everyone. There is only one sink per floor, and it is located very far from the patients. A great majority of the patients have infectious diseases such as HIV, tuberculosis, intestinal parasites, and infectious hepatitis, so hand washing is especially important.
After two weeks of frustration I found a solution. Hand sanitizer is an effective way of killing most germs and does not require running water; unfortunately it is too expensive for the hospital to purchase. With some research I found some recipes for homemade hand sanitizers that costs a fraction of the price of commercial products yet are effective disinfectants. I tested recipes until I found one the staff members like the most. I am now working with the chief of nursing to ensure that the hospital can afford to make it in sufficient quantities indefinitely. This is only a small change but I believe it will result in a significant reduction of infections passed from patient to patient and to the workers themselves. My hope it that they not only continue to use the hand sanitizer but that this will begin to instill confidence that there are ways we can start to limit unnecessary hospital born infections.