week2

Hey so i have had the runs for 4 days and missed a bit of hospital this week, hence the reason for non-communication also. Think i am on the mend now and hope to be fighting fit for the coming week in hospital! So what should i tell you about this week?

Our supervisor and founder of the MIMP program, Jon Dowell, has been here in malawi for the past couple of weeks to ensure things are going to plan etc. His visit has proven very successful and maybe this is a good time to explain why i am here and what i am doing.

Jon became aware that every year thousands upon thousands of medical students descend on developing country rural poor hospitals for 6 weeks of the year, learn a lot, see a lot, and have a great time. He began to question the ethics behind this. Clinical time is taken from patients as doctors often spend time teaching these students. Most students head to these places with little knowledge of infectious/tropical diseases, and his question is what does the hospital get in return for this service. So this program aims to have students in one hospital for (ideally the whole year, but exams get in the way) 9 months of the year, under supervision from a clinician who is hired directly for that job - hence not taking away someone else clinical time, and in
addition - in return for having us we were required to bring a sum of money to spend on the ward.

That was the plan... and it is going quite well, we were at first meant to be based in paediatrics but unfortunately the department is so disorganised there was no place for us, and the first group felt they did not learn anything there. So we are now based on the medical wards, under a Dr Namarika - who is so wise! We are trying to find a place for us where we can be of some use, and Jon's presence has helped that. We are all allocated a specific bay and are 'responsible' for those patients - ie we should know the patients well, ensure investigation and management is carried out, or do it ourselves, and do odd jobs around the ward. As there is a significant language barrier, we have come up with a way around this by buddying up with clinical officer students - which works 2 ways - they help us communicate and we teach by example - clerking patients and doing procedures as well as teaching them in specific tutorials - to come hopefully.
We are also carrying out an audit for the ward, which will help them in many ways and we are currently in discussions regarding what we will be spending out money on. Suggestions so far are really just basic things that every ward should have - glucometers and strips, BP machines, Oxygen concentrators, a trolley - the current trolley is used for 2 wards and is used for carrying patients, food at lunchtime and dead bodies to mortuary....you can imagine the infection control issues!!

So that is kind of where we are just now, we have to keep the momentum up while everyone involed is keen, and hopefully we will have a place in this hospital for years to come.

anyway hope that has explained it a little bit.

becks