Medical consent form – Lost in translation?

This is the English translation of a surgery consent form included in the hospital guidelines. It has the gist, but perhaps it isn't quite what the writer meant..? … [Read more...]

Healthy baby girl, FREE to whoever can feed her

As a mom, it tears at my heart. It was shocking at the same time that I know it meant a better life for the baby. It's commonplace, but I don't often personally see or hear of it. A woman gave birth to a healthy baby girl around 7am, at a health center where we were field-testing some questionnaires. Usually anyone admitted to a facility is accompanied by throngs of family members, who provide the care to the patient that back home would be done by health staff (eg providing meals, making sure medicines are taken, changing the dressings etc). But there was no one with this very young mother. She was thin, ragged, and very weak. She breastfed the baby a bit, on prompting by the staff, but by evening someone noticed that she hadn't eaten … [Read more...]

Chlong tonle – the other side of the river is so far for some women in Cambodia

A woman died today after giving birth to a healthy baby boy. We came to the health facility and saw her just in time to see the life fade from her eyes after hemorrhaging in the ward where there were four midwives and an obstetrician on duty. Only one staff was attending to the patient at the time of death - a student midwife. The student claimed she told the staff, but they were busy with other patients. The staff corroborated this. The fact that there was no prioritization for the emergency case is testament to how dysfunctional the health sector still is, and how poor the capacity of health staff are that this is allowed to happen. There won't be a maternal audit, or changes to standard operating procedures, because this facility is not … [Read more...]

US continues to be the highest donor by volume of the OECD countries

Here's an interactive update on ODAs from the OECD. It's a simple, straightforward series, worth clicking through if you like seeing the big picture. The most relevant is that the US still remains the top donor in absolute terms (followed by Germany, the United Kingdom, France, and Japan - all present in Cambodia except DfID who exited in 2011). This is despite a real drop of 0.9% from 2010. Thankfully there's a consensus among policymakers that foreign assistance is a critical component of foreign policy, even in the midst of calls for massive cuts during this election year. Seriously, US political "debates" are like tragicomedies except it makes your head hurt because you're aware it isn't entertainment. But I digress. Updating … [Read more...]

Testing for Inter-rater reliability

I haven't used a stats package in a long time. I remember back in grad school how interesting my Biostats and BioInformatics courses were, especially Janet Hughes' classes. But in my professional life, I hardly ventured beyond the first five tasks in the function button on the standard Excel toolbar. My QI (Quality Improvement) team has been pre-testing some clinical assessment questionnaires for Health Centers. The questionnaires consist of a checklist and a rating, for two assessors to fill out while observing a specific consultation eg an Antenatal Care visit. The checklist scores are weighted with qualitative ratings. For example, of the items which the midwife conducted during the Physical Examination, the assessors rate the … [Read more...]

a nursing mom at work

Having a baby is a life changer, and thankfully our life outside the US has been good for us. The social culture in SE Asia and my profession are both supportive of young families. Staff and diners here don't cringe when we walk into a restaurant or food shop; instead they fight over who gets to hold the baby while we eat, and he's returned to us with the bill. Second, we're lucky that my employer is so supportive of new mothers. There's a nursery at the office so nursing moms to bring our babies to work. My colleagues help make sure that I can pump on the days I don't bring the baby by scheduling me into the meeting rooms. I have an unofficial flex time. And on travels I can bring the baby (and his nanny) with me. My current work has to … [Read more...]

Budget cuts by hatchet or scalpel?

The excerpt below is from PBS's Need to Know. Read the entire piece, Budget Cuts by Hatchet or Scalpel, written by Joshua Foust. Follow him on Google+. This weekend’s “debt deal” in Congress, which raised the debt ceiling and agreed to some cuts in the future, contains a change in how the international affairs budget is calculated within the federal budget. In Section 102 of the bill, Function 150 budgets are reclassified as “security.” This means foreign assistance and development programs — USAID, the Millennium Challenge Corporation (MCC) and lots of State Department programs — are now in the same budget category as the Departments of Defense, Homeland Security and the National Nuclear Safety Administration. It might seem like a … [Read more...]

Telemedical emergency care in the US

It's about time someone thought of this! Medical Provider Adds Virtual House Calls To Its Services (image from … [Read more...]