As many of you know, I’m currently doing medical rotations in South Africa. Here is an update.
This was an email I typed to my friend Lindsay…but feel free to read it as well.
Ok, so here’s the scoop on the good SA. Yes, it is winter here, which is not nearly as cold as Chicago, thank GOD. It’s about 55-65 everyday so far, but it gets rather cold at night (prolly around 45 or less). There arent that many bugs but that’s cause we’re in the Western Cape province and right by Capetown so it’s mainly all housing and industry, not really room for bugs. There will probably be more when we go on safari.
All of the students speak English, basically anyone who is educated speak English. Most of the patients speak English but are usually embarrassed to speak it around the doctors. The reason is that doctors in South Africa are almost equivalent to God, and you wouldnt want to speak poorly in front of God (also, since doctors are god, there’s no malpractice in the public sector hospitals). So instead, they speak Afrikaans and pretend that they cant speak English. Then there are a select few that only speak Xhosa (said Kosa) and speak neither Afrikaans nor English, in which case you are shit out of luck, pardon the _expression.
The Cape Town area doesnt have a lot of wildlife, and actually lions, tigers, and bears never lived on the same continents We’ll see tons of critters when we go on safari though, so I’m not worried. Apparently though, whales arrive in late June, so we might go whale watching one weekend, but we’re not going diving as there are great white sharks in the cape, and a student here was actually killed by one last weekend. Yeah, scary. Also, it’s a little cold to be going in the ocean.
So what have we been doing? Well, today we actually just got back from a town called Franschoek which means French Hook in Afrikaans (Hook or hoek means a mountain corner, which we took to mean valley). Anyway, Franschoek was populated by French Protestants who fled France during the reign of Louis (not actually sure whether it was XV or XVI) and brought wine culture to South Africa…hence Franschoek is wine country. So went wine tasting, which was just amazing, and then we went to Stellenbosch, which is the heart of wine country and where the main campus of the university is. Very nice town and one of the most expensive places to live in the Western Cape. But…South Africa is a dichotomy because you have people who are extremely rich and people who are extremely poor. So just outside of Stellenbosch (it’s actually part of Stellenbosch) is one of the poorest neighborhoods in Western Cape with an 85% prevalence. It’s very sad. Usha and I were travelling with a student here and he was telling us a lot about South African history and it was very interesting (South Africa gained independence from England in 1960, it’s a very young country and has come a long way considering).
So, really what have we been doing? First, let me say that we are in a government run hospital. Again, this is where the dichotomy of South Africa plays out, as the private sector hospitals are excellent care and beautiful hospitals because the people who go there can afford health insurance. This is only about 10% of the population though and a mostly white south african population. Our hospital is public and government run, therefore the hospital isnt as nice and the care isnt as good. Basically they do the best they can (which is actually pretty good). We learned today that Tygerberg hospital used to be one of the best hospitals in South Africa in the apartheid days (the hospital is actually entirely symmetrical to reflect that blacks should be on one side while whites on the other….each side of the hospital is perfectly matched…gives new meaning to separate but equal). Since those days though, the hospital has become rundown, although the government is starting to invest more money in Tygerberg. This isnt really evident in Trauma though because it’s so fast paced and quick that there really isnt time, apparently we’ll notice the difference more when we’re in OB/GYN.
This week (wednesday, thursday, friday) we started in Trauma, which basically involves going to rounds at 8 am to about 10 or 10:30 am. Then there is a tutorial at 11 which goes until 1pm. We are on rounds with 4 doctors: 1 consultant (attending), 2 “residents”, one intern; and also student interns which are 6th year students and then 3rd year students who are just starting their clinicals. So we go on rounds and listen and learn. This part isnt really all that interesting except that we’ve learned SO much about stab wounds, motor vehicle accidents, blunt traumas, penetrating traumas (almost everyone is a stab wound, South Africa has a very high crime rate). The tutorials have been really informing and actually make me feel like I know what I’m doing sometimes. We learned the ABCDE’s of resuscitating a trauma patient and about the different types of burns, etc. Tonight and tomorrow night we’re on call. So tonight we’ll probably learn how to suture, we already learned how to intubate, we’ll probably learn how to put in IVs and draw blood. Apparently the weekends are VERY busy in trauma. We’re on trauma all next week and then we have two weeks of OB/GYN where we will be catching babies (in SA, it’s required to catch 25 babies in order to become a doctor, and yes, they say catching, not delivering). After that we do a week of community health although that might get changed to pediatrics (paediatrics as they spell it here) and then a week of HIV. Then we’re off to safari for three days and then back to Chicago.