Obstetrics 4000

Tenwek School of Nursing

Jesus instructed him, "Don't talk about this all over town. Just quietly present your healed self to the priest, along with the offering ordered by Moses. Your cleansed and obedient life, not your words, will bear witness to what I have done." But the man couldn't keep it to himself, and the word got out. Soon a large crowd of people had gathered to listen and be healed of their ailments. As often as possible Jesus withdrew to out-of-the-way places for prayer.  Luke 5:14-16 (The Message)

This hospital provides care for some 4000 deliveries per year and it is likely to exceed that number given our current census.  Besides being a referral center it is also a provider of care when the national health system is “on strike/slow down” given either the demands of physicians or nurses.  

This is a opportunity to consider the larger context of care and care systems.   No matter where we live, it seems that demand always overwhelms the resources.  Mission hospitals are no different.   The system of care in Kenya is based on the “British” system that utilizes nurses as the primary providers and the physicians as consultants.  Any system has its limits and at this time the impact of the lack of nursing resources in other hospitals puts a  heavy pressure on hospitals like Tenwek.

From a U.S. perspective, we see similar stresses when we have natural disasters that disrupt normal delivery of care...remember Katrina and Joplin.  In either case, delivery of care is interrupted and people suffer.  Emergencies are redefined and triage is used to limit the impact.  

Like Jesus, we are forced to think and pray about new “delivery” methods.   Can we redirect human and material resources to prepare us for the new demands.  It is important to see the demands as a new opportunity to more effectively provide the care when the systems seem inadequate!

Iserson KV.  Moskop JC.  Triage in medicine, part I: Concept, history, and types. Annals of Emergency Medicine.  49(3):275-81, 2007 Mar.

Moskop JC.  Iserson KV. Triage in medicine, part II: Underlying values and principles. [Review] [23 refs]  Annals of Emergency Medicine.  49(3):282-7, 2007 Mar.