HOD PAEDIATRICS

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S… Speaker 1 (HOD PAEDIATRICS)

Good morning,

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S… Speaker 1 (HOD PAEDIATRICS)

ma. Thank you for your time.

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S… Speaker 1 (HOD PAEDIATRICS)

We are conducting the interview as part of the stakeholder

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S… Speaker 1 (HOD PAEDIATRICS)

engagement process for the development of the strategic plan of University

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S… Speaker 1 (HOD PAEDIATRICS)

of Patakot Teaching Hospital from 2026 to 2030.

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S… Speaker 1 (HOD PAEDIATRICS)

The discussion will take about 15 to 20 minutes,

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S… Speaker 1 (HOD PAEDIATRICS)

ma, and we will focus on your perspectives

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S… Speaker 1 (HOD PAEDIATRICS)

on key priorities for improving the hospital.

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S… Speaker 1 (HOD PAEDIATRICS)

Your participation is entirely voluntary and you may choose

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S… Speaker 1 (HOD PAEDIATRICS)

not to answer any question or stop at any time.

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S… Speaker 1 (HOD PAEDIATRICS)

The information you provide will be kept confidential

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S… Speaker 1 (HOD PAEDIATRICS)

and used only for strategic planning purposes.

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S… Speaker 1 (HOD PAEDIATRICS)

Please,

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S… Speaker 1 (HOD PAEDIATRICS)

ma, can we know your name and your

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S… Speaker 1 (HOD PAEDIATRICS)

role, ma?

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S… Speaker 3 (HOD PAEDIATRICS)

Okay,

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S… Speaker 2 (HOD PAEDIATRICS)

I'm Professor Yagoidi.

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S… Speaker 2 (HOD PAEDIATRICS)

I'm currently acting.

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S… Speaker 2 (HOD PAEDIATRICS)

for Professor Paul,

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S… Speaker 2 (HOD PAEDIATRICS)

who is the head of the Department of Pediatrics.

1:01

S… Speaker 1 (HOD PAEDIATRICS)

Thank you,

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S… Speaker 1 (HOD PAEDIATRICS)

ma. So with your permission,

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S… Speaker 1 (HOD PAEDIATRICS)

I would like to take notes and audio record this session

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S… Speaker 1 (HOD PAEDIATRICS)

for accuracy.

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S… Speaker 1 (HOD PAEDIATRICS)

Do I have your consent to take notes?

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S… Speaker 3 (HOD PAEDIATRICS)

You can go ahead.

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S… Speaker 1 (HOD PAEDIATRICS)

Thank you,

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S… Speaker 1 (HOD PAEDIATRICS)

ma. And do I have your consent to audio record this session,

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S… Speaker 3 (HOD PAEDIATRICS)

ma? You can go ahead.

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S… Speaker 1 (HOD PAEDIATRICS)

Thank you very much,

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S… Speaker 1 (HOD PAEDIATRICS)

ma. So...

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S… Speaker 1 (HOD PAEDIATRICS)

As I've said earlier,

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S… Speaker 1 (HOD PAEDIATRICS)

the purpose is to obtain strategic insights from clinical leaders

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S… Speaker 1 (HOD PAEDIATRICS)

to inform priorities for service delivery,

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S… Speaker 1 (HOD PAEDIATRICS)

workforce,

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S… Speaker 1 (HOD PAEDIATRICS)

infrastructure,

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S… Speaker 1 (HOD PAEDIATRICS)

patient care,

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S… Speaker 1 (HOD PAEDIATRICS)

and training within the University of Potter Court Teaching Hospital Strategic

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S… Speaker 1 (HOD PAEDIATRICS)

Plan from 2026 to 2030.

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S… Speaker 1 (HOD PAEDIATRICS)

So,

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S… Speaker 1 (HOD PAEDIATRICS)

for Section 1.

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S… Speaker 1 (HOD PAEDIATRICS)

It's under service delivery.

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S… Speaker 1 (HOD PAEDIATRICS)

What are your major bottlenecks affecting clinical service delivery

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S… Speaker 1 (HOD PAEDIATRICS)

in your department or in your unit,

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S… Speaker 3 (HOD PAEDIATRICS)

Ma? To start with,

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S… Speaker 2 (HOD PAEDIATRICS)

if we can compartmentalize them.

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S… Speaker 2 (HOD PAEDIATRICS)

We have the human aspect staffing.

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S… Speaker 2 (HOD PAEDIATRICS)

We don't have enough resident doctors

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S… Speaker 2 (HOD PAEDIATRICS)

working in the department.

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S… Speaker 2 (HOD PAEDIATRICS)

So that makes road stream them.

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S… Speaker 2 (HOD PAEDIATRICS)

difficult and then you know like the different colleges the West African College

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S… Speaker 2 (HOD PAEDIATRICS)

the National Prodigitalist Medical College they have

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S… Speaker 2 (HOD PAEDIATRICS)

curriculum that the residents must go through so for

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S… Speaker 2 (HOD PAEDIATRICS)

example they may say community pediatrics you should do a

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S… Speaker 2 (HOD PAEDIATRICS)

rotation of two months special care baby

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S… Speaker 2 (HOD PAEDIATRICS)

units you should do a rotation of three months and so on and so forth so

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S… Speaker 2 (HOD PAEDIATRICS)

if they don't have adequate staff

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S… Speaker 2 (HOD PAEDIATRICS)

The resident's rotation will not be affected.

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S… Speaker 2 (HOD PAEDIATRICS)

So where are residents supposed to do two months somewhere?

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S… Speaker 2 (HOD PAEDIATRICS)

They may cut it short because the emergency is lacking and the emergency

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S… Speaker 2 (HOD PAEDIATRICS)

is very important.

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S… Speaker 2 (HOD PAEDIATRICS)

So right now they don't have enough residents

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S… Speaker 2 (HOD PAEDIATRICS)

to do that rotation.

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S… Speaker 2 (HOD PAEDIATRICS)

And then materials,

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S… Speaker 2 (HOD PAEDIATRICS)

so that's in terms of staff.

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S… Speaker 2 (HOD PAEDIATRICS)

They also have the issue of materials.

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S… Speaker 2 (HOD PAEDIATRICS)

A child comes in the clinic,

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S… Speaker 2 (HOD PAEDIATRICS)

for example, right now.

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S… Speaker 2 (HOD PAEDIATRICS)

Patients are going to buy paper.

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S… Speaker 2 (HOD PAEDIATRICS)

full -scarf sheets from Mala to consult.

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S… Speaker 2 (HOD PAEDIATRICS)

Before now,

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S… Speaker 2 (HOD PAEDIATRICS)

the department used to provide continuation sheets

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S… Speaker 2 (HOD PAEDIATRICS)

with Department of Pediatrics labelled on

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S… Speaker 2 (HOD PAEDIATRICS)

it, where you write and see a patient.

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S… Speaker 2 (HOD PAEDIATRICS)

But now,

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S… Speaker 2 (HOD PAEDIATRICS)

as the parents are coming,

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S… Speaker 2 (HOD PAEDIATRICS)

they are told to buy full -scarf sheets and bring along.

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S… Speaker 2 (HOD PAEDIATRICS)

And they also don't have investigation forms.

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S… Speaker 2 (HOD PAEDIATRICS)

When you see a patient,

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S… Speaker 2 (HOD PAEDIATRICS)

it's still the same full -scarf sheet you tear.

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S… Speaker 2 (HOD PAEDIATRICS)

to write for investigations and then when you want to take samples

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S… Speaker 2 (HOD PAEDIATRICS)

patient is also told to go to malam and buy syringe

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S… Speaker 2 (HOD PAEDIATRICS)

buy bottle and all that so before now we used to have all those things

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S… Speaker 2 (HOD PAEDIATRICS)

available so that when the patient goes pay they give

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S… Speaker 2 (HOD PAEDIATRICS)

you your syringe give you your bottle and then you come with it for blood letting

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S… Speaker 2 (HOD PAEDIATRICS)

So all those things.

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S… Speaker 2 (HOD PAEDIATRICS)

So if a child comes,

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S… Speaker 2 (HOD PAEDIATRICS)

you have to now go and be sending the child back and forth before the child

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S… Speaker 2 (HOD PAEDIATRICS)

can be properly sent.

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S… Speaker 2 (HOD PAEDIATRICS)

So do that.

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S… Speaker 1 (HOD PAEDIATRICS)

Thank you for that,

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S… Speaker 1 (HOD PAEDIATRICS)

Ma. Then which services are overstretched,

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S… Speaker 1 (HOD PAEDIATRICS)

underutilized,

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S… Speaker 1 (HOD PAEDIATRICS)

or need expansion in the Department of Pediatrics,

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S… Speaker 3 (HOD PAEDIATRICS)

Ma? Well,

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S… Speaker 2 (HOD PAEDIATRICS)

talking about overstretching of services,

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S… Speaker 2 (HOD PAEDIATRICS)

I don't really...

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S… Speaker 2 (HOD PAEDIATRICS)

What do you mean by that?

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S… Speaker 1 (HOD PAEDIATRICS)

That is,

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S… Speaker 1 (HOD PAEDIATRICS)

for instance,

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S… Speaker 1 (HOD PAEDIATRICS)

what you gave,

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S… Speaker 1 (HOD PAEDIATRICS)

the instance you gave that we need to take blood

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S… Speaker 1 (HOD PAEDIATRICS)

sample, is it the emergency that

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S… Speaker 1 (HOD PAEDIATRICS)

is overstretched?

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S… Speaker 1 (HOD PAEDIATRICS)

That people must be there,

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S… Speaker 1 (HOD PAEDIATRICS)

according to what you said,

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S… Speaker 1 (HOD PAEDIATRICS)

resident doctor must be there,

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S… Speaker 1 (HOD PAEDIATRICS)

even if they are going for other posting.

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S… Speaker 1 (HOD PAEDIATRICS)

So do we have any other services that are overstretched?

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S… Speaker 2 (HOD PAEDIATRICS)

in the department of pediatrics apart from the emergency section

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S… Speaker 2 (HOD PAEDIATRICS)

or any

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S… Speaker 2 (HOD PAEDIATRICS)

service that are underutilized maybe you have a service that people do don't

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S… Speaker 2 (HOD PAEDIATRICS)

come for it maybe there is a particular procedure that

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S… Speaker 2 (HOD PAEDIATRICS)

is available to be done in the department but you hardly have patients that

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S… Speaker 1 (HOD PAEDIATRICS)

requires it i don't think there is any same for what we

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S… Speaker 1 (HOD PAEDIATRICS)

are we are lacking in those services that we should

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S… Speaker 1 (HOD PAEDIATRICS)

have

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S… Speaker 1 (HOD PAEDIATRICS)

I don't see any available equipment

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S… Speaker 1 (HOD PAEDIATRICS)

or instruments or we say,

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S… Speaker 1 (HOD PAEDIATRICS)

oh, this thing is available and nobody is using it.

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S… Speaker 1 (HOD PAEDIATRICS)

There is nothing like that.

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S… Speaker 1 (HOD PAEDIATRICS)

Instead, most of our equipment are broken down and we are looking for how we can fix

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S… Speaker 1 (HOD PAEDIATRICS)

them because we are having to send our patients out.

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S… Speaker 1 (HOD PAEDIATRICS)

For example,

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S… Speaker 1 (HOD PAEDIATRICS)

the dialysis.

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S… Speaker 1 (HOD PAEDIATRICS)

We have patients that are on chronic dialysis,

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S… Speaker 1 (HOD PAEDIATRICS)

patients who have chronic kidney disease are needing dialysis.

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S… Speaker 1 (HOD PAEDIATRICS)

When we go to the dialysis unit,

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S… Speaker 1 (HOD PAEDIATRICS)

we are told that there are no consumables.

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S… Speaker 1 (HOD PAEDIATRICS)

So,

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S… Speaker 1 (HOD PAEDIATRICS)

patient has to go out to Bantu.

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S… Speaker 1 (HOD PAEDIATRICS)

As you can imagine,

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S… Speaker 1 (HOD PAEDIATRICS)

UPTH is out of town,

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S… Speaker 1 (HOD PAEDIATRICS)

more or less.

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S… Speaker 1 (HOD PAEDIATRICS)

They have to now take a taxi because there is no ambulance to even carry the

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S… Speaker 1 (HOD PAEDIATRICS)

patient.

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S… Speaker 1 (HOD PAEDIATRICS)

Either they take a taxi or they bring their private car to carry that

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S… Speaker 1 (HOD PAEDIATRICS)

child to town and bring the child back.

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S… Speaker 1 (HOD PAEDIATRICS)

because of dialysis.

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S… Speaker 1 (HOD PAEDIATRICS)

We used to have an echo machine,

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S… Speaker 1 (HOD PAEDIATRICS)

and that echo machine has broken down for years.

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S… Speaker 1 (HOD PAEDIATRICS)

Solely for pediatrics.

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S… Speaker 1 (HOD PAEDIATRICS)

Pediatric echo,

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S… Speaker 1 (HOD PAEDIATRICS)

because the probes for pediatrics is different from that of adults.

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S… Speaker 1 (HOD PAEDIATRICS)

So that echo machine has also broken down.

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S… Speaker 1 (HOD PAEDIATRICS)

In fact,

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S… Speaker 1 (HOD PAEDIATRICS)

We tried to fix it and they said that that particular brand

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S… Speaker 1 (HOD PAEDIATRICS)

of the Echo is now obsolete and the person who was to repair it advised

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S… Speaker 1 (HOD PAEDIATRICS)

that we should get a,

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S… Speaker 1 (HOD PAEDIATRICS)

what is it called?

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S… Speaker 1 (HOD PAEDIATRICS)

to get the modern one.

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S… Speaker 1 (HOD PAEDIATRICS)

So we have not been able to get a modern one.

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S… Speaker 2 (HOD PAEDIATRICS)

So this example of this echo machine would fall under

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S… Speaker 2 (HOD PAEDIATRICS)

expansion.

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S… Speaker 2 (HOD PAEDIATRICS)

These are the services we need to expand,

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S… Speaker 2 (HOD PAEDIATRICS)

like provision of modern echo machine.

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S… Speaker 2 (HOD PAEDIATRICS)

Thank you,

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S… Speaker 2 (HOD PAEDIATRICS)

Ma. So the third one under service delivery.

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S… Speaker 2 (HOD PAEDIATRICS)

What practical changes will most improve efficiency and

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S… Speaker 2 (HOD PAEDIATRICS)

quality of care?

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S… Speaker 1 (HOD PAEDIATRICS)

Well,

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S… Speaker 1 (HOD PAEDIATRICS)

one of the things,

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S… Speaker 1 (HOD PAEDIATRICS)

like I was in...

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S… Speaker 1 (HOD PAEDIATRICS)

FMC Jabi recently last week for accreditation

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S… Speaker 1 (HOD PAEDIATRICS)

and what I noticed there was that the

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S… Speaker 1 (HOD PAEDIATRICS)

EMR electronic

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S… Speaker 1 (HOD PAEDIATRICS)

medical records is working very very well very efficient

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S… Speaker 1 (HOD PAEDIATRICS)

and when a child is seen in the

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S… Speaker 1 (HOD PAEDIATRICS)

outpatient or in the

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S… Speaker 1 (HOD PAEDIATRICS)

consultant, pediatric clinic,

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S… Speaker 1 (HOD PAEDIATRICS)

everything is entered into the system.

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S… Speaker 1 (HOD PAEDIATRICS)

And if that child,

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S… Speaker 1 (HOD PAEDIATRICS)

for example, is admitted,

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S… Speaker 1 (HOD PAEDIATRICS)

that admission record and everything that the doctor has done goes to

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S… Speaker 1 (HOD PAEDIATRICS)

the ward.

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S… Speaker 1 (HOD PAEDIATRICS)

And that child is just moved to the ward.

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S… Speaker 1 (HOD PAEDIATRICS)

And when the child gets to the ward,

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S… Speaker 1 (HOD PAEDIATRICS)

they can access that record and begin to attend to the child.

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S… Speaker 1 (HOD PAEDIATRICS)

And if the child needs any draw,

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S… Speaker 1 (HOD PAEDIATRICS)

it's accessed in the pharmacy.

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S… Speaker 1 (HOD PAEDIATRICS)

the child can go and pick up the drugs that have been prescribed by the doctor

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S… Speaker 1 (HOD PAEDIATRICS)

from the pharmacy.

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S… Speaker 1 (HOD PAEDIATRICS)

If the child needs any investigation,

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S… Speaker 1 (HOD PAEDIATRICS)

he goes to the lab.

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S… Speaker 1 (HOD PAEDIATRICS)

And all the child needs to do,

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S… Speaker 1 (HOD PAEDIATRICS)

the parent will present the child,

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S… Speaker 1 (HOD PAEDIATRICS)

their sample is collected,

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S… Speaker 1 (HOD PAEDIATRICS)

and the result is sent electronically to the ward and

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S… Speaker 1 (HOD PAEDIATRICS)

to whoever saw the child.

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S… Speaker 1 (HOD PAEDIATRICS)

So you can assert all these things are linked up.

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S… Speaker 1 (HOD PAEDIATRICS)

So you don't have,

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S… Speaker 1 (HOD PAEDIATRICS)

it takes away the stress because right now what we have is that you send a child

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S… Speaker 1 (HOD PAEDIATRICS)

for investigation, you have to go there,

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S… Speaker 1 (HOD PAEDIATRICS)

look for the result,

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S… Speaker 1 (HOD PAEDIATRICS)

back and forth,

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S… Speaker 1 (HOD PAEDIATRICS)

back and forth,

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S… Speaker 1 (HOD PAEDIATRICS)

takes time,

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S… Speaker 1 (HOD PAEDIATRICS)

waste patient time,

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S… Speaker 1 (HOD PAEDIATRICS)

waste doctor's time.

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S… Speaker 1 (HOD PAEDIATRICS)

But if everything is connected,

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S… Speaker 1 (HOD PAEDIATRICS)

not like what we had before where you see a child,

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S… Speaker 1 (HOD PAEDIATRICS)

the records are not available in the ward,

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S… Speaker 1 (HOD PAEDIATRICS)

if the child goes back to the ward,

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S… Speaker 1 (HOD PAEDIATRICS)

they have to click all over again,

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S… Speaker 1 (HOD PAEDIATRICS)

making it difficult for both the doctor and the patient.

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S… Speaker 1 (HOD PAEDIATRICS)

medical record that i saw there and it was working in nigeria was excellent

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S… Speaker 1 (HOD PAEDIATRICS)

so if we can have something like that it will really help and

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S… Speaker 1 (HOD PAEDIATRICS)

if you i don't know if you notice where you are climbing up the records department

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S… Speaker 1 (HOD PAEDIATRICS)

you see all our folders are on the corridor it needs

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S… Speaker 1 (HOD PAEDIATRICS)

expansion they need help so and

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S… Speaker 1 (HOD PAEDIATRICS)

then this card system it's

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S… Speaker 1 (HOD PAEDIATRICS)

good

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S… Speaker 1 (HOD PAEDIATRICS)

It's okay,

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S… Speaker 1 (HOD PAEDIATRICS)

but recently I hear that they have scrapped it,

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S… Speaker 1 (HOD PAEDIATRICS)

and some patients have already paid money into that card,

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S… Speaker 1 (HOD PAEDIATRICS)

loaded their cards,

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S… Speaker 1 (HOD PAEDIATRICS)

only to come.

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S… Speaker 1 (HOD PAEDIATRICS)

I saw a patient in clinic on Tuesday.

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S… Speaker 1 (HOD PAEDIATRICS)

The last visit she came,

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S… Speaker 1 (HOD PAEDIATRICS)

like two or three weeks earlier,

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S… Speaker 1 (HOD PAEDIATRICS)

she said,

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S… Speaker 1 (HOD PAEDIATRICS)

okay, let her just load money in the card,

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S… Speaker 1 (HOD PAEDIATRICS)

only to come three weeks later for follow -up.

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S… Speaker 1 (HOD PAEDIATRICS)

She's told that she can no longer use it.

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S… Speaker 1 (HOD PAEDIATRICS)

Well, she has her money in the card.

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S… Speaker 1 (HOD PAEDIATRICS)

And you know how difficult money is right now for a patient and a mother.

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S… Speaker 1 (HOD PAEDIATRICS)

So she has now go and look for other sorts of funds

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S… Speaker 1 (HOD PAEDIATRICS)

to be able to get access for her child to be seen.

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S… Speaker 1 (HOD PAEDIATRICS)

So all those,

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S… Speaker 1 (HOD PAEDIATRICS)

I don't know how you can address it.

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S… Speaker 1 (HOD PAEDIATRICS)

Okay,

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S… Speaker 1 (HOD PAEDIATRICS)

thank you very much.

10:18

S… Speaker 2 (HOD PAEDIATRICS)

So all this will really impact negatively on the quality of

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S… Speaker 2 (HOD PAEDIATRICS)

care. Thank you so much for the insights now.

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S… Speaker 2 (HOD PAEDIATRICS)

Under the Human Resources for Health,

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S… Speaker 2 (HOD PAEDIATRICS)

what are the most critical staffing gaps in your department?

10:32

S… Speaker 1 (HOD PAEDIATRICS)

We need registrars.

10:36

S… Speaker 1 (HOD PAEDIATRICS)

We need registrars,

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S… Speaker 1 (HOD PAEDIATRICS)

enough registrars in the department.

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S… Speaker 1 (HOD PAEDIATRICS)

And then of course we need,

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S… Speaker 1 (HOD PAEDIATRICS)

yes, very critical right now because we are top heavy and

10:49

S… Speaker 1 (HOD PAEDIATRICS)

a lot of,

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S… Speaker 1 (HOD PAEDIATRICS)

because of the structure of our academic work here.

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S… Speaker 1 (HOD PAEDIATRICS)

This is a training institution.

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S… Speaker 1 (HOD PAEDIATRICS)

So our residents go and they pass their exams.

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S… Speaker 1 (HOD PAEDIATRICS)

And you cannot put them back after they have passed.

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S… Speaker 1 (HOD PAEDIATRICS)

So once they come in,

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S… Speaker 1 (HOD PAEDIATRICS)

within two years,

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S… Speaker 1 (HOD PAEDIATRICS)

they have passed.

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S… Speaker 1 (HOD PAEDIATRICS)

They have become senior registrars.

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S… Speaker 1 (HOD PAEDIATRICS)

And we don't see new registrars coming in.

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S… Speaker 1 (HOD PAEDIATRICS)

So that becomes a problem.

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S… Speaker 1 (HOD PAEDIATRICS)

So a lot of them,

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S… Speaker 1 (HOD PAEDIATRICS)

even right now,

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S… Speaker 1 (HOD PAEDIATRICS)

a lot of them have passed their exams.

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S… Speaker 1 (HOD PAEDIATRICS)

But we are still making them work as registrars because there are no registrars.

11:23

S… Speaker 2 (HOD PAEDIATRICS)

thank you so what challenges affect staff production of course we need

11:27

S… Speaker 1 (HOD PAEDIATRICS)

nurses too but i know you are going to go to the nursing department so i'm hoping

11:31

S… Speaker 2 (HOD PAEDIATRICS)

that the nurses will tell you their deficiencies so what challenges

11:35

S… Speaker 2 (HOD PAEDIATRICS)

affect staff productivity motivation or retention

11:39

S… Speaker 1 (HOD PAEDIATRICS)

well we know how what is happening in this year right

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S… Speaker 1 (HOD PAEDIATRICS)

now right now well it's 1400 so

11:48

S… Speaker 1 (HOD PAEDIATRICS)

i don't need to tell you anything we all know what is going on so it's affecting

11:52

S… Speaker 1 (HOD PAEDIATRICS)

a lot of

11:53

S… Speaker 2 (HOD PAEDIATRICS)

a lot of things affecting a lot of things so that's part of the challenge

11:57

S… Speaker 2 (HOD PAEDIATRICS)

is that is affecting them being motivated yes coming to work spending

12:01

S… Speaker 1 (HOD PAEDIATRICS)

spending some of them come from obibo i

12:05

S… Speaker 1 (HOD PAEDIATRICS)

don't know how far how well you know i live

12:10

S… Speaker 1 (HOD PAEDIATRICS)

in elementary junction so i drive but i know i spend up to 100

12:14

S… Speaker 1 (HOD PAEDIATRICS)

000 a week plus just to fill my tank so you can imagine

12:19

S… Speaker 1 (HOD PAEDIATRICS)

those

12:20

S… Speaker 1 (HOD PAEDIATRICS)

staff coming all the way from Obibu,

12:22

S… Speaker 1 (HOD PAEDIATRICS)

they will spend a good portion of their money on foils.

12:26

S… Speaker 1 (HOD PAEDIATRICS)

So the salaries,

12:27

S… Speaker 1 (HOD PAEDIATRICS)

I don't know,

12:29

S… Speaker 1 (HOD PAEDIATRICS)

you cannot do anything about it,

12:31

S… Speaker 1 (HOD PAEDIATRICS)

but that is part of a big problem.

12:33

S… Speaker 2 (HOD PAEDIATRICS)

It's affecting everybody.

12:35

S… Speaker 2 (HOD PAEDIATRICS)

So what strategy will strengthen the workforce over the next five years?

12:40

S… Speaker 2 (HOD PAEDIATRICS)

Well,

12:41

S… Speaker 1 (HOD PAEDIATRICS)

I don't know, because this is a training institution.

12:44

S… Speaker 1 (HOD PAEDIATRICS)

What used to be in the past,

12:47

S… Speaker 1 (HOD PAEDIATRICS)

years ago?

12:49

S… Speaker 1 (HOD PAEDIATRICS)

For residency,

12:51

S… Speaker 1 (HOD PAEDIATRICS)

that's why you have a resident.

12:54

S… Speaker 1 (HOD PAEDIATRICS)

They are available.

12:55

S… Speaker 1 (HOD PAEDIATRICS)

So we have residence quarters.

12:56

S… Speaker 1 (HOD PAEDIATRICS)

We had residence quarters.

12:58

S… Speaker 1 (HOD PAEDIATRICS)

We had house officers quarters.

13:00

S… Speaker 1 (HOD PAEDIATRICS)

Because that's why they call house officers.

13:02

S… Speaker 1 (HOD PAEDIATRICS)

Now many of them don't leave again.

13:04

S… Speaker 1 (HOD PAEDIATRICS)

They've scrapped this house.

13:06

S… Speaker 1 (HOD PAEDIATRICS)

But for a training institution,

13:08

S… Speaker 1 (HOD PAEDIATRICS)

it's very important.

13:09

S… Speaker 1 (HOD PAEDIATRICS)

Because the house officer will be available any time T.

13:12

S… Speaker 1 (HOD PAEDIATRICS)

So you're talking about five years.

13:15

S… Speaker 1 (HOD PAEDIATRICS)

That's what I'm telling you,

13:16

S… Speaker 1 (HOD PAEDIATRICS)

bringing it up.

13:16

S… Speaker 1 (HOD PAEDIATRICS)

Because if we can have residence quarters.

13:19

S… Speaker 1 (HOD PAEDIATRICS)

and have house officers quarters.

13:21

S… Speaker 1 (HOD PAEDIATRICS)

So the resident has no excuse and the house officer has no excuse.

13:25

S… Speaker 1 (HOD PAEDIATRICS)

So we need those things to be back.

13:27

S… Speaker 1 (HOD PAEDIATRICS)

Even the consultants used to stay in.

13:29

S… Speaker 1 (HOD PAEDIATRICS)

Like when we were in a temporary site,

13:31

S… Speaker 1 (HOD PAEDIATRICS)

we had quarters for the consultants,

13:32

S… Speaker 1 (HOD PAEDIATRICS)

for the residents.

13:34

S… Speaker 1 (HOD PAEDIATRICS)

You can imagine a consultant that has surgery by 1 a .m.

13:38

S… Speaker 1 (HOD PAEDIATRICS)

You are a gynecologist.

13:39

S… Speaker 1 (HOD PAEDIATRICS)

They call you by 1 a .m.

13:40

S… Speaker 1 (HOD PAEDIATRICS)

A woman is bleeding.

13:41

S… Speaker 1 (HOD PAEDIATRICS)

Just stroll down from your house and come and do the surgery and go

13:45

S… Speaker 1 (HOD PAEDIATRICS)

back home.

13:46

S… Speaker 1 (HOD PAEDIATRICS)

And all those things are no longer there. And now with all this insecurity.

13:51

S… Speaker 1 (HOD PAEDIATRICS)

There is no ambulance.

13:52

S… Speaker 1 (HOD PAEDIATRICS)

When we were in the temporary site,

13:53

S… Speaker 1 (HOD PAEDIATRICS)

we had ambulance that would pick the resident,

13:55

S… Speaker 1 (HOD PAEDIATRICS)

they would do their work,

13:56

S… Speaker 1 (HOD PAEDIATRICS)

take them back.

13:57

S… Speaker 1 (HOD PAEDIATRICS)

Now there is no ambulance with all the insecurity.

13:59

S… Speaker 1 (HOD PAEDIATRICS)

Will your husband allow you to come out by 2 a .m.

14:03

S… Speaker 1 (HOD PAEDIATRICS)

to come and do?

14:04

S… Speaker 1 (HOD PAEDIATRICS)

You understand what I mean?

14:05

S… Speaker 1 (HOD PAEDIATRICS)

So there are many things that are no longer available,

14:09

S… Speaker 1 (HOD PAEDIATRICS)

that used to be available and make the work much easier.

14:12

S… Speaker 1 (HOD PAEDIATRICS)

So we need those ambulance services.

14:14

S… Speaker 1 (HOD PAEDIATRICS)

We need quarters for our residents,

14:16

S… Speaker 1 (HOD PAEDIATRICS)

for our consultants,

14:17

S… Speaker 1 (HOD PAEDIATRICS)

for our house officers.

14:19

S… Speaker 1 (HOD PAEDIATRICS)

so they will be on ground and the issue of old transport these do not

14:23

S… Speaker 1 (HOD PAEDIATRICS)

arise since we are talking about five years yes we should

14:27

S… Speaker 2 (HOD PAEDIATRICS)

have this at the back of our mind all right well other infrastructure equipment

14:32

S… Speaker 2 (HOD PAEDIATRICS)

and technology although you have mentioned what key infrastructure

14:36

S… Speaker 2 (HOD PAEDIATRICS)

equipment gaps limit service delivery

14:40

S… Speaker 1 (HOD PAEDIATRICS)

I've talked about dialysis.

14:42

S… Speaker 1 (HOD PAEDIATRICS)

We need our own dialysis,

14:44

S… Speaker 1 (HOD PAEDIATRICS)

pediatric dialysis machine resident in our and not one

14:48

S… Speaker 1 (HOD PAEDIATRICS)

that will be epileptic.

14:49

S… Speaker 1 (HOD PAEDIATRICS)

Today they say no consumable,

14:51

S… Speaker 1 (HOD PAEDIATRICS)

tomorrow they say no light,

14:52

S… Speaker 1 (HOD PAEDIATRICS)

tonight tomorrow they say no this.

14:53

S… Speaker 1 (HOD PAEDIATRICS)

So let it be functional because this will also generate revenue for

14:57

S… Speaker 1 (HOD PAEDIATRICS)

the hospital.

15:00

S… Speaker 1 (HOD PAEDIATRICS)

our own dialysis machine working in upta we

15:05

S… Speaker 1 (HOD PAEDIATRICS)

should be able to do that in the hospital not have any reason to send a child

15:09

S… Speaker 1 (HOD PAEDIATRICS)

out from upta that is supposed to be the tertiary institution

15:14

S… Speaker 1 (HOD PAEDIATRICS)

to go and do investigation outside or do echo outside

15:18

S… Speaker 1 (HOD PAEDIATRICS)

or do ultrasound outside or do dialysis outside all

15:22

S… Speaker 1 (HOD PAEDIATRICS)

those issues we don't need

15:24

S… Speaker 1 (HOD PAEDIATRICS)

And there are things that are available.

15:25

S… Speaker 2 (HOD PAEDIATRICS)

Yes.

15:26

S… Speaker 2 (HOD PAEDIATRICS)

This next question,

15:27

S… Speaker 2 (HOD PAEDIATRICS)

you have answered it,

15:28

S… Speaker 2 (HOD PAEDIATRICS)

but let me just mention it again.

15:30

S… Speaker 2 (HOD PAEDIATRICS)

What are your priority equipments?

15:32

S… Speaker 2 (HOD PAEDIATRICS)

I can't even answer that.

15:33

S… Speaker 1 (HOD PAEDIATRICS)

In fact,

15:35

S… Speaker 1 (HOD PAEDIATRICS)

the basics.

15:37

S… Speaker 1 (HOD PAEDIATRICS)

Let's begin from the basics.

15:38

S… Speaker 2 (HOD PAEDIATRICS)

Okay.

15:39

S… Speaker 1 (HOD PAEDIATRICS)

We should have functional standiometer.

15:43

S… Speaker 1 (HOD PAEDIATRICS)

Standiometer in all our words.

15:48

S… Speaker 1 (HOD PAEDIATRICS)

weighing scales in all hours,

15:50

S… Speaker 1 (HOD PAEDIATRICS)

blood pressure machine in all hours.

15:53

S… Speaker 1 (HOD PAEDIATRICS)

The echo and these ones are even bigger ones.

15:55

S… Speaker 1 (HOD PAEDIATRICS)

These ones are cheap,

15:57

S… Speaker 1 (HOD PAEDIATRICS)

basic infusion pumps in our special care baby unit.

16:00

S… Speaker 1 (HOD PAEDIATRICS)

So I'm sure that the HOD must have sent those

16:04

S… Speaker 1 (HOD PAEDIATRICS)

equipment lists because over and over time they request for equipment

16:08

S… Speaker 1 (HOD PAEDIATRICS)

lists.

16:09

S… Speaker 1 (HOD PAEDIATRICS)

You send these equipment lists and you wait and wait and then you're discouraged.

16:13

S… Speaker 1 (HOD PAEDIATRICS)

So I'm sure they have the equipment list.

16:15

S… Speaker 2 (HOD PAEDIATRICS)

so what improvements are needed in digital systems or clinical technology

16:20

S… Speaker 1 (HOD PAEDIATRICS)

i mentioned it now functional electronic medical

16:24

S… Speaker 1 (HOD PAEDIATRICS)

records functional not the one that you stay in clinic and you type everything

16:28

S… Speaker 1 (HOD PAEDIATRICS)

you go to the world it's not available it doesn't get to the lab you

16:33

S… Speaker 1 (HOD PAEDIATRICS)

know so it should be interconnected such that once it is entered

16:37

S… Speaker 1 (HOD PAEDIATRICS)

yes the lab will get it the words will get it you will not go to the

16:41

S… Speaker 1 (HOD PAEDIATRICS)

world and start all over again you know how long it takes to do pediatric clerking it's not like adult

16:45

S… Speaker 1 (HOD PAEDIATRICS)

clerking so doing that discourage

16:50

S… Speaker 1 (HOD PAEDIATRICS)

doctors using it the last time.

16:51

S… Speaker 1 (HOD PAEDIATRICS)

So we want to see a system where when we do the clerking in the clinic,

16:55

S… Speaker 1 (HOD PAEDIATRICS)

when they get to the ward,

16:57

S… Speaker 1 (HOD PAEDIATRICS)

they can assess it.

16:58

S… Speaker 1 (HOD PAEDIATRICS)

The labs can assess it when the patient goes there to do their sample.

17:02

S… Speaker 1 (HOD PAEDIATRICS)

The pharmacy can assess it.

17:04

S… Speaker 1 (HOD PAEDIATRICS)

And when the lab,

17:05

S… Speaker 1 (HOD PAEDIATRICS)

they finish with the result,

17:06

S… Speaker 1 (HOD PAEDIATRICS)

they can send it to the system and everybody can assess it.

17:09

S… Speaker 1 (HOD PAEDIATRICS)

We can see the patient's results.

17:11

S… Speaker 1 (HOD PAEDIATRICS)

And of course,

17:12

S… Speaker 1 (HOD PAEDIATRICS)

the time of assessing this,

17:15

S… Speaker 1 (HOD PAEDIATRICS)

because what we have here,

17:18

S… Speaker 1 (HOD PAEDIATRICS)

In JB,

17:19

S… Speaker 1 (HOD PAEDIATRICS)

they could get their results if it's emergency 24 hours.

17:23

S… Speaker 1 (HOD PAEDIATRICS)

If it's outside the emergency,

17:24

S… Speaker 1 (HOD PAEDIATRICS)

48 hours.

17:25

S… Speaker 1 (HOD PAEDIATRICS)

Here,

17:26

S… Speaker 1 (HOD PAEDIATRICS)

sometimes food block can take us almost a week to get results.

17:30

S… Speaker 1 (HOD PAEDIATRICS)

I hope I'm not talking too much.

17:32

S… Speaker 2 (HOD PAEDIATRICS)

It's really impacting on the care.

17:35

S… Speaker 1 (HOD PAEDIATRICS)

So,

17:36

S… Speaker 2 (HOD PAEDIATRICS)

Ma, we are going to patient care and experience,

17:41

S… Speaker 1 (HOD PAEDIATRICS)

Ma.

17:41

S… Speaker 2 (HOD PAEDIATRICS)

What are the main challenges affecting patient care and

17:45

S… Speaker 1 (HOD PAEDIATRICS)

satisfaction?

17:47

S… Speaker 1 (HOD PAEDIATRICS)

The main challenge like I said if we don't have if you have only one doctor

17:52

S… Speaker 1 (HOD PAEDIATRICS)

to see 40 patients.

17:54

S… Speaker 1 (HOD PAEDIATRICS)

Even when they come by 7 a .m.

17:56

S… Speaker 1 (HOD PAEDIATRICS)

Pediatric clerking,

17:57

S… Speaker 1 (HOD PAEDIATRICS)

by the time you are clerking,

17:59

S… Speaker 1 (HOD PAEDIATRICS)

family and social history,

18:00

S… Speaker 1 (HOD PAEDIATRICS)

sometimes they wonder what you are doing.

18:01

S… Speaker 1 (HOD PAEDIATRICS)

How many houses are you living?

18:03

S… Speaker 1 (HOD PAEDIATRICS)

How many windows are in your house?

18:04

S… Speaker 1 (HOD PAEDIATRICS)

Do you have toilet system?

18:06

S… Speaker 1 (HOD PAEDIATRICS)

Is it flushing one?

18:07

S… Speaker 1 (HOD PAEDIATRICS)

So one patient alone,

18:09

S… Speaker 1 (HOD PAEDIATRICS)

depending on what that patient has,

18:11

S… Speaker 1 (HOD PAEDIATRICS)

can take you up to one hour to clerking.

18:14

S… Speaker 1 (HOD PAEDIATRICS)

And then you have 40 people there waiting for you.

18:17

S… Speaker 1 (HOD PAEDIATRICS)

So the patient will not understand what you're doing.

18:20

S… Speaker 1 (HOD PAEDIATRICS)

But all that is because the child cannot talk for themselves.

18:23

S… Speaker 1 (HOD PAEDIATRICS)

He's an adult.

18:23

S… Speaker 1 (HOD PAEDIATRICS)

I have a headache.

18:24

S… Speaker 1 (HOD PAEDIATRICS)

But it's from the question you ask the parents that you now know what the

18:29

S… Speaker 1 (HOD PAEDIATRICS)

child's problem is.

18:30

S… Speaker 1 (HOD PAEDIATRICS)

So when you have only one registrar in the clinic,

18:33

S… Speaker 1 (HOD PAEDIATRICS)

seeing all those 40 people,

18:35

S… Speaker 1 (HOD PAEDIATRICS)

it will now affect patient care.

18:38

S… Speaker 1 (HOD PAEDIATRICS)

But if you have enough registrars,

18:41

S… Speaker 1 (HOD PAEDIATRICS)

enough hands,

18:42

S… Speaker 1 (HOD PAEDIATRICS)

you have how many cubicles,

18:43

S… Speaker 1 (HOD PAEDIATRICS)

and patients are being maybe five at a row,

18:46

S… Speaker 1 (HOD PAEDIATRICS)

even if it takes one hour,

18:47

S… Speaker 1 (HOD PAEDIATRICS)

you know that one hour I assume five,

18:49

S… Speaker 1 (HOD PAEDIATRICS)

then another five coming to be faster.

18:53

S… Speaker 1 (HOD PAEDIATRICS)

So that affects patients' care.

18:55

S… Speaker 1 (HOD PAEDIATRICS)

So we need more hands.

18:57

S… Speaker 1 (HOD PAEDIATRICS)

We need more hands.

18:58

S… Speaker 2 (HOD PAEDIATRICS)

So where are the major issues in waiting time,

19:01

S… Speaker 2 (HOD PAEDIATRICS)

communication,

19:02

S… Speaker 2 (HOD PAEDIATRICS)

or continuity of care?

19:04

S… Speaker 1 (HOD PAEDIATRICS)

It's the same thing now.

19:07

S… Speaker 1 (HOD PAEDIATRICS)

Waiting time is because there's not enough hands.

19:10

S… Speaker 2 (HOD PAEDIATRICS)

What of communication you

19:14

S… Speaker 2 (HOD PAEDIATRICS)

have mentioned in the EMS system?

19:16

S… Speaker 2 (HOD PAEDIATRICS)

What of continuity of care?

19:18

S… Speaker 1 (HOD PAEDIATRICS)

Continuity of care?

19:22

S… Speaker 1 (HOD PAEDIATRICS)

continuity of case it boils down to the same EMR the records are

19:26

S… Speaker 1 (HOD PAEDIATRICS)

available and then like I said the if

19:30

S… Speaker 1 (HOD PAEDIATRICS)

you go down as you're going just look on your right hand side you see our folders outside so

19:36

S… Speaker 1 (HOD PAEDIATRICS)

if those folders are properly kept they have enough cabinets they have enough

19:40

S… Speaker 1 (HOD PAEDIATRICS)

space getting them out will be

19:44

S… Speaker 1 (HOD PAEDIATRICS)

easy because sometimes the patient comes today but that patient comes for

19:48

S… Speaker 1 (HOD PAEDIATRICS)

follow -up they can't find the folder

19:50

S… Speaker 1 (HOD PAEDIATRICS)

Patient spends two,

19:51

S… Speaker 1 (HOD PAEDIATRICS)

three hours going from here,

19:52

S… Speaker 1 (HOD PAEDIATRICS)

go to main record,

19:53

S… Speaker 1 (HOD PAEDIATRICS)

go to this,

19:54

S… Speaker 1 (HOD PAEDIATRICS)

go to that, looking for folder.

19:55

S… Speaker 1 (HOD PAEDIATRICS)

And then oftentimes,

19:57

S… Speaker 1 (HOD PAEDIATRICS)

sometimes they will say,

19:58

S… Speaker 1 (HOD PAEDIATRICS)

okay, take temporary folder.

20:00

S… Speaker 1 (HOD PAEDIATRICS)

and go and be seen for today while we still look for the folder.

20:03

S… Speaker 1 (HOD PAEDIATRICS)

But if they have enough space

20:07

S… Speaker 1 (HOD PAEDIATRICS)

and enough cabinets and those things are arranged,

20:10

S… Speaker 1 (HOD PAEDIATRICS)

either alphabetically or whatever means they are using,

20:14

S… Speaker 1 (HOD PAEDIATRICS)

to be easier to assess those things.

20:16

S… Speaker 1 (HOD PAEDIATRICS)

Thank you.

20:17

S… Speaker 2 (HOD PAEDIATRICS)

Thank you, Ma.

20:18

S… Speaker 2 (HOD PAEDIATRICS)

So,

20:19

S… Speaker 2 (HOD PAEDIATRICS)

what changes will significantly improve patient experience and outcomes?

20:25

S… Speaker 1 (HOD PAEDIATRICS)

More staffing.

20:26

S… Speaker 1 (HOD PAEDIATRICS)

That's one.

20:28

S… Speaker 1 (HOD PAEDIATRICS)

More staffing.

20:29

S… Speaker 1 (HOD PAEDIATRICS)

Then the basic equipment should be available.

20:33

S… Speaker 1 (HOD PAEDIATRICS)

We shouldn't be talking about not having weighing scale,

20:37

S… Speaker 1 (HOD PAEDIATRICS)

not having spigmo manometer,

20:40

S… Speaker 1 (HOD PAEDIATRICS)

not having standiometer.

20:41

S… Speaker 1 (HOD PAEDIATRICS)

As I speak to you now,

20:43

S… Speaker 1 (HOD PAEDIATRICS)

it's only one standiometer we have in consultant pediatric clinic.

20:47

S… Speaker 1 (HOD PAEDIATRICS)

And that was,

20:47

S… Speaker 1 (HOD PAEDIATRICS)

I think it was donated by either an NGO,

20:50

S… Speaker 1 (HOD PAEDIATRICS)

somebody that donated it.

20:52

S… Speaker 1 (HOD PAEDIATRICS)

So each time I have to...

20:54

S… Speaker 1 (HOD PAEDIATRICS)

measure a child's height.

20:55

S… Speaker 1 (HOD PAEDIATRICS)

I have to go and borrow it from the other clinic.

20:57

S… Speaker 1 (HOD PAEDIATRICS)

All that one will waste time now.

20:59

S… Speaker 1 (HOD PAEDIATRICS)

You send somebody to go to these people and make sure,

21:01

S… Speaker 1 (HOD PAEDIATRICS)

that would be,

21:02

S… Speaker 1 (HOD PAEDIATRICS)

if they're not using it,

21:03

S… Speaker 1 (HOD PAEDIATRICS)

please bring the sanguometer for me.

21:04

S… Speaker 1 (HOD PAEDIATRICS)

As for the outpatient clinic,

21:06

S… Speaker 1 (HOD PAEDIATRICS)

we don't even have any at all.

21:07

S… Speaker 1 (HOD PAEDIATRICS)

As for the Sphig,

21:09

S… Speaker 1 (HOD PAEDIATRICS)

we don't have any Sphig that is designated for clinic.

21:13

S… Speaker 1 (HOD PAEDIATRICS)

So like the nephrology unit,

21:15

S… Speaker 1 (HOD PAEDIATRICS)

we used to buy our own Sphig.

21:17

S… Speaker 1 (HOD PAEDIATRICS)

So all those things,

21:18

S… Speaker 1 (HOD PAEDIATRICS)

you should walk into this clinic,

21:19

S… Speaker 1 (HOD PAEDIATRICS)

there should be Sphig on the table,

21:21

S… Speaker 1 (HOD PAEDIATRICS)

there should be stethoscope on the table.

21:22

S… Speaker 1 (HOD PAEDIATRICS)

So all those things waste time.

21:24

S… Speaker 1 (HOD PAEDIATRICS)

Those are things that waste time when you have to go and beg for this,

21:27

S… Speaker 1 (HOD PAEDIATRICS)

go and buy paper,

21:29

S… Speaker 1 (HOD PAEDIATRICS)

go and buy this.

21:30

S… Speaker 1 (HOD PAEDIATRICS)

Those are things that should be available in abundance on

21:34

S… Speaker 1 (HOD PAEDIATRICS)

the table as you come into the clinic.

21:36

S… Speaker 2 (HOD PAEDIATRICS)

So I want to talk on the training and capacity development.

21:39

S… Speaker 2 (HOD PAEDIATRICS)

You know that this is a training center.

21:42

S… Speaker 2 (HOD PAEDIATRICS)

So what gaps exist in clinical training on residency programs?

21:47

S… Speaker 1 (HOD PAEDIATRICS)

Yeah, I think the wrong person in this question.

21:48

S… Speaker 1 (HOD PAEDIATRICS)

The other day I sat down and talked to myself.

21:51

S… Speaker 1 (HOD PAEDIATRICS)

I said I have worked in UPTH.

21:53

S… Speaker 1 (HOD PAEDIATRICS)

for almost 30 years.

21:55

S… Speaker 1 (HOD PAEDIATRICS)

I have never been sponsored,

21:57

S… Speaker 1 (HOD PAEDIATRICS)

apart from when I was a resident,

21:59

S… Speaker 1 (HOD PAEDIATRICS)

maybe going for my update courses and all that.

22:02

S… Speaker 1 (HOD PAEDIATRICS)

I've never been sponsored for any training.

22:04

S… Speaker 1 (HOD PAEDIATRICS)

So we need sponsorship for,

22:07

S… Speaker 1 (HOD PAEDIATRICS)

we need,

22:08

S… Speaker 1 (HOD PAEDIATRICS)

because we need to,

22:09

S… Speaker 1 (HOD PAEDIATRICS)

this is training institution,

22:10

S… Speaker 1 (HOD PAEDIATRICS)

we need to update ourselves,

22:11

S… Speaker 1 (HOD PAEDIATRICS)

even as a consultant.

22:12

S… Speaker 1 (HOD PAEDIATRICS)

As a consultant,

22:13

S… Speaker 1 (HOD PAEDIATRICS)

I've worked here for more than,

22:14

S… Speaker 1 (HOD PAEDIATRICS)

I came here as a consultant 2009.

22:21

S… Speaker 1 (HOD PAEDIATRICS)

I have not been sponsored for any training that

22:25

S… Speaker 1 (HOD PAEDIATRICS)

was possible to sponsor me to go for this training and come back.

22:29

S… Speaker 1 (HOD PAEDIATRICS)

So any training I have to go,

22:31

S… Speaker 1 (HOD PAEDIATRICS)

I have to...

22:32

S… Speaker 1 (HOD PAEDIATRICS)

cough it out,

22:33

S… Speaker 1 (HOD PAEDIATRICS)

out of my pocket to go and come.

22:35

S… Speaker 1 (HOD PAEDIATRICS)

And then use it to train the junior ones.

22:38

S… Speaker 2 (HOD PAEDIATRICS)

And it's applicable to the resident doctors as well?

22:40

S… Speaker 1 (HOD PAEDIATRICS)

It's applicable to the resident.

22:42

S… Speaker 1 (HOD PAEDIATRICS)

Everybody should have,

22:43

S… Speaker 1 (HOD PAEDIATRICS)

even if they say,

22:44

S… Speaker 1 (HOD PAEDIATRICS)

oh, one in two years or three years,

22:46

S… Speaker 1 (HOD PAEDIATRICS)

at least you have that.

22:47

S… Speaker 1 (HOD PAEDIATRICS)

That isn't part of the incentive that,

22:49

S… Speaker 1 (HOD PAEDIATRICS)

ah, hospital sponsored me to go and do a nephrology course.

22:52

S… Speaker 1 (HOD PAEDIATRICS)

So I'll be happy to volunteer.

22:56

S… Speaker 1 (HOD PAEDIATRICS)

You understand?

22:57

S… Speaker 1 (HOD PAEDIATRICS)

Do whatever it takes for the hospital in respect of that nephrology.

23:01

S… Speaker 1 (HOD PAEDIATRICS)

It has not stopped us thus far.

23:03

S… Speaker 1 (HOD PAEDIATRICS)

But I must say that it's part of the thing that used to motivate

23:07

S… Speaker 1 (HOD PAEDIATRICS)

people in their working environment.

23:09

S… Speaker 1 (HOD PAEDIATRICS)

That's what I would say.

23:10

S… Speaker 2 (HOD PAEDIATRICS)

So what are the major constraints to continuous professional development?

23:15

S… Speaker 1 (HOD PAEDIATRICS)

We have already answered this.

23:18

S… Speaker 1 (HOD PAEDIATRICS)

Let me not overflug it.

23:19

S… Speaker 2 (HOD PAEDIATRICS)

How can training be strengthened to improve service delivery?

23:22

S… Speaker 1 (HOD PAEDIATRICS)

I've already said that...

23:26

S… Speaker 1 (HOD PAEDIATRICS)

Anyhow they want to do it,

23:28

S… Speaker 1 (HOD PAEDIATRICS)

even if you say once in four years,

23:30

S… Speaker 1 (HOD PAEDIATRICS)

at least one consultant is sent from all this.

23:33

S… Speaker 1 (HOD PAEDIATRICS)

Like in pediatrics,

23:36

S… Speaker 1 (HOD PAEDIATRICS)

we have about eight subspecialties.

23:38

S… Speaker 1 (HOD PAEDIATRICS)

We have neonatology,

23:39

S… Speaker 1 (HOD PAEDIATRICS)

we have nephrology,

23:41

S… Speaker 1 (HOD PAEDIATRICS)

we have cardiology,

23:42

S… Speaker 1 (HOD PAEDIATRICS)

we have neurology,

23:43

S… Speaker 1 (HOD PAEDIATRICS)

we have respiratory theology,

23:46

S… Speaker 1 (HOD PAEDIATRICS)

we have hemato -oncology.

23:48

S… Speaker 1 (HOD PAEDIATRICS)

So we have all those subspecialties.

23:50

S… Speaker 1 (HOD PAEDIATRICS)

So even if you say once in four years,

23:52

S… Speaker 1 (HOD PAEDIATRICS)

at least every one person in all these places will have had a change.

23:56

S… Speaker 2 (HOD PAEDIATRICS)

So this

24:01

S… Speaker 2 (HOD PAEDIATRICS)

is the last section,

24:02

S… Speaker 2 (HOD PAEDIATRICS)

priority setting.

24:03

S… Speaker 2 (HOD PAEDIATRICS)

What are the top three strategic priorities

24:08

S… Speaker 2 (HOD PAEDIATRICS)

UPTH must focus on between this year,

24:11

S… Speaker 2 (HOD PAEDIATRICS)

2026 and 2030?

24:13

S… Speaker 1 (HOD PAEDIATRICS)

I think that I don't believe

24:17

S… Speaker 1 (HOD PAEDIATRICS)

in going for the highfalutin things when even the basics are not available.

24:22

S… Speaker 1 (HOD PAEDIATRICS)

So as it stands now,

24:23

S… Speaker 1 (HOD PAEDIATRICS)

before now,

24:25

S… Speaker 1 (HOD PAEDIATRICS)

I can walk into the emergency room and

24:29

S… Speaker 1 (HOD PAEDIATRICS)

there are continuation sheets for the doctors to write.

24:33

S… Speaker 1 (HOD PAEDIATRICS)

The patient is not going to buy paper.

24:35

S… Speaker 1 (HOD PAEDIATRICS)

There is fig.

24:37

S… Speaker 1 (HOD PAEDIATRICS)

There is stethoscope.

24:40

S… Speaker 1 (HOD PAEDIATRICS)

There is weighing scale,

24:42

S… Speaker 1 (HOD PAEDIATRICS)

functional weighing scale.

24:43

S… Speaker 1 (HOD PAEDIATRICS)

Let me tell you the experience I had this morning.

24:45

S… Speaker 1 (HOD PAEDIATRICS)

I was seeing a child before I came up to meet two people.

24:47

S… Speaker 1 (HOD PAEDIATRICS)

The child was weighed.

24:49

S… Speaker 1 (HOD PAEDIATRICS)

Very ill child.

24:50

S… Speaker 1 (HOD PAEDIATRICS)

Very,

24:51

S… Speaker 1 (HOD PAEDIATRICS)

very ill.

24:52

S… Speaker 1 (HOD PAEDIATRICS)

Was weighed in clinic,

24:54

S… Speaker 1 (HOD PAEDIATRICS)

outpatient clinic,

24:55

S… Speaker 1 (HOD PAEDIATRICS)

CPC to be precise.

24:57

S… Speaker 1 (HOD PAEDIATRICS)

Child was weighing 37 kg.

25:00

S… Speaker 1 (HOD PAEDIATRICS)

child is in the world with the world skill child is weighing 34

25:05

S… Speaker 1 (HOD PAEDIATRICS)

kg

25:07

S… Speaker 2 (HOD PAEDIATRICS)

Same child.

25:07

S… Speaker 1 (HOD PAEDIATRICS)

Same child.

25:09

S… Speaker 1 (HOD PAEDIATRICS)

Not that the child lost weight.

25:11

S… Speaker 1 (HOD PAEDIATRICS)

Because if maybe the child had edema,

25:12

S… Speaker 1 (HOD PAEDIATRICS)

had lost weight in two days,

25:14

S… Speaker 1 (HOD PAEDIATRICS)

then you can say,

25:15

S… Speaker 1 (HOD PAEDIATRICS)

oh, the weight dropped.

25:16

S… Speaker 1 (HOD PAEDIATRICS)

That is why the edema fluid has gone.

25:18

S… Speaker 1 (HOD PAEDIATRICS)

That's why the child.

25:18

S… Speaker 1 (HOD PAEDIATRICS)

But we have had this problem.

25:20

S… Speaker 1 (HOD PAEDIATRICS)

Because the scales,

25:21

S… Speaker 1 (HOD PAEDIATRICS)

either they are old,

25:22

S… Speaker 1 (HOD PAEDIATRICS)

they are not functioning,

25:23

S… Speaker 1 (HOD PAEDIATRICS)

they are no longer sensitive,

25:25

S… Speaker 1 (HOD PAEDIATRICS)

but we are just managing them.

25:27

S… Speaker 1 (HOD PAEDIATRICS)

And all those,

25:28

S… Speaker 1 (HOD PAEDIATRICS)

it affects patient care and treatment.

25:30

S… Speaker 1 (HOD PAEDIATRICS)

Because in all pediatrics,

25:32

S… Speaker 1 (HOD PAEDIATRICS)

we calculate the drugs based on the weight of the child.

25:35

S… Speaker 1 (HOD PAEDIATRICS)

So if a child is actually 34 and we have been calculating using 37,

25:40

S… Speaker 1 (HOD PAEDIATRICS)

so we have been giving the child overdose of what the child should get.

25:43

S… Speaker 1 (HOD PAEDIATRICS)

So let us get those basics.

25:45

S… Speaker 1 (HOD PAEDIATRICS)

No child,

25:46

S… Speaker 1 (HOD PAEDIATRICS)

no parent should come here and be going to buy paper or going

25:51

S… Speaker 1 (HOD PAEDIATRICS)

to buy bottle for test or going to syringe,

25:56

S… Speaker 1 (HOD PAEDIATRICS)

going to buy syringe,

25:57

S… Speaker 1 (HOD PAEDIATRICS)

cotton wool, methylated spirit.

26:00

S… Speaker 1 (HOD PAEDIATRICS)

We should get it right.

26:01

S… Speaker 1 (HOD PAEDIATRICS)

These are things that can be sorted out this year,

26:05

S… Speaker 1 (HOD PAEDIATRICS)

not even to say it in next year.

26:07

S… Speaker 1 (HOD PAEDIATRICS)

So that in any clinic or any ward,

26:11

S… Speaker 1 (HOD PAEDIATRICS)

those things should be...

26:13

S… Speaker 1 (HOD PAEDIATRICS)

available and in abundance,

26:14

S… Speaker 1 (HOD PAEDIATRICS)

so that we don't do all those basic things,

26:17

S… Speaker 1 (HOD PAEDIATRICS)

standiometer,

26:18

S… Speaker 1 (HOD PAEDIATRICS)

weighing scale,

26:19

S… Speaker 1 (HOD PAEDIATRICS)

sphygmomanometer,

26:20

S… Speaker 1 (HOD PAEDIATRICS)

stethoscope,

26:21

S… Speaker 1 (HOD PAEDIATRICS)

all those things should be available and in abundance.

26:24

S… Speaker 1 (HOD PAEDIATRICS)

Before we now climb up,

26:25

S… Speaker 1 (HOD PAEDIATRICS)

when we now know that those ones are available,

26:27

S… Speaker 1 (HOD PAEDIATRICS)

we can now start talking about our echo,

26:29

S… Speaker 1 (HOD PAEDIATRICS)

our dialysis machine,

26:30

S… Speaker 1 (HOD PAEDIATRICS)

our ultrasound scan,

26:31

S… Speaker 1 (HOD PAEDIATRICS)

our this and that,

26:32

S… Speaker 1 (HOD PAEDIATRICS)

all those ones are big,

26:34

S… Speaker 1 (HOD PAEDIATRICS)

but these ones are basic.

26:35

S… Speaker 1 (HOD PAEDIATRICS)

So let's get those basic things first.

26:38

S… Speaker 1 (HOD PAEDIATRICS)

And then,

26:39

S… Speaker 1 (HOD PAEDIATRICS)

of course, thank God,

26:42

S… Speaker 1 (HOD PAEDIATRICS)

Chief Medical Director has been able to address the issue of electricity.

26:46

S… Speaker 1 (HOD PAEDIATRICS)

At least now we can say that we have electricity in

26:51

S… Speaker 1 (HOD PAEDIATRICS)

the emergency room and in the SCBE.

26:55

S… Speaker 1 (HOD PAEDIATRICS)

So there is no day.

26:57

S… Speaker 1 (HOD PAEDIATRICS)

Even if it goes,

26:58

S… Speaker 1 (HOD PAEDIATRICS)

it will come back.

26:59

S… Speaker 1 (HOD PAEDIATRICS)

It doesn't stay the whole day,

27:01

S… Speaker 1 (HOD PAEDIATRICS)

no light that you will say before,

27:03

S… Speaker 1 (HOD PAEDIATRICS)

two days, three days.

27:03

S… Speaker 1 (HOD PAEDIATRICS)

We have stable light and also

27:08

S… Speaker 1 (HOD PAEDIATRICS)

water.

27:10

S… Speaker 1 (HOD PAEDIATRICS)

You can open the taps and you have running taps,

27:13

S… Speaker 1 (HOD PAEDIATRICS)

water.

27:13

S… Speaker 1 (HOD PAEDIATRICS)

So water is available,

27:14

S… Speaker 1 (HOD PAEDIATRICS)

light is available.

27:16

S… Speaker 1 (HOD PAEDIATRICS)

Those are the things that I mean by having the basics.

27:18

S… Speaker 1 (HOD PAEDIATRICS)

So like all these other syringe,

27:20

S… Speaker 1 (HOD PAEDIATRICS)

paper,

27:21

S… Speaker 1 (HOD PAEDIATRICS)

cutting wool,

27:22

S… Speaker 1 (HOD PAEDIATRICS)

meditative spirit,

27:23

S… Speaker 1 (HOD PAEDIATRICS)

they are basics.

27:24

S… Speaker 1 (HOD PAEDIATRICS)

They are basics that nothing that we should be lacking in teaching hospital.

27:27

S… Speaker 1 (HOD PAEDIATRICS)

And then gloves.

27:28

S… Speaker 1 (HOD PAEDIATRICS)

Gloves.

27:30

S… Speaker 1 (HOD PAEDIATRICS)

We talk about infection prevention.

27:32

S… Speaker 1 (HOD PAEDIATRICS)

Gloves,

27:34

S… Speaker 1 (HOD PAEDIATRICS)

you see.

27:35

S… Speaker 1 (HOD PAEDIATRICS)

Should be in abundance.

27:36

S… Speaker 1 (HOD PAEDIATRICS)

Yeah, it should be in abundance.

27:37

S… Speaker 1 (HOD PAEDIATRICS)

We shouldn't be lacking all those things.

27:40

S… Speaker 1 (HOD PAEDIATRICS)

Those things really help.

27:42

S… Speaker 2 (HOD PAEDIATRICS)

Thank you, Ma.

27:42

S… Speaker 2 (HOD PAEDIATRICS)

This is just to wrap it up.

27:44

S… Speaker 2 (HOD PAEDIATRICS)

What should UPTH start doing now?

27:47

S… Speaker 1 (HOD PAEDIATRICS)

In terms of the staffing,

27:51

S… Speaker 1 (HOD PAEDIATRICS)

everything.

27:52

S… Speaker 2 (HOD PAEDIATRICS)

Where do you think we can do?

27:54

S… Speaker 2 (HOD PAEDIATRICS)

We can start from.

27:55

S… Speaker 1 (HOD PAEDIATRICS)

What I've told you now.

27:57

S… Speaker 1 (HOD PAEDIATRICS)

I said the basics.

27:58

S… Speaker 1 (HOD PAEDIATRICS)

That parents should not be buying paper.

28:00

S… Speaker 1 (HOD PAEDIATRICS)

Paper should be.

28:01

S… Speaker 1 (HOD PAEDIATRICS)

Before now,

28:03

S… Speaker 1 (HOD PAEDIATRICS)

they had a printer that would print and say,

28:05

S… Speaker 1 (HOD PAEDIATRICS)

Department of Pediatrics,

28:07

S… Speaker 1 (HOD PAEDIATRICS)

continuation sheet.

28:08

S… Speaker 1 (HOD PAEDIATRICS)

Supply it to the nurses,

28:09

S… Speaker 1 (HOD PAEDIATRICS)

supply it to the doctors.

28:11

S… Speaker 1 (HOD PAEDIATRICS)

So it's available in the world.

28:13

S… Speaker 1 (HOD PAEDIATRICS)

So once a patient comes,

28:14

S… Speaker 1 (HOD PAEDIATRICS)

just as you're sending the patient folder in for the doctor to see,

28:18

S… Speaker 1 (HOD PAEDIATRICS)

the nurse attaches the continuation sheet.

28:21

S… Speaker 1 (HOD PAEDIATRICS)

not to send the parents say go to malang go and buy full scarf sheet to be seen

28:26

S… Speaker 1 (HOD PAEDIATRICS)

And then we used to get investigation forms,

28:29

S… Speaker 1 (HOD PAEDIATRICS)

department of microbiology,

28:32

S… Speaker 1 (HOD PAEDIATRICS)

department of hematology,

28:34

S… Speaker 1 (HOD PAEDIATRICS)

department of chemical pathology.

28:36

S… Speaker 1 (HOD PAEDIATRICS)

They used to supply those forms to the nurses.

28:38

S… Speaker 1 (HOD PAEDIATRICS)

So as the patient needs investigation,

28:40

S… Speaker 1 (HOD PAEDIATRICS)

even the S3 forms,

28:41

S… Speaker 1 (HOD PAEDIATRICS)

they will arrange it on the table in the morning.

28:45

S… Speaker 1 (HOD PAEDIATRICS)

So you have microbiology form,

28:47

S… Speaker 1 (HOD PAEDIATRICS)

hematology form,

28:48

S… Speaker 1 (HOD PAEDIATRICS)

chemical pathology form,

28:50

S… Speaker 1 (HOD PAEDIATRICS)

anatomical pathology form,

28:51

S… Speaker 1 (HOD PAEDIATRICS)

radiology form already on the doctor's table.

28:55

S… Speaker 1 (HOD PAEDIATRICS)

So once you finish seeing a child and you feel that that child needs investigation,

28:59

S… Speaker 1 (HOD PAEDIATRICS)

just collect the form and write.

29:02

S… Speaker 1 (HOD PAEDIATRICS)

Now we don't,

29:03

S… Speaker 1 (HOD PAEDIATRICS)

I don't even know,

29:04

S… Speaker 1 (HOD PAEDIATRICS)

maybe the doctors that were graduating now,

29:06

S… Speaker 1 (HOD PAEDIATRICS)

they don't know the color of those forms.

29:08

S… Speaker 1 (HOD PAEDIATRICS)

They don't know that there were any forms.

29:10

S… Speaker 1 (HOD PAEDIATRICS)

I'm telling you the truth and it's very sad because we now buy paper from

29:14

S… Speaker 1 (HOD PAEDIATRICS)

Malam, tier 1824,

29:15

S… Speaker 1 (HOD PAEDIATRICS)

and then write.

29:19

S… Speaker 1 (HOD PAEDIATRICS)

Even for prescribing drugs,

29:21

S… Speaker 1 (HOD PAEDIATRICS)

we see T .M.

29:22

S… Speaker 1 (HOD PAEDIATRICS)

Allen's paper,

29:22

S… Speaker 1 (HOD PAEDIATRICS)

I write for drugs.

29:24

S… Speaker 1 (HOD PAEDIATRICS)

So those are basics.

29:25

S… Speaker 1 (HOD PAEDIATRICS)

So we cannot be talking big,

29:27

S… Speaker 1 (HOD PAEDIATRICS)

big things until we settle this small one.

29:29

S… Speaker 2 (HOD PAEDIATRICS)

So we can start from there.

29:30

S… Speaker 1 (HOD PAEDIATRICS)

Basics,

29:31

S… Speaker 1 (HOD PAEDIATRICS)

let all those things be available.

29:32

S… Speaker 1 (HOD PAEDIATRICS)

When we enter the clinic,

29:33

S… Speaker 1 (HOD PAEDIATRICS)

let those things be on the table.

29:35

S… Speaker 1 (HOD PAEDIATRICS)

Even for the doctor and the nurse that is seeing the patient,

29:38

S… Speaker 1 (HOD PAEDIATRICS)

you will be happy to just collect microbiological form and fill urine

29:42

S… Speaker 1 (HOD PAEDIATRICS)

MCS,

29:43

S… Speaker 1 (HOD PAEDIATRICS)

not to send the patient.

29:45

S… Speaker 1 (HOD PAEDIATRICS)

all those things waste patient time you now send the patient go and buy a full

29:49

S… Speaker 1 (HOD PAEDIATRICS)

scarf sheet from mala so that i will write urine mcs for your child you

29:53

S… Speaker 1 (HOD PAEDIATRICS)

understand so i hope i'm not talking too much so

29:57

S… Speaker 2 (HOD PAEDIATRICS)

this is this is the next one is what do

30:02

S… Speaker 2 (HOD PAEDIATRICS)

what should we stop do so you have mentioned we should stop allowing

30:06

S… Speaker 2 (HOD PAEDIATRICS)

all this to

30:07

S… Speaker 1 (HOD PAEDIATRICS)

If the thing is available on the table,

30:10

S… Speaker 1 (HOD PAEDIATRICS)

nobody will send parents to go and buy Malam's full -stab sheets.

30:13

S… Speaker 1 (HOD PAEDIATRICS)

You will just collect it and use it.

30:15

S… Speaker 1 (HOD PAEDIATRICS)

They are sending because it is not available.

30:18

S… Speaker 1 (HOD PAEDIATRICS)

Because if you say,

30:20

S… Speaker 1 (HOD PAEDIATRICS)

okay,

30:20

S… Speaker 1 (HOD PAEDIATRICS)

from now henceforth,

30:21

S… Speaker 1 (HOD PAEDIATRICS)

nobody should send for Malam to go and buy parents to go and buy paper.

30:25

S… Speaker 1 (HOD PAEDIATRICS)

Oh, you have not provided me with the paper to write it,

30:28

S… Speaker 1 (HOD PAEDIATRICS)

so what do I do?

30:29

S… Speaker 2 (HOD PAEDIATRICS)

So what can we do differently?

30:32

S… Speaker 1 (HOD PAEDIATRICS)

I've said this, I've said everything.

30:34

S… Speaker 1 (HOD PAEDIATRICS)

We can do different.

30:35

S… Speaker 1 (HOD PAEDIATRICS)

If these things are available,

30:36

S… Speaker 1 (HOD PAEDIATRICS)

we are there in the clinic to work.

30:40

S… Speaker 1 (HOD PAEDIATRICS)

Let the things that we need to work be made available to us.

30:44

S… Speaker 1 (HOD PAEDIATRICS)

Like I would like to see my patient,

30:47

S… Speaker 1 (HOD PAEDIATRICS)

weigh the patient,

30:49

S… Speaker 1 (HOD PAEDIATRICS)

know that this weight is correct,

30:50

S… Speaker 1 (HOD PAEDIATRICS)

do the height of the patient,

30:51

S… Speaker 1 (HOD PAEDIATRICS)

check the child's temperature.

30:52

S… Speaker 1 (HOD PAEDIATRICS)

In fact,

30:54

S… Speaker 1 (HOD PAEDIATRICS)

at that time, when I started working as a resident,

30:57

S… Speaker 1 (HOD PAEDIATRICS)

when I went to a temporary site,

30:58

S… Speaker 1 (HOD PAEDIATRICS)

every child in SCBU.

31:01

S… Speaker 1 (HOD PAEDIATRICS)

Dr.

31:01

S… Speaker 1 (HOD PAEDIATRICS)

and Professor Ramambo was our HOD.

31:03

S… Speaker 1 (HOD PAEDIATRICS)

He's late now.

31:04

S… Speaker 1 (HOD PAEDIATRICS)

Every child,

31:06

S… Speaker 1 (HOD PAEDIATRICS)

because it's SCBU,

31:07

S… Speaker 1 (HOD PAEDIATRICS)

and those babies are delicate,

31:09

S… Speaker 1 (HOD PAEDIATRICS)

every baby had their own stethoscope,

31:11

S… Speaker 1 (HOD PAEDIATRICS)

every baby had their own tape,

31:13

S… Speaker 1 (HOD PAEDIATRICS)

every baby had their own thermometer,

31:15

S… Speaker 1 (HOD PAEDIATRICS)

so that you don't transfer infection from one newborn.

31:18

S… Speaker 1 (HOD PAEDIATRICS)

This is a newborn baby.

31:19

S… Speaker 1 (HOD PAEDIATRICS)

Imagine your own newborn baby.

31:20

S… Speaker 1 (HOD PAEDIATRICS)

Transfer infection from this newborn baby to the other newborn baby.

31:23

S… Speaker 1 (HOD PAEDIATRICS)

So because of that,

31:24

S… Speaker 1 (HOD PAEDIATRICS)

every court had tape,

31:27

S… Speaker 1 (HOD PAEDIATRICS)

thermometer.

31:30

S… Speaker 1 (HOD PAEDIATRICS)

what is it called stethoscope hanging on their bed and

31:34

S… Speaker 1 (HOD PAEDIATRICS)

then of course we had those SCBU gowns of course I think they

31:39

S… Speaker 1 (HOD PAEDIATRICS)

still have those ones they had the gowns they had the whatever disposable

31:43

S… Speaker 1 (HOD PAEDIATRICS)

footwear before you enter

31:47

S… Speaker 1 (HOD PAEDIATRICS)

you change you wear that gown wear the footwear cover your mask cover your head

31:51

S… Speaker 1 (HOD PAEDIATRICS)

so that when you're going in there you know that yes I'm going to a sterile

31:55

S… Speaker 1 (HOD PAEDIATRICS)

environment let me not go and cause infection here

31:58

S… Speaker 1 (HOD PAEDIATRICS)

So,

31:58

S… Speaker 2 (HOD PAEDIATRICS)

thank you for your valuable insights,

32:01

S… Speaker 1 (HOD PAEDIATRICS)

Ma.

32:01

S… Speaker 2 (HOD PAEDIATRICS)

Your contribution will directly inform the UPT's strategic

32:06

S… Speaker 2 (HOD PAEDIATRICS)

plan for 2026 to 2030.

32:09

S… Speaker 1 (HOD PAEDIATRICS)

So,

32:09

S… Speaker 2 (HOD PAEDIATRICS)

we are very grateful,

32:10

S… Speaker 2 (HOD PAEDIATRICS)

Ma. Thank you for your audience.

32:12

S… Speaker 1 (HOD PAEDIATRICS)

Thank you,

32:13

S… Speaker 1 (HOD PAEDIATRICS)

but before you end your call,

32:15

S… Speaker 1 (HOD PAEDIATRICS)

I have spent how many minutes?

32:17

S… Speaker 1 (HOD PAEDIATRICS)

No more than 30 minutes talking with you people.

32:22

S… Speaker 1 (HOD PAEDIATRICS)

I want to know that there will be a change.

32:25

S… Speaker 2 (HOD PAEDIATRICS)

Yes, that is why we are.

32:26

S… Speaker 1 (HOD PAEDIATRICS)

I do.

32:27

S… Speaker 1 (HOD PAEDIATRICS)

Because I don't believe in talking too much.

32:29

S… Speaker 1 (HOD PAEDIATRICS)

Because if you come back next time and I've not been able to get continuation sheets for my patients,

32:33

S… Speaker 1 (HOD PAEDIATRICS)

I will not talk to you.

HOD PAEDIATRICS

Samenvatting

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