Observations

The mothers are mostly quiet, often sitting in a chair asleep beside their child, like passengers on an overnight flight, trying to find some comfortable position to pass the hours. There is not a single happy expression on their face, as if life is difficult even in their dreams.

By day the mothers have a variety of looks - concern, fear, apathy. Life carries on for the parents with feeding, changing, cuddling, and playing. There are a lot new toys courtesy of Santa and this keeps the older toddlers and younger children occupied. Of course some desire the toy the other child has and this makes the unit a microcosm of community life. For the infants, there are times when they are carried by a parent, nurse or volunteer, so they know their life is more than a bed with crib bars, intravenous lines, nasal cannulae, nasogastric tubes, and dressings. 

There are bathrooms for the volunteers and staff and separate latrines for the families. The latrines are lined up at the back of the compound and a terrible odor announces their location before they are visible.

Family members eat home-prepared food from metal pots. They sit outside on the ground, a bench or a concrete ledge. Rice and beans is very common, perhaps the staple.  Don’t see vegetables or meat as often. There are sparrows that covet any rice or other morsel of food that escapes their lips.

The unit is very dirty. Only the floors are cleaned and this is done several times a day with a wet mop, but the surfaces of tables, carts, sills, and equipment is always covered in dust, which over time becomes a sticky sort of dirt. No one tidies up and charts, equipment, and papers are often buried. At lot of time is wasted looking for things.

The hospital charts are set up similar to back home and the charting by the nurses is very good. Charting by the doctors is neither legible nor good.  Perfunctory notes. Even so, their decisions are good, which is more important than perfect charting.

Anything metal is rusted. The air conditioners leak on the floor. The freezer for the meds has not been defrosted for a very long time. The electrical outlets spark when you plug something in.

The grounds are covered with rubble in one corner of the compound. Small geckos race between the rocks. When the sun goes down the insects come out.   

The tap water is clear but not recommended for consumption.  I will not brush my teeth in the tap water. I use the filtered water and I use the UV SteriPEN on this as an extra precaution.

The security guards at the gate carry automatic weapons or shotguns. A little gun has no intimidation value. I heard small caliber gunshots just around dusk. Gunshot wounds are common in the adults.