The medicine ward is divided into 2 sides with 1 team on each side. Today, observed medicine rounds. DKA apparently is quite common here as the first presentation of a diabetic patient since routine labs and check ups are extremely rare. There is a lady in the ICU with a chronic hand ulcer and presenting with DKA. This is not necessarily anything new, but the degree of infection and ulcers/abscess/wounds people present with is mind-boggling at times. Why were they unable to come into the hospital earlier? Many people try "country" medicine first because it's cheaper, thus one reason for the delay to coming to the hospital.
I will try to post some pictures soon (I think the photo files are too big and the internet is slow here).
Heard about hospital admission costs: (conversion rate 1USD = 70LD)
ED fees = 100 liberian dollars
Hospital admission: 2500LD (plus 2000LD in advance for meds and supplies)
ICU admission: 4500LD
Patients need to pay upfront before they can even enter the ED triage or whereever they need to go. There was a highly publicized case of a young man who was very ill, came to the ED, could not pay his triage fee, and was refused admission and literally DROPPED DEAD outside of the ED. The family refused to take the body away until the press came.
And once they are admitted, they have to pay their hospital fees before being discharged. If unable to pay the fee, then they can't leave the hospital and continue to accrue further debt while they stay in the hospital. There is a lady who owes 34,000 LD, and I wonder when she's ever going to leave. I hope the hospital social worker will be able to help in cancelling her debt.
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