The University Teaching hospital is the only tertiary hospital in Zambia.It boasts of having produced some of the best calibre doctors on the continent.Draw backs of working for UTH is the fact that its very poorly equipped and this does pose a danger to patients lives.

One of the things the unsuspecting Zambian public does not know about UTH is procedures like Lumbar punctures are done at ones own risk.UTH does not even use proper lumbar puncture needles and rarely is this technique done under sterile conditions. Countless people have died after this seemly simple procedure has been done. You ask why? Well ask any juniour doctor who has never worked abroad or in a private hospital and they will tell you they have never seen a lumber puncture needle and hardly ever make sure a patient does not have a raised intracranial pressure before performing the procedure.

A lumbar puncture should never be performed without first making sure the patient does not have raised pressure.Doing this causes a downward displacement of the brain which is 100% fatal.

So are the doctors to blame? Maybe but UTH needs proper funding otherwise its really a death trap for the sick. Doctors shouldn’t rush to perform academic procedures when they hardly even have a functional laboratory to support them.

for one mistake made for not knowing,ten mistakes are made for not looking(Lindsay)

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122 COMMENTS

  1. Dr HK this is your area of interest can we learn from you? Not just castigating and shaming FTJ teach us something

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  2. This article raises almost alarmist pronouncements but with no real data to back it up. Is negligence to blame for the low survival rate, if at all this premise is even true?

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  3. UTH is an institution we should “have been” proud of, & we “could still be!” That place has produced talent, that one can only dream of, if one were to roll out the alumni & where everyone is & what they are doing, you’d have a lump in your throat wondering why why??? Well, roll back the years, when they politicians would harp about how insolent the junior doctors were & didn’t hesitate to fire them, no one came to their aid. So they learnt quickly, to keep their heads down & how to get on the next plane out – medicine is one profession that is a passport to the world, people sacrifice their lives in their youth to study for 7 long years to serve & save other peoples lives even for a pittance as long as they can be appreciated & looked after. It is now down to the masses to get these politicians to turn the ship round, it is time people became proactive – People have to learn that to make MP’s accountable, you have to make life hard for them, hound them whenever you meet them..cont

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  4. cont… make them feel uncomfortable to the point where they feel threatened, only then will they wake up & return to parly to direct prioritised spending for real developmental purposes. We are too timid with them, & only look at them in awe as they cruise around in the landcruisers! We have all experienced too much pain losing loved ones in these institutions, BUT it’s all in our hands, WE CAN CHANGE IT!!!We only have to mobilise & sensitise. MP’s need to really pressure MOH – the PS, no one should shield him, he should be pursued with the same vigour expended on FTJ.

    The process described above is true – & the narrator knows what he is talking about. It is just the tip of the iceberg!

    On another point,when doctors protest at the senseless amount of force to subdue someone & this is rubbished, we should all be very afraid – not that I underestimate the dangers they face – publicly condoning police conduct of this type, may give a few rogue cops to be a bit trigger happy.

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  5. This is all conjecture and am sure just hived off some Journal.let us have a factual and balanced response from some Doctor who has worked at the UTH.

    We are waiting

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  6. The article is horrifically misleading,inaccurate and distasteful.LusakaTimes please remove it immediately.We are more than willing to discuss the health situation in Zambia but not against the backdrop of such ill-concieved articles!!

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  7. Citizen, what conjecture? Every UNZA trained medic has worked at UTH – UNIVERSITY TEACHING HOSPITAL, IT IS ZAMBIA’S ONLY MEDICAL SCHOOL for your information.

    I understand your desire to work around facts, it appears this is one fact that has slipped your grip.

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  8. Pundit, hold your horses. DENIAL is inherent to our beings, hence the distasteful truth revolts you. Doctors take the “Hippocratic Oath”,(Google this) to serve & save lives, to do nothing that will harm their patients, & strive to do anything in their capacity to make them well. For a very long time medics have worked in conditions above & have quietly complained within the system but to no avail – reason being, the hard truths of medicine maybe quite revolting to the lay person, so you have been spared this for a very long time, there comes a time when the bull has to be taken by its horns!.

    It is also the duty of a medic to alert the public of what conditions would be ideal for you to be served better.

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  9. #8. Why should we believe this story?
    Comments like the one from #6. CITIZEN are there to bring balance to this debate.

    Stories like this one must surely give us reason to INVESTIGATE but we must resist the temptation to believe this as gospel truth because this may all be a lie. But it may also be true!!!

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  10. The situation being described in the article is the herniation of the medulla and cerebellum at the foramen magnum which could occur when a lumbar puncture is performed on a patient with increased intracranial pressure.A lumbar puncture is contraindicated in patients with raised ICP. Back in the day at UTH,I did see some patients collapse after a Lumbar puncture was done.But we didn’t have the necessary tools to rule out raised pressure.Could we honestly ask someone from chileje to cough up thousands of kwacha to do a CT scan and casualty wards never had fundoscopys either.But in retropect I think people should be told they could die after the LP.And consultants should not be pressure on interns to perform LP if the proper precautions are not being followed.okey got to dash to threatre!

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  11. #10 Mwaice Born rich this story is true,I have a number of examples from my relations and friends who have never survived these lumbar punctures.This operation is mainly operated on people with menegitis/malaria and none who has experienced such an operation has ever come back to life, so something must be wrong somewhere,we need DR HK or Dr abc to shade some light about the missing link between surival and death for those who undergo such operation.Of late at UTH those Registrars actually discourage such an op and merely puts up to the relatives to decide.My sister in law died in much a similar way.Prevention is better than cure,if its an area needing cleaning up, it must be done without delay, there is no need to deny bugs are all over even in developed nations we hear things like MRSA,colostridium deficile etc, so who are we to ignore this? safety kulisunga wemwine naya ku shop Born rich mwaice

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  12. #11 you have put your finger right on spot.Dr Lambart and company must be held responsible for deaths emanting out of this crude and painful op.Its true those tuma consultants na crooks law just instruct junior doctors to do these lumbar punctures knowing very well that someone wont survive.Zambians need to know their rights to better medical facilities not these deaths as a result of negligence.Some people have died in that Admission ward at UTH after such weird op.God forbid,Dr abc where are based,from this writing I can tell you are not in Zambia,can we start a Lumbar puncture NGO just to enlighten the public about the dangers involved and the risks there from?

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  13. Lumbar punctures(LP) are not performed nilly willy, they are performed in cases that are not clearcut to rule out Meninigitis(Mngts). Thus in a case of clearcut bacterial meningitis, it is almost unnecessary to do the LP becoz of the risk highligted above. There are however different types of Mngts, such as Viral & TB which are not necessarily associated with high Intracranial pressures, & in these on a balance of risks, an LP is required to make a definitive diagnosis to allow the appropriate therapy to be administered. LP maybe useful in ruling Cerebral malaria in a slide negative pt not responding to antimalarial therapy, though in the acute phase the most logical thing would be to cover the pt for both pathologies, thus avoiding the catastrophic herniation of the brain.

    It brings us back to POLITICAL PRIORITIES, UTH should have been singled out to be equipped with modern diagnostic equipment. Where we fail is in appreciating that the little we maybe trying to save in the..cont

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  14. cont.. long run is actually not a saving, becoz, a life can be “costed”. In the west, this is then extrapolated to the cost the community has to pay for the loss of a particular person. To simplify things, Arsenal, have just lost their key player, to replace him, will take more than just money but maybe a number of years when the will have to wallow in mid or bottom league if not careful. Thus if we were to look at issues such as this in that perspective, we will appreciate that the apparent savings we are making aren’t worth it. In the same vein, if we retain the medics we have trained for 7 long years, the cost of renumerating them & equipping them, is NOTHING COMPARED to the cost of lives lost,when they could have been saved & further contributed to society, PLUS cost of hiring foreign medics PLUS the long time it takes to train medics to the level we will be satisfied with their services currently being appreciated/enjoyed abroad.

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  15. #14 & 15 Bauze Ngozi , great stuff, in my cabinet you will be Minister of Health Management,Medical Investment and Well meaning life design Equipment director.That is why I always ask you people living in diaspora, we must make use of your exposure back home, your experiences can not be ignored but needs to well placed in our systems please come back early Bauze not when you are finished elo ukalebwela ninshi your mouth is full of dentures, no the time is now.How can the entire UTH not have a CT scan?when we spent $893,000 on evacuating politicians to Morning side clinic who return as cargo? Its shameful nayanomba kuma order nafulwa sana Bauze, see you at 17hrs

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  16. I am now understanding why politicians and the rich Zambians prefer to obtain medical treatment abroad. If the story is true then we have a public institution which requires immediate action. We have many workers in the Health Ministry who should ensure that the institution is well maintained and running efficiently. It looks like we have employees who accept the current situation and do nothing. In developed nations employees and general public bring such cases to light before it is too late. In Africa, we keep quiet and accept poor services which results such poor performance continuing for many years. We should always expose such poor institutions so that govt can rectify the situation.

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  17. to my cousin mujina who died last week in the admission ward of UTH after a lumbar puncture may your soul rest in peace.You were only 24 years old,newly married,with a small baby.You refused to have the lumbar puncture done but the doctor convinced the relatives around you it was safe.Now see what has happened.To people out there follow your intuition.Not only where lumbar punctures are concerned.I believe God warned the girl thats why she didn’t want a lumbar puncture but some underpayed overworked junior doctor convinced the relatives otherwise.please doctors tell the public the dangers before you do such tests.who is going to raise that baby now?

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  18. #18 tumelo, really makes sad reading. And you guys your are telling me that all we going to do about this situation is to come to the computer, pull the keyboard and complain? Right now as we are complaining, a lumbar puncture is being done on someone without being told the risk.

    Lets stand up and be counted.

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  19. Fellow contributors, lets veer away from specific procedures as even those percieved to be erudite in this field are fluffing about in their explanations!!

    What can be done to improve UTH,Mongu General,Kasama General etc??Equipment alone will not solve half the problems these institutions have.Any ideas on funding,training and the modality of accessibility to services offered by a referral hospital?? We can make more progress if someone can tells us how to legislate against negligent medical personnel!!!

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  20. look I’m not going to bad mouth my fellow doctors but I believe if UTH, which is a tertiary hosp was properly equipped 90% of the problems would be solved.I was embarrassed some years ago when I ,for the first time worked in a well equipped renal unit.I was asked to do a peritoneal dialysis and I had to tell them I didn’t know how to do it and a colleage had to show me.He asked what we did in zambia,how I would have treated a similar patient in my own country.With sad realisation I said this patient would have died if she was in zambia.The catheters and needles used were not too expensive and if people had their priorities in order back home I’m sure they would afford these things.So its not really negligence where doctors are concerned but they need to be better equipped.

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  21. #12. mudaala kuku, too bad that you have relatives and friends who as you have said, have no survived this operation. I am sure there are alot others who share you experience.

    Having said that, you must appreciate that, that is not sufficient reason to believe this story. Tell you what, i have a examples of people who have succesifully undergone this operation at UTH!!!

    It is too early to make a verdict. We need more authentic data.

    As i have said before, this must cause us to Investigate before we can make the right verdict on the issue.

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  22. #21 see Dr abc’s comment #21 , actually now these Dotors know the outcome that is now they let you decide.They will table the pros and cons, but would not go into details.Look at comment #18 may be these hospitals have bugs like MRSA we hear about in the world which Lambart and Company dont want to talk about.That Chi UTH ,Ndola Central, Kitwe etc they are badly kept,may be some pathogens fly all over and when that LP is being performed they just get in.Or may be there s always mis diagnosis but the fact this story is true and cant be ignored.Ask Dr chalapa from Maina Soko who does these ops.

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  23. It is a known fact that UTH is one of the best hospitals that has trained many health cadres in our nation. It is there at UTH where I was “baptized” to the world of Medicine. In my time, HIV/AIDS was just creeping in and was not so much a factor as is the case now. I may not comment specifically about the questions that have been raised because as I said I was there in mid eighties but did most of my work at Kitwe Central Hospital. Usually, in most cases where lumbar puncture (LP) is indicated, an underlying serious condition such as meningitis, cerebral malaria etc is present. From my clinical practice most of these cases are 50/50 in cases of mortality or survival.

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  24. ctd. UTH had had a very good CSD (Centralized Sterilization Dept). I do not know presently. Besides the conditions mentioned above, today, we have major challenges in medicine with many opportunistic infections in the shadows of AIDS, vis-à-vis some fungal, bacterial or viral infections such as Cryptococcal meningitis, Coccidioidomycosis, Histoplasmosis, Cytomegalovirus (CMV), Listeria spp, syphilis, TB etc. Many of the fungal infections above were not a major factor 20 years ago but now are. LP procedure of course is not without risk. As mentioned above of course failure to rule out increased intracranial pressure is certainly almost always fatal. Post operative care is also important and it now brings me to a political observation. I have never heard of a country that pruned its health workers (under strong instructions by WB and IMF) but Zambia. USA, Britain and many developed nations are not self sufficient with health personnel but made our politicians do away with nurses, clinical officers and other important health personnel. It takes long to replace these mind you we only have one school of medicine and one College of Health Sciences. Nursing care at UTH and many big hospitals of Zambia is another major factor besides the above conditions. Our work force has left and is now being enumerated better than our own country which too is a shame.

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  25. HK you once grafted at UTH what do you have to tell us,CK and Dr abc left before you, before you started working with Dr Garg, you were a junior doctor in the Admission tell us about these colostridium deficiles, MRSA,etc you friends have propunded even me a lay person propunded inga iwe? Kano fye ukuponta pali FTJ?Taulekula bwino.challenge your collegues with forensic data about why UTH is a departure lounge of late especially after Lumbar jazz

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  26. I just did a lumbar puncture or spinal tap a couple of days ago in a US hospital.Brain CT was done prior to the LP.
    Herniation occurs in approximately 1% of patients with bacterial meningitis.
    clinicians commonly obtain a CT scan before doing a spinal tap, on the basis of two beliefs:that herniation is a frequent risk in meningitis and that a CT scan can accurately predict its development. neither belief is correct.(Infectious Diseases by David C.Dale pg 210)
    Trained at UTH,retired by FTJ.
    MEDICAL CARE IS NOT CHEAP. A LUMBAR PUNCTURE IS A VERY IMPORTANT PROCEDURE IN MEDICINE.

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  27. km- usa I agree with you that brain herniation is supposed to be rare but why do we see a good number of patients collapsing after the procedure?

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  28. #29 dr abc, you may still need a bit more experience. Indeed pt may collapse, but you to need to think outside the box, they may collapse for a variety of reasons – Herniation is one but rare. It could also be due to the fact that the pt is so ill and moribund & just happens to collapse following the LP. Correct me if am wrong, an LP is considered when one suspects the meningitis(Mngts) as not clearcut & for culture & sensitivity purposes, & further ruling out other types of Mngts. Modern teaching in diagnosing bacterial Mngts, classes this as a”clinical diagnosis”, thus negating diagnosis following investigation – thus clinical skills need to be up to scratch – you need to indentify the following: rash – which is noticeable in black skin too(no excuse!); Neck stiffness, Brudzinski’s, Kernigs etc. In rapidly deteriorating pt treatment with widespectrum antibiotics recommended b4 investigations, which shud cover most serious Mngts. PCR & blood cultures will do in absense of LP.

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  29. #28 KM-USA, nice to hear how readily available CT scans are in USA, it’s also good that you have noted that the scans are DONE ON FALSE PREMISES, but taht aside, in the US the overiding reason for scans is to avoid medical malpractice suites, hence in your scenario it is no surprise that alot of investigations are carried out even when there is no obvious indication except that the medic wants to make sure he /she protects their license.

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  30. Iyooo kwena ama zedians balinwa data! Guys continue, ifwe tuleumfwakofye nokusambilila at the same time. Can we have more topics for discussion on this site, maybe the politicians may learn one or two things and hope fully improve our country.

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  31. I forgot one thing, whats the availability of this site to the general Zambian public. Can someone answer this please coz this data needs to be read widely for it to have an impact on Zedian’s lives!

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  32. dr bauze, whats your view of using normal hypodermic needles for a LP as is the practice at UTH and under non sterile conditions.Whilst being at UTH I felt like my favourite TV star when I was a kid magyver. We were for ever improvising things.I remember even tearing a piece off the lab form to use as a swab.I remember using NG tubes instead of a urinary catheter.Its easy to leave the country and forget these things ever happened but our people are being subjected to awful conditions.Aren’t such practices against Human rights.Is it fair to see politicians waste money on cars whilst patients are being told an IV line can’t be set up because we’ve run out of canulas.I may not have the years of experience under my belt like you but I think we should pay back to the zambian people one day by buying some of the equipment badly needed or just making people aware of how bad the situation is.A poorly stocked UTH has become the norm and the rich continue to fly off to RSA for treatment

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  33. #35dr abc, I understand where u are coming from,I know the status of UTH. Green needles are fine if they are the only ones available, though you have to remember that the chances of your pt developing a Post Dural Puncture Headache will be higher, to avoid this use the smallest calibre needle available, however this will depend on the trade off between length & calibre as they weren’t designed for that purpose lengthwise.

    Improvisations, well, man wouldn’t have reached this level if it hadn’t been for improvisations, you just have to be sensible with what you are doing, avoid taking unnecessary risks to your pt or your practice – question you shud always ask yourself is,”would I want anyone doing this to the person you love or hold dear most?” If your gut instinct is no, don’t do it!

    As of what has to be done concerning politics, read my earlier postings on this thread, #4 & #5.

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  34. Ba LusakaTimes please introduce a medical corner for learned men and women to share important developments in medicine and other medical fields that need fine tuning.
    Iwe Chi Dr HK ulikwisa kanshi? BaJoze can you find Dr HK? Ever since FTJ fired you its like you have changed your career to an insulting boy.Come here this is where you belong not uko kubaice abena Easy na Born Rich.

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  35. #29 Pts.may collapse/die after LP because of brain stem herniation or indeed because of the nature of the infection.Mind you meningitis or meningoencephalitis is a very serious illness with a high and respectable mortality rate even in the USA.
    I believe the commonest form of meningitis at UTH is crypto. in AIDS pts with CD4 counts below 100.
    One of the most important part of treatment in these unfortunate pts.inaddition to iv ampho B or fluconazole is serial lumbar punctures especially when the openning pressure is high.
    Not doing serial and timely LPs to relief high ICP in crypto. pts is malpractice to say the least.If this is tidious to do then ask the neurosurgeons to insert a shunt.
    If you cant do a lumber pucture ,let it be done under interventional radiology.

    #31 once you suspect meningitis in a pt.The next procedure should be an LP unless there are absolute contraindications.Failure to do so is malpractice.A kerning’s is not sensitive enough.

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  36. #32 The fear of malpractice law suites makes the US doctors be at the cutting edge of medical knowledge and research.It makes us respect the patient regardless of their background.
    If malpractice law suites were rife in Zed in general and UTH in particular ,probably we wouldn’t be discussing basic hospital hygiene and lumber punctures.
    Americans value life thats why they invest into healthy care.If Kuku or Dr abc is appointed MOH PS next week and chooses to buy herbal medicine for HIV/AIDS pts.from the far east and not standard meds from GSK.Are you gonna blame the West?

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  37. I concur with #38 KM – USA, that infection by Cryptococcal species should be the leading cause of meningitis in our situation for UTH. This kind, a fungal infection is not an easy condition to treat as many people (even lay) know how cerebral malaria and bacterial meningitis can be deadly because they are serious conditions. The medication reserved for cryptococcal (Amphotericin B, my teacher in the USA calls it, “Ampho terrible”) is also highly toxic. Patients with these conditions are usually in AIDS status and usually with poor nutrition, a major factor in our situation where we only depend on IV glucose for feeding but our friends in developed countries have various IV nutrients that can make a difference.

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  38. A month ago a friend lost a patient at UTH. She told me that they had refused to allow the Dr. perform an LP. She had told me that the Dr. was not happy with her since she led the family in refusing the procedure to be done on the patient and after the pt had died, she told the Dr. the reason why. She had had three other relatives in the past two years that had died following an LP. I may not know the conditions the patients had but it is not uncommon nowadays to postulate the diagnosis that these pts had had. Anyway, I also want to say that in the USA (e.g. John Hopkins Hospital) they have constituted a protocol to follow for certain procedures and in the event of any deaths of this nature they will sit down to establish the cause and make sure that that failure will never be repeated. Of course human error does occur but the standards are adhered to highly.

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  39. Maybe if this could be investigated, UTH must check all the reusable LP needles that they have. If it is established that they could be the cause they should be disposed of! It is an expensive venture but not cheaper than life. Hospitals are the commonest places you get resistant types of bacteria and perhaps just like ICUs, theatres get bad bugs, CSD must be checked and fumigated. This can be done and sterile conditions should also be promoted which I know is part of training. That brings me to prions, especially Creutzfeld-Jacob Disease, CJD. This is not so much focused on but could be another area that we should check on.

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  40. #37. Kuku
    Mudaala KUKU, these doctors are not of any help here. They belong to the wards!!

    They went to the same school but are busy contradicting each other like economists. The other thing is that the languague they are using is “textbook language”. It has no place in the real world.

    Ifwe na ‘Easy’ tulafumya data iyamano!!!

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  41. #43 Mwaice Born Rich, people differ in IQ and application, comprehension and innovation, and its common to find differing views /responses.Its just like lawyers they have read the same piece of law but when a case comes up we always see differing defences and only one emerges victor, why?Its not like Maths were the answer will always be the same irrespective of the method.what they are doing is like a refresher course, I would encourage this cos they are dealing with life,each one of them is learning from the other which is quite healthy.Iwe na Easy mulafumya data pantu iyalubana aba balefumya data iya correct all they need is encouragement and they should not feel shy or embarrassed to express their inadequacies because that is the only way to boost their effectiveness and excercise good work practices

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  42. Ok mudaala kuku #44. I hope they only differ on this blog and in the classroom. I only hope this bickering does not happen in the operating room because that can be very fatal.

    Imagine 2 doctors arguing with each other on which method to use when operating on a patient, whilst the patient is battling for his life. I wonder to what extent such things have contributed to mortality rate!!!

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  43. #43 Born Rich, There is no contradiction here. All of us have agreed on the most probable cause of the problem and without doubt the doctors and staff at UTH I believe do have the idea of what is going on. In medicine it is difficulty to pinpoint a cause without seeing a patient physically and doing appropriate diagnostic tests. So all we are relying upon here is history (in this case hearsay) and are just trying to explain possibilities. Doctors always think of possibilities (differential diagnoses) and always rule them out one by one to come to diagnoses and this is the same thing that is being done here just to broaden or to share helpful knowledge. I am sure next time you hear of a similar situation you could as well think of this likelihood.

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  44. #45 mwaice Born Rich , medicine is not like engineering where you gamble with designs,these guys take time before an op is performed but sometimes they are prone to errors like anyone else may be sometimes due to wrong prognosis especially in developed countries that is why law suits are more prevalent there than in Africa,the example in question is wrong diagnosis for cancer where the radio grapher was giving wrong info about patients, in that regard its difficult to assume that the Dr was at fault,but Iam so certain these guys plan their ops,incompetent ones you can easily tell like Dr HK, you tell him you have mumps he gives you quinine,you have hernia you end up being castrated,you have breast cancer you end up with hesterectomy, mwaice wamona data tulefunya not ilya mufunya na Easy pali ba Sata, change management mwaice, not ama quotes ya Marslows kwaliba na Hertzeberg theories,kwaba na Kaizen theories,then TQM(total quality management) so mwilatutinya baice

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  45. #47.Mudaala Kuku and CK #46 listen to this:

    Not long ago (16 july 2007) there was a story running on this blog about a three man crew of a Rosa Minibus belonging to a Lusaka businessman which was found dead in their bus.The three were believed to have suffocated to death in the vehicle after sleeping with a charcoal blazier in Kalomo

    Now there were 2 interesting MDs on the blog; the one Dr. abc who said “Treatment would be removing the patient from the that enviroment and administering 100% oxygen”

    The other Dr. L said “You do not administer 100% Oxygen unless you want to induce Oxygen intoxication. What is recommended is 60% in a humdifier”

    Did i say 2 doctors? No, I was wrong!!! Yet another Dr. M said “….between 60 -90% O2……”

    Here you 3 MDs in fiece debate as to what is supposed to be done. As someone on the blog said, one wonders what these 3 MDs would do if they are on the scene of the accident!! One would be doing the exact opposite of what the other is doing.

    Ever heard of homeopath? Allopathy? Maybe that is what is at play here.

    Waunfwa mudaala Kuku ati naine data epoyaba. te?

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  46. I am greatful to Dr abc, Bauze, CK, and KM

    This is a very enlightening debate, this is as it should be. Now we are getting facts and not conjecture……..Correct diagnosis, proper equipment,correct procedure, investigations and Aids in pertiants all have a telling effect on the outcome of a lumbar puncture(This is what we have learnt from this debate).

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  47. #48 Mwaice Born Rich apapena naku diga, data epoyaba nomba pantu utampilapo ukusabaila, ulebika hypothesis mwaice to make the whole story interesting ,efilya nacikweba ati IQ differs, some are just bookwormers and cant use initiatives, sometimes theory can be misleading, but experience can actually lead you.May be those Drs who just stambled on that mini bus story were interns like Easy,Iwe Citizen dont conclude the subject there is still more to discuss, dont cut them short, they need to recommend to each other the current practice vis a vis Lumbar Puncture and what the mitigating factors must be incase of complications, death must be the last thing I want to listen to.Imwe Bashinganga continue Iam waiting……

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  48. #50 Iwe ka KUKU

    There is need to surmarise, otherwise from over elaboration we risk losing the core ingrdients of this argument.

    I have learnt what I need to from my leaned collegue and can now form an informed opinion

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  49. # 45 Born Rich, I appreciate your concerns and fears. There should be no need for apprehension! In real life and under normal circumstances junior doctors work under experienced hands and this is the trend in all medical education. They take instructions from seniors who have managed presenting conditions before and in many operations offer a helping hand to these veterans until they become competent themselves and pass on the knowledge. At UTH we have major or minor ward rounds in which the most junior a student nurse, clinical officer, medical student, intern, up to the consultant take turns to answer questions and brain storm on management. The consultant has a final say but many times even the most junior would bring out the right management and a senior person will consolidate the information. By the time you are through your knowledge has increased so you should not fear since cases of you facing two surgeons offering two different management protocols on the operating tables are rare.

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  50. #52 CK thanks for your effort. I am just waiting to hear from mudaala Kuku. Good afternoon.

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  51. #50 mudaala kuku, you, CK and the rest of the blog have ‘made my day’. Enjoy the rest of the day naba shing’anga. They are here to do us good, afterall. good afternoon.

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  52. I’m a nurse on the copperbelt and have worked over 25years in mine hospitals.We do lumbar punctures daily and this helps treat patients promptly.In all my 25 years + of work I’ve never experienced a lumbar puncture killing anybody.If this is happening at UTH,deaths occuring 1-2 hrs post LP must be investigated.The public should know that LP is a very necessary tool for treatment and death after LP is not the norm.

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  53. #55 Mayo beatrice ala wacita bwino ukwisa pa blog,please bring more women on the blog,we want gender equality, only men debate here like Zambia is a country without men.That is why our concern is the cleanliness of the environment under which this op is performed.Read through what the Drs have articulated above.Lambart and his soldiers must be investigated on a serious note. Ala mwandi Beatrice naubomba 25 years non-stop when are you retiring? Start thinking of opening your own surgery for Lumbar punctures.

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  54. #38KM-USA you still have some way to go b4 you become a FULLY FLEDGED EXPERIENCED CLINICIAN & wise enough to understand the dynamics that determine medicine the world over.

    1st, as concerns your argument about LP’s I will refer you to this abstract written by your Americans becoz you are so convinced that they are at the cutting edge, but maybe a slight pity for you that it didn’t show up on your radar – “Fatal Lumbar Puncture: Fact vs Fiction – An approach to a Clinical Dilemma” by William J. Oliver et al Paediatrics Vol 112 No:3 Sept 2003.(Google)

    Medical research in different countries is governed by certain bodies that limit what can be done and what shouldn’t. The limits of what can be done in Europe are different from what can be done in the US. I wonder how many american medics will side with you when you claim,”medical malpractice, is what puts them at the cutting edge of medical knowledge & research!” Malpractice sieves out bad clinicians, doesn’t drive research.

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  55. The article you sited bauze was interesting.Ct scans hardly show abnormalities in acute bacterial meningitis and thus would be expensive and impractical in the zambian setting.Perhaps we should place more emphasis on focal neurological signs and delay the LP if they are present.whats your view on #55 thats a good record the mine hospitals seem to have.

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  56. I grew up in the mine area. Their facilities are excellent. Their work culture immaculate and possibly never have the word “improvising” in their vocabulary. Of course I am not surprised by # 55 Beatrice’s great professional work exhibited by their staff. I like the way she narrows it to the 1-2 hrs post LP period which could be crucial in determining the possible fault. In the USA, certain Drs. do not take high risk patients and some hospitals do not either. Reason? If mortality rates were to be calculated, figures will undoubtedly fault those Drs. and hospitals that take high risk or terminally ill pts subsequently, raising malpractice insurance costs. UTH does take these! It also has very poor patient: nursing ratio. Overworked workforce, poor equipment with poor enumerations is not good for good health care. Otherwise, I still support Beatrice for the need to investigate to immediately correct the problem for life is precious.

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  57. #57 Doctors get sued not because they are bad.
    Reasons for malpractice lawsuits.
    1.Adverse medical outcome 2/2 deviation from standard
    practice.
    2.Doing procedures on pts. without prior consent.
    eg. HIV testing,transfusion human blood products,
    doing a lumbar pucnture,drug overdosage,mis-
    diagnosis …….etc
    3.Percieved arrogance i.e poor Pt/doctor relationship
    4.Not telling the truth or covering up a mistake.
    Interestingly,the public know that doctors are not
    gods with a small g,rather human and can make a
    mistake.In the US statitics show that doctors
    who confess and acknowledge their mistakes to the
    pt.or relatives to an expired pt. are seldom sued.
    Inadequate , unsatisfactory or use of medical
    jargon will undoutbably raise suspicion and invite
    a lawsuit.
    5.Some people just love to sue unsuspecting doctors and hospitals with a hope of a quick out of court settlement.
    6.There are 101 reasons amigo!!!

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  58. In my entire learning and practice that spurns a period of 10 years l have only seen one baby collapse after LP and Dr. Chomba then,mentioned something about brain herniation.l have done countless LPs and have not seeen anyone collapse immediately.

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  59. l do not know now on the standards of UTH,but what l do remember,from 10 years ago is that,LP needles could be found in certain places and the procedure can be done in the manner it is suppose to be done.l did afew LPs properly in Kitwe and Kabwe,everything properly,using fundoscopy and LP under sterile conditions.So maybe UTH is a death trap but,someone dying out of LP is as low as 0.01%.

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  60. #61KM-USA for crying out loud, look up “bad”, if what you have listed isn’t , tell me what is. For all your worth, try to show some comprehension!

    #62drK95 your comments are indeed welcome, but you are very amiss when you go about naming people when you can’t even identify yourself. You basically have implied that this person stood by as this procedure was done, without making sure that it was safe to do so – are you able to attest to that fact? (It is nice to know that you are trying to bring some credence to your story, but there are better ways than incriminating someone without doing justice to their supervisory abilities).

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  61. #64 Bauze I like your authority, keep it and regulate your fellow doctors, no wonder Born Rich is very concerned.

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  62. This is a very intresting topic, its sad to hear that alot of people are dying after an LP.
    perhaps the doctors at uth even the ones abroad can do an audit retrospectively to see how these procedures were carried out and what led to the deaths, we can speculate that they may have been very ill patients and with or without the LP they could have died anyway.
    if we study the records we can come up with recomendations and current guidelines based on the info we obtain.
    over the 12 years I have been a doctor, I have not witnesed a person die directly from an LP procedure and I do remember at one time whilst at kitwe central,
    doing almost five LPs in a day.
    true we may not have ct scans or even sometimes fundoscopy equipment but, as i was once told by a great physician humanity has reached this far because of the clinical eye.raised Intra cranial pressure that could lead to death on LP can be deduced
    clinically, Try watching the crazy tv doc house!

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  63. if you do your audit then you could present your case boldly to the powers that be, its better to state that we have lost an x no of patients because of the lack of x from 2006 to x period and these deaths could have been avoided.
    singing we need money endlessly is like praying for a good life with no goal in your hands!.

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  64. Kuku this is interesting why did you tell me. You just mentioned Beautrice and her 25 yrs of experience. We shold admit out UTH is in bad shape we need to revamp. Two days ago those who are rich, exvacuted VJ to South Africa. Why? clear fear of this death trap and UTH. You mean apart from LP there are no other ways that patients can be helped.

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  65. #68 Mwaice that is why I gave you those specs for the person who should be president come 2011.
    Our Leaders are just a hopeless bunch,VJ is not in govt, why spend on someone who is not a civil servant? KK goes to UTH, why should a criminal be accorded such a gesture?This man attempted to steal $7m from govt,of late is an ambassordor,I really dont understand African politics, they damn dirt.I cant wait to have a president who respects the Zambian people.

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  66. The next campaign in line with help matters. I cannot afford to helping other get rich. Real buy a CT to scan someones body is a problem. You you need are trained people who can use these equipments. A has just a duty of interpretting the results and give the right medication. Every thing outsourcing. Wake up Zambians.

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  67. #70Easy, sometimes you make “stellar”(i.e. star-like)contributions & easy to comprehend but other times you seem “all @ sea”(i.e. all over the place!), try to proof read b4 you press the submit button, we will then be able to appreciate you good intending contributions!

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  68. First of all l am not trying to give my story credence or name names,so that we doubt their supervisory roles,.I was a student then and the one who did an LP is a qualified MD,whether there was a back room talk after or not ,lam not in a position to say.However,l must say that all things when they happen bad or good helps us to learn so that in future we may use or avoid them.Can we not say what the Consultant said and his/her name is just because we think this may tarnish their name…..LPs however is a very safe procedure and l will continue to do it regardless of what someone may say,unless we have a better way to manage menngitis.

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  69. ‘Outsourcing’ as a word has been demonised on this blog. There are some things that you MUST outsouce to run efficiently.
    All big companies get components of their final product from smaller ones. A car manufacturer for example does NOT have to make tyres, elcrical components, batteries etc, all these items are OUTSOURCED.
    Coming to LP, Yes UTH needs to make changes, but there is nothing grossly wrong with their current practice. They just need to follow sterile protocols…and be more serious.

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  70. #73Hey, you have misunderstood the term “outsourcing”,
    it is not the same as “buying!” It means, instead of you continuing to produce something, you decide to obtain/buy from a cheaper source, i.e.rather than making it yourself.

    You don’t seem to comprehend what the problem @ UTH is, no surprise you see nothing wrong, what would help you is one of two things, a) start by reading each & every posting on this thread [exclude yours] or b] pay UTH a visit, that will be enough in itself.

    #72drk95,nice you have not named anyone this time, the point was, if you’re unwilling to put your name down, you shouldn’t be putting anyone elses’& you ought to quote them verbatim rather than speculate.

    A word of advice, in today’s clinical practice IT ISN’T ACCEPTABLE, “JUST TO GO AHEAD & LEARN FROM YOUR MISTAKES” @ the expense of the pt. You should know your limits & seek senior help early, so that you are directed in how best to manage the particular problem.

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  71. Bauze 74,….”Outsourcing is NOT buying it is buying”…Is that what your 2nd sentence implies?
    Kindly rephrase it if you want to conjure a different meaning.
    UTH simply needs reinvestment and good regular funding. They do not have sterile LP needles at the moment, have never had in a long time, how do you expect them to do better when they have to improvise?

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  72. UTH will never have proper equipments for its various departments as long as our politicians are always rushed to RSA for treatment. Some of them do end us coming back in casikets. We need leaders like KK who are willing to go to a Zambian hospital at any cost. Only then will UTH be a real true hospital.

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  73. Hey, i may have confused you, to put it simply, producing internally be it country or company is ,”Self-sourcing”, whilst the opposite is outsourcing, so when you refer to a hospital as “outsourcing”, doesn’t really apply, becoz they buy all their consumables. Hospitals don’t produce per se but help their clients on their way to recovery.

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  74. Bauze, cheers mate!, I realise we have a very similar understanding if not the same.
    I am very zambian, may NOT look like one, but i am out here so i can not go to UTH to see for myself. I know UTH in and out, they use what are called ‘IV cannulas’ for LP, its medically OK but the right thing is used specifically designed ‘LP needles’.

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  75. Dr CK #42, you are not talking about CJD, you are talking about ‘Variant CJD’, the one that affects the younger group.
    You point is right on anyway.

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  76. #73 ,74 ‘outsourcing ‘ refers to procuring a non core good or service offsite.i.e in a counsultancy firm, HR department is irrelevant so the best one does is outsource the HR function usually comes as result of cost implications.Gains must outweigh costs.

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  77. Opus, I missed this nice debate I thought this was closed topic since no one contributed sometime. I want to put it clear for the common man, jim and jack to understand the word Outsourcing- it means give away a services of product´s production to a more competent skilled manpower or when you are unable to meet that service or produce the product in house. This is the caseb at UTH, it just does outsourcing by sending patients to Morningside clinic this can termed also in business JIT- just in time. For UTH agreeing that a patient must be evacuated means applying JIT inorder to save life. For a firm it could be a cost measure as kuku put profits must outweigh cost. Stupid managers like FTJ will fire, lie off workers in this process, this was the problem with junior doctors.

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  78. #81Easy, nicely said! I have a feeling the politicians will be after you – What?? Yes!! To make you their policy advisor & press spokesperson for that matter!!! With ideas like yours, who wouldn’t?

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  79. #82 bauze, Is not true what I said? Its common sense if you are sick and you live in Libala you go to this clinic and if the medical officer as they are normal called in Zambia cannot help you he will refer you UTH were you have to queue for hours or days in left pocket you should have K60, 000.00 as registration fee. I wonder if ba Mwaanga went through this process iyo no nibapamwamba (VIP)/(VRP). I am trying to make funny of the patient the procedure at our hospitals.

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  80. #83 I know you were joking, i was also just putting a bit of spin to spice up the humour!!

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  81. 84# bauze, sorry for this misconception somehow my pc is cutting some words which makes what I say ambogious. Oh yes what I said above its truth it no fantasy.Look now even the private sector is waking up have you heard the good news not for all Zambian but at least a fraction of the population. ZANASE hospital coming 2 private firms Baypot and Microfin have partnered to build a hospital in Makeni area. The only question remains why a military hospital? I hope it will be quality of Morningside clinic.

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  82. It appears the meaning of outsourcing is generally agreed now. In the case of UTH sending patients to SA is ‘outsourcing’. Wow! what about as regards to LP?

    My conclusion stands then, that outsourcing has nothing to do with LP. Unless you suggest ba VJ went for LP in SA.

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  83. 86# LPM is a special case it fall under SLA- Special level Agreements. Hhahaha what a good service level agreement. Oh yes it is a special level arrangement which the president of the nation enjoys.

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  84. why are you in UTH if you don;t need an LP?IV canullas are sterile.It is acceptable to use iv canulla for LP.If your relative died after an LP condolences.He probably would have died even if an LP was not done.Please stop being alarmists.

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  85. ah ba ihr. must you revisit your microbiology and learn what a sterile procedure is? Do you drape and swab your patients before doing a LP? do you wear sterile gloves or just disposable gloves when doing an LP. Just because you are going to use a sterile canula doesn’t make the whole procedure sterile.

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  86. #88 ba ihr bushe nimwe ba intern? Can I come and do an LP on you? You sound like you have menengetis, actually I will just my kitchen fork to pierce you so that you jerk up your standards,I feel for your patients

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  87. I think everyone has a different experience at UTH but most of us have had bad experiences, I for one have a brother that had a lumbar puncture performed at UTH and somehow survived it, it’s been almost 10 years now , at the same time I lost a daughter due to negligence in that hospital, without going into details, I had been in the hospital for a long time b4 someone attended to me with the baby dying in lu lapse, I just wish I was where I am now because someone would have been held accountable.How many times have the so called Dr.s misdiagnose patients,I can not comment on surgeries but I know that UTH is a death trap, a healthy mother of twins died after the c section, for some reason after she dellivered , they left the wound open , it got infected and she died from thos complications,been in the US a while, maye we gat a lot to do, to learn , invest and hold those docs accountable,everyone of the docs have private bussiness at the expense of public funds, (sorry no more space)

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  88. 5nomore, thats a sad story you give unfortunately quite common even abroad.There was a time I was on call at UTH paediatrics,there was such a long queue of mothers with babies.I decided to go see who was in the queue just incase there was a very sick child that needed attention. I found a mother in the queue,holding a baby nicely wrapped in a blanket.She smiled at me and I almost bypassed her but decided to take a peek. To my horror, under the nice blanket was a baby who was turning blue and a few seconds from death.I grabbed the baby and took it to the emergency room for resuscitation.The baby lived…My point is if a child is very sick,parents should not calmly wait in the queue but demand to see a dr.,throw tantrums or anything to save the childs life.Doctors are human,sometimes we go for a bathroom break,tea break,etc but we would drop everything in a beat to save a life.When you go to hospitals ask questions and pray to be attended by a good doctor.

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  89. #93 drabc, I don’t think your advice is very wise, becoz I wonder how you would personally cope if you had 20 irate parents screaming at you. The solution comprises mutliple facets:

    1) Adequate staffing levels of both medics & nurses,
    2) Appropriate info, well displayed, describing your Triage method, which would help keep things orderly,
    3) Adequate supply of diagnostic facilities as well as treatment modalities.

    Just becoz one becomes a parent, one shouldn’t expect all of them to recognise a moribound child – for some it’s their first time being a parent, & they may not have an elderly relative around who may have a bit more experience than them. As witnessed by yourself & I hope you learnt much from it, becoz many other medics will recount numerous such stories, for if they didn’t, that would tell you how much time they spent at the “Coal-face!”

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  90. #94 Bauze, your comments augment the advice and experience that #93 drabc has given. However, your choice of words takes away from what may appear to be good advice from you. I am sure that drabc’s experience has taught other care providers one or two things. You will be amazed to know that you could have the right equipment but with poor staff attitude it may amount to nothing. Both are important. To inform your colleague who brings out important life’s experience that his contribution was “not wise,” in my opinion, is bad judgment for I can attest to his experience on several occasions. On many occasions I had prayed under my breath and put up drips or done procedures where others had failed or thought was done with, nevertheless turned around. I had also seen patients or relatives intercede for their loved ones and something changed. Yes, we need equipment, we need more staff but we need the right kind of staff too.

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  91. #95CK are you seriously telling me his advice to get parents/relatives shouting at the staff is good advice?? Have you ever been faced with such a situation? It’s about time you spend some time at the “Coal Face!”

    The issue of having good equipment but not applying it is a different ball game altogether – if one fails to carry out their duty inspite of being able to – spells NEGLIGENCE; If someone fails to use the equipment/what he has been taught – spells INCOMPETENCE. When you talk of attitudes, if you tell me that you openly observed incompetent or negligent practice but didn’t bring it to light, then you too are guilty of conniving/permitting this practices to continue – this attitude is worse than the attitude of those you are heaping the blame on. WHAT NEEDS TO CHANGE IN ZAMBIA, IS FOR PEOPLE TO STAND UP & POINT OUT WHAT IS WRONG THERE & THEN – correct if able to, NOT afterwards or as an after thought as you demonstrate! What were you afraid of then & not now??

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  92. Thank you CK. You know I think this bauze just likes differing with other doctors and trying to make us look like we are “NK”(if you are from ridgeway you know what that means).Bauze hospitals are very intimidating places for the general public and parents especially in zambia do not know their rights.
    1. UTH does not have adequate staffing so thats “pie in the sky”.Serious cases take priority and these are not always brought to the doctors attention on time.So parents should by all means take action if they see their child deteriorating prior to being seen.
    2.You talk of info being displayed.Thats good if everyone can read and I doubt any parent with a sick child is going to stop to read the nice posters dr.bauze sticks up!
    3. your third point again works in an idealistic enviroment not zambia at present.

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  93. #97 drabc, am I surprised by your response – NO! Indeed you are NK, instead of confronting the problem you are just out to solicit sympathy! Ask any jim & jack on the street about solutions to UTH,& am pretty sure if not all, majority will enumerate what I just said. You don’t have to be a medic to tell that – you really are a disappointment to the profession.

    Why NK, becoz you expect parents/patients to know more than you do, so you expect them to triage themselves – how on earth did you get out of medical school?? If these parents/patients knew what was going on they would probably sort it out before they got to you – people don’t come to hospital to show their faces to “the good bright eyed docs”, they come for help, & if you can’t organise in a way which helps them obtain the help they need speedily, you indeed end up failing in the way you have narrated. Just becoz somethings look like a pie in the sky, doesn’t mean you give up, you strive to achieve them the best way you can!

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  94. FYI drabc & CK I’d never been afraid to take on the establishment when I was there, coz I took on people in the MOH, they never got to post me by their own whim, I got them to post me where I wanted, I ruffled few feathers there to, becoz am simply not one that easily falls onto ones back side when the going gets tough, am where I am becoz of that spirit. I spend time on this blog to try to help zambia becoz that’s my homeland, inspite of the better personal things I could be doing right now; MEDIOCRITY I don’t accept!!! I don’t choose to pick fights, but if that is what you intepret my contributions to be, hard luck. Post sensible contributions, & I can tell you I ‘ll be the first to applaud!!

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  95. yaba mudala iwe!I don’t have the time or energy to stoop to your level of thinking. I don’t see whats wrong with advising parents to be aggressive if they feel they are not getting the attention they need from doctors like DR BAUZE.When I say aggressive,I don’t mean they should come shout at us but make sure their child gets attention quickly if its serious.They should ask questions and not just accept what Dr.bauze says as gospel truth.By the way I also did not get posted to the funny place MOH wanted me to go to.I never shun a challenge and I don’t accept mediocrity. You see, you and I are in a better place but our fellow countrymen are not.UTH is probably worse than when we left it so don’t give advise that will work in John Hoppkins medical centre (or whatever its called).

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  96. #96 & 101 Bashinganga please stop being political, this subject was flowing nicely from the start so what has gone wrong? Stop personal attacks, just help one another to understand what they have not experienced,your obejctive is to save life, so you are priviledged with special data or book references just pass it on so that one can reconcile themselves with their defiencies otherwise this behaviour is un acceptable.

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  97. Am always surprised to see how the so called intellectuals of Zambia behave the way they do. I worked at UTH for a year i was volunteering. I started with A block to Emergency Room. My attention is with E 22 were i saw patients dying of Lumber puncture. Doctors don’t care i will give an example, One doctor one day just made the patient sit on the bed and then he got the injection and injected her. It was the most pathetic thing i ever saw. because i was there helping left the hand of the patient. After three hours, she died. I tell you UTH has got no proper equipments if only you guys could accept UTH can develop.

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  98. #103 chibwe, no one is denying that these things don’t happen, the problem is that most pipo who have posted on this, certainly report their experiences, & sad to say these are unfortunate if not traumatic incidents for them & I empathise; However having said that, I may use my own experience to counter that the numbers mentioned here are less than the successful LP’s I have witnessed & done. However, we can only come up with the true scale of the problem if someone came up with the statistics – which am sure are available if record keeping has been done diligently. Having enumerated the problem, measures to address the problem can then, hopefully, be instituted.

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  99. I recently read a posting at one of the leading Teaching Hospitals in one country that read, “Recent study shows that patients actually do better at teaching hospitals. It may be as simple a reason as that the more people who study and care for a patient as that the more thorough and complete their care.” I could not help it but think about UTH with such a statement. “Theoretically and on paper, the statement was right about UTH,” so I thought to myself. In practice, however, I found it wanting for our set up as UTH. Truthfully, the care and management offered at UTH is often textbook and therefore current and worthwhile because UTH provides intellectually sound and appropriate management that is standardized, consequently, leads the nation on that.

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  100. Ctd. Nevertheless, the “Big Elephant” or large size of the institution has not been matched with the required number of staffing, therefore tends to negate the positives that quality care that is expected to be offered by this giant teaching hospital. These cases, which are not uncommon, unfortunately, stem from understaffing or performance of certain procedures with “trial and error” in the absence of a must be present senior who has an eagle’s eye and functions as a guide to the student or junior. Staffing of UTH, in my opinion, remains a major factor in reported incidents of malpractice which of course cannot be divorced from poor enumeration and failure to retain highly qualified personnel. Low morale among staff, poor patient-heath care provider ratio resulting in overworking and poor salaries are the major factors in reportedly unsatisfactory care at Zambia’s giant hospital.

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  101. #103 Chibwe. Thanks for your contribution. However, it is very difficult for any care provider to deduce that the sticking of a needle brought about the death of the patient in question. Needles are used everyday, and their perception from the lay person’s point of view, vary greatly from suspicion to anxiety to fear. As a volunteer, while I am aware that you could have observed something that appeared not to be normal, it is very difficult for any trained staff to appear to be convinced because the rationale from most of us could be one of doubt or that you might really not have understood what was going on! However, if empathy or time for explanation of the procedure by the provider was perceived as to be lacking, your conclusion could be as well as mine.

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  102. Well, maybe the author has a point but I doubt there is a point regards the assessment of patients pressure and having seen or not the lumbar puncture needle. When I did my training in Zambia in a medical related field, I got armed with necessary technical knowledge with pictorial images of instruments and functional anatomy for approach for such procedures. Unless, the author says, there no books to prepare the medical students which I doubt…, though latest books take a while to get there. However, books for such routine procedures or info on such could even been accessed on the internet. Let’s not denigrate ourselves too much…, yes we may not have the right equipment due to funding but our human investment needs to be nurtured and encouraged to do their best despite the odds.

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  103. Am sorry i took time to respond i appreciate what my above authors have said. The point i wanted to clarify is this; if people say that UTH has got proper medical facilities and that management is doing its best to improve. I totally disagree, in the sense that its not only UTH i have volunteered to work for but also other hospitals around the world. for example nothing like those procedures i saw in UTH about LP’s, have i seen elsewhere. In the USA, Holland ,Senegal, Zimbabwe and South Africa all these countries dealt with this issue well. They don’t do it like we do it. The example of a woman is many among many cases at UTH. Am not a medical officer but after talking to people they do not even know what has been done to them. I love Zambia and i wouldn’t have been saying this if i did not witness LP’s. Many Authors in this forum were condemning the main article And for me there is no doubt that the article is right. we need to be honest so that we can change our attitudes.

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  104. Its true of what we say about our country Zambia, but am hereby asking those who defend our country very much to come out of the Cave of the Peace country.But these issues are effecting our nation. Zambian leaders are letting us down, they go out and do their medicals outside the country and thereby not know what is happening inside. Not all have this privileged. I have worked in some many hospitals and hospices within Zambia and outside, but what I see in our country is a mess.

    I can even ask the local leaders to go and check the hospice in Kabwata how clean it is and the facilities it is offering, much better than the so called UTH. When I was working there, it was always surprising to see someone coming from UTH to seek medical attention there. Wake up, I agree with what Chibwe is saying, there is alot of evil taking place in UTH.

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  105. #110 Mictem so who are the evil lot?? The staff? The leaders as you put it/politicians? Or the masses like you who just complain & do nothing about it? I’m sure that last bit will incense quite a lot, but correct me if am wrong, aren’t these the same zambian masses that kicked out KK; That stopped Kafupi for going for a third term? Well, if they are – then tell me, what stops them from carrying out a similiar persistent campaign to demand for the medical facilities that they deserve?? The staff have for many years & occasions gone on strike for the betterment of services for you, however you have been hoodwinked by the various govts whenever this happened, to say it was illegal for them to do so – in a sense yes, but they weren’t just doing it for kicks – & predictably, the masses sided with the govts of the day, hence the reason why staff have found it easier to seek greener pastures than to be ridiculed & humiliated. So one can demonise UTH as much as they like, but status quo!

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  106. The bottomline is underfunding. Bauze you got it right. Management at UTH presides over the meagrest resources you could imagine. Yet they are expected to perform tertiary care on a first level care budget. In 2003 MOH presented a capital inventory of all health facilities in Zambia. The level of undercapitalization was staggering. Now we even have a serious HR crisis. Internal management anc clinical practice are a small issue here.

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  107. I remember I was in Lusaka for at two of the times UTH doctors went on strike.The first time I wasn’t sick and neither were any of my close relatives so I was apathetic towards the strike.The second time a close relative was very ill and even died and boy did we fume over the poor services at UTH.I’m sure the rest of the zambian population behaves that way.They only want to take action on issues directly affecting them there and then.If we were all sick at the same time perhaps we launch a more vigorous campaign.So to answer your question Bauze I think us,the masses are the evil ones.Till this is rectified or some radical govt is in power the status quo will continue.

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  108. Inonge!What? 3am? You are really vigilant or is it a night shift that keeps you up?

    In a sense you are right, the evil aspect was in response to #110, but I guess what you are conveying is that people are docile or apathetic when it comes to demanding the medical services they deserve, inspite of paying taxes. The civil society has only gotten onto its feet in the last 10-15yrs or so, I THINK THIS IS A CHALLENGE FOR THEM TO LEAD THE MASSES, not in just politics but ISSUES SUCH AS THIS ONE, they will get more cred by persuing such, & leave little room for detractors to call them political opportunists, but more of a responsible civil society which leads in the betterment of the lives of the people.

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  109. ahh, Inonge, what you need , is Hypnos & his sons, morpheus, phobetor & phantasos(Greek mythology)to intercede for you, & a drop of nectar from the river styx(rather than caffe latte) for you to have some blissful sleep!! With a few Muses to sing the lullaby, shall your nocturnal desires be met, rather than you “Counting the sheep!”

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  110. Yes but perhaps if Aphrodite paid me a visit I wouldn’t need Hypnos and his sons!So tell me how do UTH doctors fair on the international scene since they are trained in a poorly stocked hospital.

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  111. inonge,like any other profession the way one fares in the international scene is based on an individual.You can be trained in the best hospital in the world and still be a lousy doctor.I think UTH doctors are still a force to reckon with.

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  112. #117 Inonge, as dr707 rightly points out, it’s the “gray matter” that counts rather than the “brawns”, (i.e. strictly, “the muscles or physical ability one has”, but I’ll borrow the term), “the equipment”. Infact, things should be much easier in terms of acquiring knowledge with the advent of the internet.

    Do not despair, Aphrodite will shower you with blessings before long!!

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  113. How many so called Zambian leaders run to foreign countries for medical procedures? How can a simple EKG be performed in South africa? If these so called leaders can be denied funding to visit these foreign Doctors then maybe, they will think more about UTH financial support. Most of our Doctors at UTH and many other medical facilities are superb, and they really help, but the main problem is equipments. From small things like pressure cuffs to CT scans, face masks for TB wards is unheard of. Equip these practitioners and they will perform wonders. NEXT I WILL TALK ABOUT HOW TO FUND THE HOSPITAL A LA WESTERN STYLE.

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  114. hey doctors! I took my child to the doctor because she was coughing I was given singulair sprinkles.This is new to me can anyone shed some light?

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