Sylvia's Journal

We should be turning to spring, in fact one of my colleagues, returning from Konar province, said everything is starting to get green and the sun is warm. But here in Kabul we appear to be turning to winter. The snow that fell last week is still on the streets and the temperatures are dipping down. We have gotten into the habit of putting our night clothes on top of the electric mattress heaters so that when it is time to turn in, both our sheets and our jammies are warm. We just have to remember to turn the switch on at 6 PM.

This morning we had a two hour conversation about the emergency triage and treatment of kids that are brought into the Indira Ghandi hospital. It was a fascinating exercise that revealed all the moving pieces that need to be managed, controlled, and improved before it can become a learning center for other hospitals.

There is the physical layout and the patient flow, the staffing, the procedure rooms, the records and registration process, the drug and consumables supply, the training materials and much more. People may talk lightly about creating a learning center but this morning revealed how complex the enterprise is. Nothing can be forgotten because everything is connected to everything although not everything is urgent right now.

Two small groups sat around a large piece of white paper with markers to draw their vision. I tried to have them anchor their discussions about what to do now in a picture of what is to be in the future. We didn’t entirely complete the task as most of the discussions focused on the physical layout and patient flow, who does what where and some on the training, but it was a good start.

It also served as a diagnostic for Andreas’ who is here, only this week, to help push the process along. I am glad he was there as there is very little I know about emergency pediatric care and I have therefore no credibility when there is a choice of options. All I can do is asking dumb questions.

Afterward we had lunch in the hospital director’s office followed by a tour that followed the patient flow. I only got to see the start of it as Saturday is my Dari class and I try not to cancel it except under duress.

I finished reading a text, in Dari, about Ibn Battuta, a contemporary of Marco Polo who, I learned, travelled 120000 kilometers, from China to Spain to Timbouktou and finally settled in Fez. During my last few years at MSH headquarters I flew that number of kilometers in a year.

Emboldened by yesterday’s barbecue experience Axel is grilling a steak, his first time I believe. We are having it together with home fries and a thick potato/leek soup that has some likeness to traditional Dutch pea soup, without the bacon and trotters of course.