Thursday, 20 March 2014

Nicola Credland's Uganda diary - entry 3

What an amazing day (again). Spent the morning in the emergency department.?  There is no ABCDE assessment, no triage, no prioritisation, no equipment, no drugs, extremely limited oxygen supply, no clean water, no vital signs equipment, a broken X-ray machine, no ECG machine and access to a CT scanner only for those who can afford it. Unconscious patients are left on the floor. They have one crash trolley for the entire hospital! During the morning I saw four serious traffic accidents, an overdose of rat poison, a machete attack and numerous extremely unwell patients all unconscious - apparently this was quite a steady shift. It tested my assessment skills to the limit and I loved every minute of it. 
In the afternoon I was teaching: arterial blood gas analysis and pulmonary embolism (no mean feat when the staff have no access to oxygen). The students were amazing. They do all of their pathophysiology training with the medical students so their knowledge is excellent. They were a pleasure to teach - excited and eager to learn, enthusiastic and asking questions constantly. They are the most polite and unassuming students I have ever met. They are not interested in getting a first class degree, they simply want to do their very best, make the tutors proud of them and care for the patients in the best way they can - how refreshing. One student got 90% in her mid-term exams and she came to the office to find out how she could have improved. When you consider the lack of clinical experiences available to them it is astounding what they know and how they cope!

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