I'm an infectious disease dork at heart. My new project with measurable outcomes is related to malaria. There are a large number of patients that are admitted with the diagnosis of malaria. However, this seems to be a catch-all for every patient with a fever. The physicians are concerned that a large number of patients are given this diagnosis without any diagnostics. Translation: people are told they have malaria based on symptoms and no lab work. I'm told that the Ministry of Health provides rapid malaria tests for free so there is absolutely no reason that patients suspected to have malaria are not being tested. The infectious disease physician was informed that this test is being done on every patient admitted for malaria from reception (the emergency room). I've been there for 4 days now and can't even find the tests.

Solution: the physician and I are working with the medical director, chief nursing officer, nurse manager of reception, clinical officers, and nurses to ensure that patients are being tested. Today I developed teaching instructions and taught how to perform the test. I'm excited about the project and hope to see it work out well and improve patient care. There are some photos of the teaching I did today.

Things otherwise are going well. I'm building relationships with the nursing staff. It continues to be frustrating at times. I have gone in later the past 2 days so I could work with am and pm shifts. This also allowed me to go play with the babies yesterday. I've included a couple of those pictures. The weather is beautiful and there are always people around to enjoy the leisure time with me. Several of the Norwegians are leaving today and tomorrow so we had a small going-away party last night.

The last pictures that I've included for your information and visualization of where I am are of the reception area (emergency room). The purple stuff in the bottle is the mystery solution they use for sanitizing everything- your hands, the table, before starting an IV...I have no idea what it actually is.