April 13th, 2018 by tarakorff

It has been almost 3 weeks since I have arrived at the Baptist Medical Centre. The time has definitely flown by! I meant to be posting more often, but with occasional internet outages and the work and community here, I have not gotten around to it nearly as often.

In reflecting on my time here so far and in discussing cases and management of patients with the other workers here, there are many striking differences from healthcare in the United States. The most obvious differences are the diseases here that we don’t have or have very few cases of in the United States and the lack of resources.

The most common diseases seen here that are few and far between in the US are probably typhoid and malaria. Snake bites are also very common here. Chronic liver disease often due to Hepatitis B or C create a significant number of healthcare visits as well. Personally, I have diagnosed 2 new cases of chronic liver disease complicated by ascites requiring paracentesis. I have done 3 paracenteses myself (with supervision, of course) and have seen a number of others. Otherwise, the illnesses are often similar, but the patients tend to have complications and limited access to resources.

While I could talk about the limited resources for some time including access to medications and equipment, probably the most easy to understand resource limitation for those that are non-medical are the labs and testing. There is no x-ray, CT, or MRI here. We are able to send patients to a town about 1 hour away to get an x-ray, but the families are typically unable to travel there or unable to pay for an x-ray. In acute situations, such a motorcycle accidents, falls from mango trees, and other trauma, this often makes diagnoses difficult. There are several ultrasounds here, which essentially constitutes all the readily available diagnostics. As far as labs, there are a handful of test we rely on such as hematocrit and urinalysis as well as specific tests for malaria, hepatitis, etc. However, we are unable to reliably test kidney function, liver function, or blood counts, which are staple labs back home. All of these factors make for challenging circumstances, especially in the very sick patients.

On a different note, this is the first time I have spent much time in another country where I clearly stand out as a foreigner. The children like to yell out, “Sominga, hello!” as you pass, meaning, “White person, hello!” On a recent trip to the market with one of the other medical students here, we were followed closely through the market by a precious little girl who would hold my hand whenever I wasn’t looking and then drop it when I turned to look at her. She then followed us about 3/4 of the way home even after we left the market and never said a word to us the whole time.  Of course, we took a picture to remember her by.

With one week left here, I am excited to see what it holds as I continue to learn about the joys and challenges of serving here.