I went to Queen Elizabeth II two Thursdays ago to test out our transilluminator device. Queen II is the national hospital in Lesotho and is located in downtown Maseru. I met Dr. Akash in the Children’s Ward. He introduced me to the doctors and nurses and I gave a quick presentation on the transilluminator. Dr. Akash suggested that I observe the blood-draws in the morning and try out my device, but the power was out and there were no lights in the blood-draw room. I spent the morning shadowing Dr. Akash instead. We started rounds in the acute ward.

What I saw at Queen II was heartbreaking. The hospital does not have enough nurses, so the mother (or another caregiver) must stay with the child at all times. Although meals are provided, the patients bring their own bedding. There is only a limited number of hospital beds, so the tiny beds are usually shared between two or more children.

I learned that the acute ward is usually for patients who need oxygen. The hospital cannot afford pulse oximeters, so the oxygen saturation levels of the patients are only checked when Dr. Akash goes around with his personal oximeter. Even then, he can’t be certain that the reading is always accurate because he only has an adult model that do fit very well on the tiny toes of the pediatric patients. That day, because the electricity was off, none of the oxygen concentrators were working. Going around, I don’t think there was a single child with an oxygen level above 80%, with many far below that. The ideal saturation level should be around or greater than 98-99%. The kids just laid there on the beds gasping and there was nothing we could do for them. There were oxygen tanks in the ward, but the regulators did not work. One of the children we saw had a severe case of pneumonia. Her chart said she was seven, but she looked like she was maybe three or four at best. She was bundled up in layers of blankets and just laid there on the bed with her eyes closed, too weak to do anything else. Her mother sat beside her, helpless. Finally, the nurses managed find two working regulators and brought in oxygen tanks for two of the sickest patients. Every single child in that ward desperately needed oxygen, but there simply wasn’t enough oxygen tanks or regulators for all of them.

In one of the other wards, I observed a spinal tap. In the U.S., this is a very elaborate procedure. However, due to the lack of supplies, the nurses at Queen II had to make do with just needles taken off of syringes. One nurse held the child while the other poked the needle carefully into the child’s back. They collected the clear fluid that dripped from the end of the needle in plastic centrifuge tubes, careful to not get any of the blood that also dripped from the puncture site.

I have spent most of my first weeks here in Lesotho at the Baylor Clinic. Although it cannot compare to the clinics and hospitals in the US, it is a well-equipped facility. My day at Queen II really showed me how much need there is for medical technologies that are appropriate and affordable. Even though Queen II is the best hospital in Lesotho, it lacked almost all the essential technologies you would find in a US hospital.

After rounds, Dr. Akash took me to the nursery, where I was able to try out our transilluminator device. The prototype actually worked very well at visualizing veins on the hands. However, the nursery doctor told me that they don’t have as much trouble with finding veins on the hand as they do with the veins on the ankle, which are deeper than those on the hand. Unfortunately, the intensity of LEDs we are currently using in the device was not high enough to illuminate the ankle veins. I have brought several different kinds LEDS with various wavelengths; I hope to come back to Queen II again to see if any of those are more effective.