Yesterday was our first day on the wards. Most of us had to be there at 8am. Angela and Tom had to get there at 7:30 for surgery. It definitely seems like it is going to be an amazing place to work in for the next 6 weeks, and quite different from American hospitals that we are all used to. First of all, there are people everywhere. The families of the patients stay at the hospital with the patients. The families are in charge of bringing food/drinks, linen/blankets & clothes for the patients while they are being treated. The family members sit outside the hospital all day and wash clothes or start a small fire to cook food for the patients. While in the hospital, mothers are allowed to stay with their sick children 24 hours/day. Other family members stay in a boarding house next to the hospital at night.
The hospital is a large one story building with lots of hallways and many wards. Shant and I are on internal medicine. We arrived at 8:00 for morning report which began by having a 3rd year medical student and a 5th year medical student both giving a case report. After they each presented their attendings grilled the students very hard about their presentation. A British student turned around and whispered to us that it is like this every morning, and the attendings are really hard on the students. After morning report we got a tour of the hospital. There is a mens ward, a female ward, an admissions ward and a TB ward. Pediatrics, surgery & OB have their own areas of the hospital. Shant and I then met up with an intern (intern means the same thing as American intern, but here the internshp lasts 18 months instead of just 12) and started rounding with her. All the patients that she had to see were in the mens ward which is basically one large room that is PACKED full of patients. If you can imagine a room with a central passage way and then 3 rows, & each row has beds right next to each other...literally touching each other. Shant guessed there are probably 60 male patients in that big room. Some are hooked up to IVs, at least one had a chest tude in, and all are very sick. We were told that 15-20% of the population of Blantyre is HIV positive, and 80-90% of the hospital pateints in the internal medicine ward are HIV positive. The intern that we were with had a list of about 28 patients that she was responsible for seeing and taking care of. She is probably in her 20s, and she is very smart and nice and caring with the patients. She talked to Shant and I in English and explained that with several of the patients she knew what the optimal medication would be to treat them, but at this hospital certain medications are just not available, so they have to opt for 2nd best. We saw about 14 patients with this intern in about 2 hours. There are no charts hanging on the walls here, rather each patient handed the intern a stack of papers that the doctors have been using each day to write notes in. Labs are often days old, and certain labs are just not practical here because they take days to return. One of the patients that we saw had an extremely low blood count, and wa sin despirate need of a blood transfusion, but blood is hard to come by here in Malawi. I could go into a detailed story on each patient that we saw and the unbelievable circumstances that they are all in, but I don't have time now. It is pretty unbelievable though. The hospital is full of very sick patients.
Everybody else had good days too. Sammie was struck by the number of malnutritioned children on the pediatric units. Tom saw some unbelievable orthopedic surgery cases and Angela was amazed by the less than sterile technique of the upper and lower GI scopes. I will go into details later. It is now time for breakfast. I will write all about the yummy food we have been eating later. For example, 2 days ago Shant made eggs, with avacado & tomatoe, and yesterday we had toast, with avacado and tomatoe. Today we will have friut salad that Simoni made for us.
Miss you all!!
The hospital is a large one story building with lots of hallways and many wards. Shant and I are on internal medicine. We arrived at 8:00 for morning report which began by having a 3rd year medical student and a 5th year medical student both giving a case report. After they each presented their attendings grilled the students very hard about their presentation. A British student turned around and whispered to us that it is like this every morning, and the attendings are really hard on the students. After morning report we got a tour of the hospital. There is a mens ward, a female ward, an admissions ward and a TB ward. Pediatrics, surgery & OB have their own areas of the hospital. Shant and I then met up with an intern (intern means the same thing as American intern, but here the internshp lasts 18 months instead of just 12) and started rounding with her. All the patients that she had to see were in the mens ward which is basically one large room that is PACKED full of patients. If you can imagine a room with a central passage way and then 3 rows, & each row has beds right next to each other...literally touching each other. Shant guessed there are probably 60 male patients in that big room. Some are hooked up to IVs, at least one had a chest tude in, and all are very sick. We were told that 15-20% of the population of Blantyre is HIV positive, and 80-90% of the hospital pateints in the internal medicine ward are HIV positive. The intern that we were with had a list of about 28 patients that she was responsible for seeing and taking care of. She is probably in her 20s, and she is very smart and nice and caring with the patients. She talked to Shant and I in English and explained that with several of the patients she knew what the optimal medication would be to treat them, but at this hospital certain medications are just not available, so they have to opt for 2nd best. We saw about 14 patients with this intern in about 2 hours. There are no charts hanging on the walls here, rather each patient handed the intern a stack of papers that the doctors have been using each day to write notes in. Labs are often days old, and certain labs are just not practical here because they take days to return. One of the patients that we saw had an extremely low blood count, and wa sin despirate need of a blood transfusion, but blood is hard to come by here in Malawi. I could go into a detailed story on each patient that we saw and the unbelievable circumstances that they are all in, but I don't have time now. It is pretty unbelievable though. The hospital is full of very sick patients.
Everybody else had good days too. Sammie was struck by the number of malnutritioned children on the pediatric units. Tom saw some unbelievable orthopedic surgery cases and Angela was amazed by the less than sterile technique of the upper and lower GI scopes. I will go into details later. It is now time for breakfast. I will write all about the yummy food we have been eating later. For example, 2 days ago Shant made eggs, with avacado & tomatoe, and yesterday we had toast, with avacado and tomatoe. Today we will have friut salad that Simoni made for us.
Miss you all!!
Niamh, ohhh my gosh your adventure sounds simply amazing. i can't even imagine what the hospital must be like, i will have to wait for the pictures. i love reading your blogs, its like i can hear you saying everything :)
ReplyDeleteOh, I miss that place! It makes practicing medicine here seem so... Predictable!
ReplyDeleteOh Niamh. I am so jealous. I should have just applied...damn it.
ReplyDelete