Tales from West Africa, one week in

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.