In my previous post, I mentioned working with INMED. For those who don’t know: INMED stands for the Institute for International Medicine and is a program based in Kansas City which offers multiple courses in International Health. I am currently a diploma candidate. To certify for the Diploma in International Medicine and Public Health, one must complete an online course at the end of which is an on-site, hands-on practicum and final exam. Also required for the Diploma is the completion of an international medical elective, performed at one of their many training sites around the world. There is also the option to complete the online courses in either International Medicine or International Public/Health to just obtain the Certificate or just attend one of the electives. INMED also offers several other courses as well which can be completed online. I learned about the program when I was in Ghana in medical school. Two Peds residents from Iowa attended through the INMED program, as Baptist Medical Center in Nalerigu where I attended my medical school elective also happens to be an INMED site. After learning more about the program, it seemed perfect.
I wanted to return to Africa and chose Uganda to get a flavor of East Africa and compare it to West. I was there in the dry season in Ghana and this is the rainy season, so for one thing it is much greener here now. Though, according to the locals, it rains throughout the year as well, just more focused during the rainy season. Evidently Lake Victoria is large enough to produce it’s own weather patterns, and we are near enough to the lake to see continuous effects of rain, even during the dry season. I chose Kiwoko (despite the fact that here physicians are expected to wear ties! very different from the scrubs and flip-flops of Ghana) due to the mix of wards available and training opportunities.
Work started today. After introductions at morning prayers (I’ll describe a typical day in a later post), we had our usual AM physicians meeting and then I was assigned to the Female Medical Ward. I’ll be on Male medical ward next week.
Already today we’ve seen a wide variety of patients. Some of the diagnoses seen just today:
- Brucellosis (there is a rapid antigen test here for this)
- HIV/TB/combination of these
- malaria
- sickle cell
- strongyloides in the lung phase of its life cycle (larvae found incidentally in sputum of TB patient!)
- stool sample positive for Giardia
- separate stool sample positive for strongyloides (different patient from above)
Besides the wide variety of diagnoses, the other main difficulty is translating the British abbreviations as well as British laboratory values. For example, O is short for edema (oedema). RBG is for random blood glucose, and they use VERY different ranges for blood glucose here! Insulin here is also prescribed as “soluble versus insoluble” with names I have never heard. That’s probably enough for today. Plan on doing some reading about the insulin used here as well as malaria treatment. Stay tuned for more…