Getting in the Zonal

After a productive day at a well-equipped private hospital, we got to explore a completely different setting at Koshi Zonal Hospital. 

As a government facility, care is less expensive, but the tradeoff is that the hospital is "under-resourced and understaffed" according to the majority of the nurses we interviewed. 

Their NICU had five babies, limited by the number of available incubators. There were no ventilators or CPAP machines for respiratory support, and the only monitor in the unit was extremely old and not beig used. When we asked why, they said that it was only for the very sick babies- but considering that several of the babies had neonatal sepsis, it was unclear what very sick meant. 

The incubators were designed and built by the hospital's own security guard. We got to talk to him and learn that he has no engineering training, but was told during his days in the military that if he found an abandoned baby in the jungle, he should place it in a box to keep warm. He was inspired by seeing expensive incubators in other hospitals to create a low-cost alternative on his own. The result is a very cool (and very warm) example of local frugal innovation. 

We spent the morning interviewing nurses and nursing students and getting feedback on our design concepts. Everyone was helpful and excited about what we were doing. We observed a nurse taking vital signs on all the babies manually, and it took her over half an hour- a huge time burden for one nurse in charge of five babies, two of whom started crying while she was taking vitals on another baby. 

The visit was important in showing us how government hospitals cope with their limited resources. In places like this, which lack so many other interventions, it can be easy to be overwhelmed by the power outages, by the crowds outside the doors, even by the lizards on the walls! However, seeing these adorable babies continues to remind me that whatever we do, it is vitally important that we do something. There are plenty of gaps that need to be filled, but it's our job to fill this one the best that we can.