Saturday, February 08, 2014

In the line of duty: Re-visiting Al Khurmah

Regular readers of my blog may perhaps remember my going to Al Khurmah for just a day about 5 months ago to substitute for their resident paediatrician. At that time, in my blog entry, I had described the horrid room in the male medical ward where they had lodged me; the room was a patient room, had an unlockable door and a viewing window in the center which could not be closed. I had stayed there from about 1 p.m. on the day of arrival until about 10 a.m. on the following day; in the morning itself, I had seen about 15 patients in the out-patient department, and had handled about 4 ER calls and 7-8 admitted patients.

I was now being sent once again to the same place for 3 days, and I made sure to clear with their medical director (through my own M.D. Dr. Shehab) that this time they would give me a proper room to stay in. I was assured of the same, and so it was with a peppyness I did not feel from within that I drove in my own car to Al Khurmah on the morning of Tuesday, the 4th of February 2014.

Al Khurmah is located south-east of Al Muwayh, about 110 km away. The road to it branches off the main Taif road about 36 kms south of my village, and the road then runs due east for another 70-odd km before you reach a fork to the south that will take you to Al Khurmah. The straight road continues onward to Raniya (a much larger town than Al Khurmah, which can be classified as a small town).

I reached the hospital in Al Khurmah at about half past eleven. I met the M.D. Dr. Hashim, a Sudanese doctor who has a diploma in Cardiology from Leeds University, U.K. He gave me two choices - either I get to stay in a room all to myself in the (where else) male ward, or share a bed with another locum doctor - Dr. Mahmoud, a surgeon who was also here on substitution duty - in a room that was located within the hospital premises. I experimented with both the places, and by evening, I shifted to the male ward room, which was not the same room I had stayed in on my earlier visit, but another room with most facilities. There was no refrigerator and no TV, though.

The work in Al Khurmah is far more than what it is like in Al Muwayh. This is not just because of the greater size of the village; it is also because the paediatric department is extremely busy because Dr. Hadidi, the specialist paediatrician whom I was replacing is loved by the local population and parents flock to him like ants to sugar. He has a no-holds barred policy: he sees every child that is brought to him, whether or not the parents have a referral sheet from the local dispensary and whether or not the patient has a file. I experienced this influx of patients throughout the three days that I was here. My O.P.D. nurse was Sr. Shahida, a Pakistani nurse. She told me that the usual number of patients that Dr. Hadidi saw each day of the week was more than 40. I got just about 50-60% of that. Partly this was because patients chose to not show me but wait for the next week when Dr. Hadidi would be back on duty; however, partly, it was also because I stopped the patients who did not have a file or a referral paper. Many of these patients tried to coax me or force me to see their wards, but I stayed adamant and continued to refuse patients without the right papers.

Emergency calls were also more frequent, and it was all I could do to manage about 6 hours of sleep through each night, that too, with breaks. On the positive side there was something that was more valuable than the negatives I have just listed: for the first time, in more than two years, I was actually seeing real patients - patients with significant problems. I enjoyed this more than I thought I would. The reason for this is not too difficult to understand: I was, until I moved to Saudi Arabia, used to dealing with genuine problems and not just sore throats and colds, which make up the majority of my patients in Al Muwayh. I saw, for example, a child with cardiac disease, another with dehydration due to loose motions, a newborn with very high fever, a preterm baby, a spastic child with penumonia, etc.

The food served by the hospital canteen needed a little tweaking. I had carried chapatis with me, and therefore, I asked the kitchen staff to not send me their khubz. Also, I requested them to send me just a little rice. They complied some of the time, and at other times, they simply forgot my instructions and sent a plateful of rice and the khubz as well. I had specifically told them not to send me jam, cheese, and other similar foods, and yet, on each of the three mornings, my breakfast continued to have these prohibited substances.

The net was either non-existent, or very slow, and hence I could not connect to the world for most of the time. However, I did venture out into the town to reach a spot where the connectivity was good (this was on the second evening), and drove to yet another place with good connectivity on the third evening. These two brief outings enabled me to check my emails and surf facebook for a little while. On the third evening, it also enabled me to connect to a college friend for the first time in more than 25 years!

Al Khurmah has a big shopping area with nearly 100-125 shops of various kinds. I had heard about this from the locals, and I went to this area on the first evening to look around. On the second evening, I went again to this "souk", but this time, in the company of one of the doctors of the hospital - a Hyderabadi radiologist working in the hospital; his name is Dr. Mohd. Nizamuddin. He took me to the souk in his car, and also decided to join me in eating out in a small Indian restaurant within the market area. Dr. Nizam is in Al Khurmah since over 5 years, and stays here with his family. However. his wife and children are presently in India, so he had no problems in joining me.

All in all, the experience at Al Khurmah was nice. I returned to Al Muwayh on Friday afternoon after lunch as Dr. Hadidi arrived form wherever he had gone for three days. 

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