the magnitude of the task

Having Hilary and Tay out here for a visit gave me the opportunity to
reflect on the way things are at Mukinge. Working in a hospital like
Mukinge is a challenge, because in order to stay sane and not completely
frustrated with things, you have to be willing to accept things as they
are. Otherwise, you get this mounting frustration which is compounded
daily by the way things are done or not done. Everywhere you look at a
place like Mukinge there's room for improvement -- better screening for
our HIV infected mothers, better management of seizure disorders, better
referral systems for people that are too sick for us to take care of,
better nursing care of paralyzed people, better education of our student
nurses, better use of our pharmacy and stores equipment, better upkeep
of our infrastructure, better records keeping for our patients, better
educational programs for our clinical staff. And you can pick one
project and try to make it work, and make little progress, and then get
distracted or put onto another project which seems more urgent. A great
example of this is the reform of the records system which I tried to
help out back in February (see the blog 'computer seances'); we had a
computer donated and tried to put together an electronic register.
However, there was a feeling by the clerks that they didn't have enough
time to do it, there was little supervision of the project because I was
too busy, the computer started to malfunction, and eventually it was let
to die a quiet death as I got caught up in trying to improve our airway
management skills, and so forth. Now we have hired a new stores manager
to help manage our inventory and help plan for shortages, something we
desperately need at the hospital; he was sent for a course by one of the
departed missionaries to help him learn. However, the quality of
education in Zambia is such that he learned little useful for working in
Mukinge in his course, so we have to redo the education that he went
through. Now, I could choose to help him learn his job, but it would
mean the neglect of the rest of my duties at the hospital to a certain
extent. So instead I choose to meet with him for an hour or two per
week, which is not nearly enough to get the job done, but is the most I
can spare for now. You pick your battles, and hope they don't pick you.