By Seshika Ratwatte
I remember the night before my first day of HES very clearly. We were sitting under a fan in my grandparents house to get away from the sticky heat. It was an exciting moment - HES is built up so much as one of THE big experiences of med school, we wondered what we were going to get to do, which rotation we’d start off, which team we’d be attached to, how long would the hours be. Perhaps the comment which will forever cement our naivety at the time was ‘At least we’ll be away from the heat tomorrow, hospitals are air conditioned.’ ‘Hospitals are air conditioned here right?’ ‘Yeah, otherwise heaps more patients will die’. It turned out that heaps more patients did die.
So with this false sense of security we eagerly bounded into the hospital on the first day. For some odd reason we were expecting structure and to be told what we were doing and where we were meant to go. Instead, we were dumped on the two medical wards - the biggest wards in the hospital and told to do whatever we wanted. We looked around - there were gaggles of students, standing around doing nothing, past them were the wards. There were about 32 beds on one side of the ward. There were probably double the number of patients - you see there were bed patients and floor patients, and some of the nurses had the job of rotating the patients who were doing better out of beds so that sicker patients could take their place.
14
Introductus
It was hot. Hot, hot, hot and sticky. It turned out that even functioning fans were a luxury on this ward. A horrendous screech filled our ears and we looked over at a meningitis patient, writhing on bed. There were barking coughs, and the sound of patients gasping on flem which subsequently spat out on the ground. We looked on the ground: there were old bandages, rubbish the odds sharps, lying next to the floor patients. Where was the hand gel, the gloves, the sharps bins?
Any sembelence of infection control?? No where to be seen. So you can imagine the two of us, Nicola (Wallace) and myself, constantly pulling out our pocket detol and gelling our hands, keeping anyone who looked infectious at an arms length. After all, we didn’t want to catch anything! There was no way we were going to end up in those beds. Or worse, the floor. To be fair to the two of us, the hospital we were working at is regarded as one of the best public hospitals in the third world. I think though, that knowing this but made the reality of the situation that much harder to accept because we thought to ourselves - if this is what it’s like in one of the best hospitals then just think about what it’s like in the poorer parts of Africa.
We ended up taking a lot of breaks that day in the students’ bag room. And in fact we fled the hospital by lunch time. It was a shock to the system. But we thought to ourselves: this is what HES is about, if you’re not confronted, or if you’re not pushed outside your comfort zone, then you’re probably not seeing or appreciating true inequity.
Those first 2 hours in the ward made a big impression on us. It was through those initial impressions that we each decided on the topics of our HES reports and decided to take a proactive stance during our placement.
The next few days were demoralising at times. We walked from ward to ward introducing ourselves, trying to navigate through the system and work out what on earth we were going to do for 8 weeks. After several shut downs and quite a few wasted hours, we stumbled into a paediatric ward round - the consultant noticed us and said ‘ah you must be electives students, come and join us’. And that was that, we spent the next four weeks there learning things which have come in handy this year, making friends and working with the local medical students, becoming a part of the team on the ward and for me personally