Hello again,
It is now Saturday, marking one week since our arrival in the Gambia. It has been quite a week. Just to reiterate what the others have said in the previous posting, we have been made to feel so welcome and are really settling in.
The clinical exposure we have had here has been very different to that which you would experience on the wards in the UK. Whilst many of the diseases remain the same, (especially the non-communicable diseases, such as diabetes and hypertension), the presentation is so late that the complications are particularly severe. I saw a diabetic foot which you could see through as it had undergone so much necrosis. The learning curve has been steep.
We also spent yesterday afternoon / evening in the A and E department, which is split into medical and surgical sides. Those in the surgical side saw a 'one doctor and one nurse' display of how to manage lots and lots of patients (mostly RTAs), where as us in the medical side got to see some 'classic' presentations. I did feel a little out of my depth however when the one doctor was called over to ICU and left the scene, leaving myself in a room with increasing numbers of patients, with whom the best I could do was take a history (if they spoke English) or do an examination.
Aside from the medicine, we have seen and done lots. Aliki, Claire and myself even saw the President the other day, as he was overseeing the large commissioning celebrations in the town centre. A big party is planned for tonight also to celebrate the graduation of the recent batch of docs, the entry of the pre-meds and our little visit. The Chief Medical Director has also announced that he would like to come, so it really will be a big do.
We're off now to a presentation on HIV and antiretrovirals.
Before I dash, I thought I should let you all know that Rob, Robby, Woody and myself played for the clinicals football team and we won!! Beating the pre-meds 3-1. We are now in the final against the nurses on Wednesday. The backdrop to the football is spectacular.
Anyway got to go. Thanks for reading.
Alex.
Saturday, 12 December 2009
Wednesday, 9 December 2009
...first few days
Nanga Deff! Hello from sunny Gambia.
We have been in Gambia for 5 days already. CRAZY. And can't believe how much we've already seen - many weird and wonderful things. And how many friends we've made. They are a fantastic bunch over here, who feed us ridiculously well, defend us from man-eating spiders, and introduce us to football Gambia-style.
We arrived on Saturday following a pretty interesting night in Manchester Airport to a greeting from half the country and 34°C! Nice. After massive introductions, a quick meeting, a dip in the pool was definitely necessary. We can also heartily recommend Julbrew, an award-winning Gambian beer.
Sunday is a day of rest, and so we were treated to a trip to the Abuko nature reserve, where we saw lots of birds, monkeys, crocodiles and some hyena (rather scary).
On Monday we were introduced to the hospital for the first time, and had the privilege of meeting most of the chaps in charge. Pretty awesome experience to be honest.
Since then we've been spending time on the wards and theatres in the mornings, going to lectures and enjoying Gambian past-times in the afternoons (especially football). The wards have been very interesting, and Woody has managed to snap a few clinical pics too.
Sadly, time is short, and we need to go eat again! So, much love everyone here; we are having a fantastic time, and we cannot speak too highly of our hosts, hostesses, and this top, top country.
Fosoma,
Anna, Gemma and Rob
P.S. good luck to the first years with their exams.
We have been in Gambia for 5 days already. CRAZY. And can't believe how much we've already seen - many weird and wonderful things. And how many friends we've made. They are a fantastic bunch over here, who feed us ridiculously well, defend us from man-eating spiders, and introduce us to football Gambia-style.
We arrived on Saturday following a pretty interesting night in Manchester Airport to a greeting from half the country and 34°C! Nice. After massive introductions, a quick meeting, a dip in the pool was definitely necessary. We can also heartily recommend Julbrew, an award-winning Gambian beer.
Sunday is a day of rest, and so we were treated to a trip to the Abuko nature reserve, where we saw lots of birds, monkeys, crocodiles and some hyena (rather scary).
On Monday we were introduced to the hospital for the first time, and had the privilege of meeting most of the chaps in charge. Pretty awesome experience to be honest.
Since then we've been spending time on the wards and theatres in the mornings, going to lectures and enjoying Gambian past-times in the afternoons (especially football). The wards have been very interesting, and Woody has managed to snap a few clinical pics too.
Sadly, time is short, and we need to go eat again! So, much love everyone here; we are having a fantastic time, and we cannot speak too highly of our hosts, hostesses, and this top, top country.
Fosoma,
Anna, Gemma and Rob
P.S. good luck to the first years with their exams.
Monday, 27 July 2009
It’s week two now – it’s been a long day, so it’s lucky we had a restful Sunday. The end of last week was very productive, and on Saturday we decided that extra-curricular adventures should be had. Saturday morning we met Dr. Levine and Essa, a security advisor from RVTH, and ventured inland to Lamin Lodge. There we took a boat up-river to the mangroves, hoping to catch a glimpse of some of the hundreds of bird species found in the Gambian skies. Oysters are harvested by the local women from the roots of mangroves. Evidently, a delicacy, but we also discovered that the shells are used to make a variety of things – lyme, paint, to mix with cement, even chicken feed. The things you learn...
We visited Essa’s mother’s compound near Lamin, where we had domoda with bongo fish and plenty of mango. Mangoes are sold on every street corner and the trees are found in most gardens, and so you are always welcomed as a guest with a plate of sweet, fresh mango. Delicious. Here, you eat from a large shared bowl – your share is the slice of bowl nearest to you and you eat with your fingers (importantly, those of your right hand). Strangely, us toubabs (white people) are provided with spoons – they’ve probably noticed how much of a mess we make. Essa has been crucial to almost every visit to the hospital. He’s a good man, always looking out for us and getting us places that, without him, would be out-of-bounds for us. He’s made sure we’ve met the right people at the right time – and it’s only recently that Nia’s got used to hearing her name being called across the courtyard of a Gambian hospital... by Essa.
We attract children like there’s no tomorrow, and we can’t usually move for them. No school on Saturday, so both us and the children thoroughly enjoyed spending the afternoon outside the compound learning new names and generally giggling at how “Keith” turns into “Key” or “Cake”, Gambian-style. We’d brought pencils to share out before we left for Kachikali, where the crocodiles live...
At Kachikali there is a museum of Gambian culture and history... and a crocodile pool. Two things we wouldn’t have put together, but it worked! There, we stroked crocodiles while they basked in the sun and took care of not disturbing the “Big Mamas”, who were heavily pregnant and thus a danger. After scaring ourselves silly, we made our way home.
Today has been really positive. We spent some hours at a gynae outpatients clinic and a short time on Labour Ward with Dr. Juan, a Cuban gynaecologist. Each day is an eye-opener for us, especially today where we saw exactly how different the clinic set-up is here compared to the UK. We arrived faced with dozens of patients lined up on benches outside the outpatients department; some with babies, some recently post-partum, some elderly, some even as young as 7 or 8 years old. The rest of the day was spent at the market (looking for cool clothes and water – a running theme) and the labs. We are waiting for the all-clear to take clinical photos of patients at RVTH. Hopefully, we’ll hear from the placement administrators tomorrow morning before our first ward round. Fingers crossed.
Nia and Keith
We visited Essa’s mother’s compound near Lamin, where we had domoda with bongo fish and plenty of mango. Mangoes are sold on every street corner and the trees are found in most gardens, and so you are always welcomed as a guest with a plate of sweet, fresh mango. Delicious. Here, you eat from a large shared bowl – your share is the slice of bowl nearest to you and you eat with your fingers (importantly, those of your right hand). Strangely, us toubabs (white people) are provided with spoons – they’ve probably noticed how much of a mess we make. Essa has been crucial to almost every visit to the hospital. He’s a good man, always looking out for us and getting us places that, without him, would be out-of-bounds for us. He’s made sure we’ve met the right people at the right time – and it’s only recently that Nia’s got used to hearing her name being called across the courtyard of a Gambian hospital... by Essa.
We attract children like there’s no tomorrow, and we can’t usually move for them. No school on Saturday, so both us and the children thoroughly enjoyed spending the afternoon outside the compound learning new names and generally giggling at how “Keith” turns into “Key” or “Cake”, Gambian-style. We’d brought pencils to share out before we left for Kachikali, where the crocodiles live...
At Kachikali there is a museum of Gambian culture and history... and a crocodile pool. Two things we wouldn’t have put together, but it worked! There, we stroked crocodiles while they basked in the sun and took care of not disturbing the “Big Mamas”, who were heavily pregnant and thus a danger. After scaring ourselves silly, we made our way home.
Today has been really positive. We spent some hours at a gynae outpatients clinic and a short time on Labour Ward with Dr. Juan, a Cuban gynaecologist. Each day is an eye-opener for us, especially today where we saw exactly how different the clinic set-up is here compared to the UK. We arrived faced with dozens of patients lined up on benches outside the outpatients department; some with babies, some recently post-partum, some elderly, some even as young as 7 or 8 years old. The rest of the day was spent at the market (looking for cool clothes and water – a running theme) and the labs. We are waiting for the all-clear to take clinical photos of patients at RVTH. Hopefully, we’ll hear from the placement administrators tomorrow morning before our first ward round. Fingers crossed.
Nia and Keith
Friday, 24 July 2009
Celebration of office, twice
Travelling's been much easier since we moved into our little office at the Public Health Labs, as they're half way between Kerr Serigne and Banjul. Banjul and all roads leading to it have been very busy recently due to the July 22nd celebrations – the 15th anniversary of when the current Gambian president came into power.
We spent Wednesday celebrating in Banjul, where we visited family compounds and watched the parade. Dr. Levine, the U.S. doctor, has taught us a great deal about the Gambia – he has invited all of us to his adopted village next weekend. We really can’t wait.
We’ve organised to spend time at A&E, O&G, and on the internal medicine wards at RVTH – with the help of a Gambian medical student, Momodou Tekanyi. We've met Dr. Ousman Lee (an F1 with an interest in pathology) who will teach us on his ward rounds next week. The Cuban doctors have been supportive and the departmental matron of A&E (Lamin Jai) has been a great help too. Momodou Lamin Jammeh ("Dux") from histopathology has been particularly good to us and is very enthusiastic. He was impressed with our learning package examples and is looking forward to Dr. Raz Ali’s arrival as he has a few cases he'd like to discuss with him. Dr. Ali is a UK pathologist travelling with us as part of the pathology programme team – he arrives a week today with our audit team: Ceri, Cathy, and Wendy. We’re really looking forward to seeing them – they might bring us more insect repellent...
Nia and Keith
We spent Wednesday celebrating in Banjul, where we visited family compounds and watched the parade. Dr. Levine, the U.S. doctor, has taught us a great deal about the Gambia – he has invited all of us to his adopted village next weekend. We really can’t wait.
We’ve organised to spend time at A&E, O&G, and on the internal medicine wards at RVTH – with the help of a Gambian medical student, Momodou Tekanyi. We've met Dr. Ousman Lee (an F1 with an interest in pathology) who will teach us on his ward rounds next week. The Cuban doctors have been supportive and the departmental matron of A&E (Lamin Jai) has been a great help too. Momodou Lamin Jammeh ("Dux") from histopathology has been particularly good to us and is very enthusiastic. He was impressed with our learning package examples and is looking forward to Dr. Raz Ali’s arrival as he has a few cases he'd like to discuss with him. Dr. Ali is a UK pathologist travelling with us as part of the pathology programme team – he arrives a week today with our audit team: Ceri, Cathy, and Wendy. We’re really looking forward to seeing them – they might bring us more insect repellent...
Nia and Keith
Tuesday, 21 July 2009
Settling in
Asalaam-aleikum!
We’re here... it felt like we’d been awake and travelling for days, but it was only some 24 hours from Swansea to Kerr Serigne via Llantrisant/Newport/Gatwick. We spent the weekend settling in and finding our way around, and set off for Banjul on Monday morning for meetings with directors and development officers at the Royal Victoria Teaching Hospital (RVTH). We had a fascinating guided tour of the hospital and met with Momodou Lamin Jammeh - a histopathologist based at both RVTH and the Gambian National Public Health Labs. He has kindly provided us with an office to work from at the NPHL (which is only a stone's throw away from Kerr Serigne) – here we have wi-fi and air-con, together with bottled water we have found them to be indispensible! We are very grateful to him and his team for all their assistance. Clinicians and directors from both bases have been amenable and seem supportive of our pathology programme – one project we are running is based on pathological procedures in the form of learning packages that can be used by Gambian medical students during their studies.
The Gambian summer is incredibly hot – each morning we prepare for the intense heat and downpours, arming ourselves with long-sleeves, light clothing, and plenty of mosquito repellent (as Nia has ended up being a meals-on-wheels for the local mozzies). To date, we have made social visits to the monkeys and explored Senegambia and its beach. It’s out of season, so all is quiet.
We are off to meet a Dr. David Levine this afternoon - he is a retired American doctor who has spent several years in the Gambia and has settled near Kerr Serigne. Tomorrow is a public holiday and so we hope to be back at RVTH on Thursday, gearing up for next week, when we’ll meet patients recruited by the pathologists and take our clinical photos. That’s if we survive the heat. And rain. And did we mention the heat?
Nia and Keith
We’re here... it felt like we’d been awake and travelling for days, but it was only some 24 hours from Swansea to Kerr Serigne via Llantrisant/Newport/Gatwick. We spent the weekend settling in and finding our way around, and set off for Banjul on Monday morning for meetings with directors and development officers at the Royal Victoria Teaching Hospital (RVTH). We had a fascinating guided tour of the hospital and met with Momodou Lamin Jammeh - a histopathologist based at both RVTH and the Gambian National Public Health Labs. He has kindly provided us with an office to work from at the NPHL (which is only a stone's throw away from Kerr Serigne) – here we have wi-fi and air-con, together with bottled water we have found them to be indispensible! We are very grateful to him and his team for all their assistance. Clinicians and directors from both bases have been amenable and seem supportive of our pathology programme – one project we are running is based on pathological procedures in the form of learning packages that can be used by Gambian medical students during their studies.
The Gambian summer is incredibly hot – each morning we prepare for the intense heat and downpours, arming ourselves with long-sleeves, light clothing, and plenty of mosquito repellent (as Nia has ended up being a meals-on-wheels for the local mozzies). To date, we have made social visits to the monkeys and explored Senegambia and its beach. It’s out of season, so all is quiet.
We are off to meet a Dr. David Levine this afternoon - he is a retired American doctor who has spent several years in the Gambia and has settled near Kerr Serigne. Tomorrow is a public holiday and so we hope to be back at RVTH on Thursday, gearing up for next week, when we’ll meet patients recruited by the pathologists and take our clinical photos. That’s if we survive the heat. And rain. And did we mention the heat?
Nia and Keith
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