July 16th, 2016 by Carlye Marszalek

WOW! My time here is going so fast! I can’t believe I have already finished 2 of the 4 weeks of the rotation already. This week went even faster than week 1. We already have our routine down so the days go by so quickly.

Monday – Wednesday I worked with Dr. Stockley and saw a wide range of cases. We had many lacerations which were fun and different to watch compared to the normal office visit. Unfortunately I wasn’t able to repair them because they were both elderly patients with very thin skin and compromised blood flow so I didn’t want to lower the risk of them healing completely. Thursday I worked with Lisanne who let me see many of her patients with me as the lead doctor. She was still in the room but I was able to type the note and lead the encounter which was much more fun than shadowing.

Friday we actually took the day off. We decided to book a tour of Kampala through Walter’s Boda Boda tours. So two drivers picked us up and led us on a 7 hour tour of Kampala. We saw all the main sites, and got many stories of the area and of the city. It was really nice to learn about the areas in which we had been spending all of our time. Some of the things we toured included the Hindu temple, the Ba’Hai Temple, the Gaddafi Mosque, the old taxi park and business center of Kampala, and the Kings Palace and old torture chambers. Along the way we also saw many sites from a far and just got to see a lot of the neighborhoods within the city. It was a great experience and I highly recommend them to anyone visiting Kampala.

To make up for the lost day on Friday, I did work a half day on Saturday. I had intended to work all day, but one of the doctors sent me home early to enjoy my weekend cause students don’t need to come on weekends. I didn’t argue with him!

Here are some of the differences I have noticed from the Surgery compared to work at home:

1. The role of the nurses. In the ER and acute care they are very similar compared to home, but in the out patient clinic, they really only work in phlebotomy. The doctor has to call back the patient, do the vitals, take them to lab, get the results and then get them the meds from the pharmacy on site. To me this is very different from home because at home the nurses in the office generally room the patient, do a nurses consult note and log the vitals, saving the doctor a lot of time, and allowing them to focus on the problem at hand.

2. The patients wait for the lab results. At home everyone gets the labs done and goes home, and the doctor or the nurse will call them with the results and the updated care plan based on the results. Here at the Surgery, the patients wait the hour or 2 for the lab results, and then the doctor calls them back in to the room to give results and the new plan. This seems to un-streamline the process because each patient ends up having to wait to see the doctor twice, making the average time spent at the clinic probably 3-4 hours.

3. LOTS of bilharzia (schistosomiasis) We seem to test everyone for the disease and with Stockley we treat probably at least 5 people a day. When you travel to foreign places everyone worries about malaria…but in reality, here malaria is rare if you stay in Kampala, but is more common if you leave the city. But Bilharzia is EVERYWHERE.