Day 1 - Orientation at the hospital and traffic guidelines

Today was set for getting an orientation to the hospital and a tour so that when I go back tomorrow. I will know what I’m doing. It took a good hour or two to get some paperwork in order. This is somewhat expected as the entire day is set aside to take care of just a few things, but hey… TIA. (TIA means “this is Africa” and can refer to the fact that things don’t happen with the same speed and efficiency that they do in the western world.) Then I went on a tour of the hospital which is all open to the outside. No AC which reminded me about one weekend during which the power system and the back-up generators failed at one of the hospitals in Pensacola. Apparently there is a mandate in Florida that patients cannot be made to stay in rooms that are warmer than 75F. Therefore these patients were all transferred to neighboring hospitals. I am not sure what temperature it was in the hospital today but I can undoubtedly say it was more than 75F and no patients were complaining. Plus, there were no divisions between patient rooms. The hospital wards are one long narrow room with beds lined up on either side and patients (some incredibly sick and with infectious diseases) lying in the beds without anything between them. Imagine the pictures of people in hospitals when the Spanish flu hit… the hospital looks a lot like those.

Wards are divided into men’s wards and women and children’s wards. I am to be assigned to ward 5 for the first week with Dr. Abdul on internal medicine. As today was my orientation day, I came in about halfway through rounds and tried to understand what was going on. It is a little challenging to try to decipher the conversation that happens with the patient in Swahili, but becomes a little clearer as the patient is presented in English. I got to hear about half of the patients’ problems which included severe pancytopenia in 2 cases, stroke, malaria, and kidney failure.

In talking to the doctor that I have been assigned to for this week and trying to explain where I am in school in relation to graduation. I learned to my surprise that I already have more training that he does in terms of the number of years of school. Dr. Abdul is a newly graduated MD intern (I think this is the equivalent of a PA in a way). However, because of the fact that doctors are so few and far between, he is charged with running a ward. It is strange and overwhelming to know that if I were here, I would be in charge of running a medical ward all by myself.

I was driven home at the end of the day by Kassim who is contracted by Elective Africa as a driver, and he drives a tuktuk. This is a 3 passenger taxi of sorts and there are tons of them throughout the city. They are relatively fast because their smaller size allows them to weave in and out of traffic between the larger cars and buses. Thank goodness that Kassim is a relatively conservative driver because traffic rules here are “more like guidelines than actual rules.”