Pippa McCosh (2007), medical school final year - 2 months (2014) experiencing medical practices in South Africa and Ghana.

First stop Cape Town working at Eerste River, small district 124 bed hospital with surgery, medicine, paediatrics and psychiatry inpatient wards and Emergency Centre treating 1800 patients and over 3500 patients monthly in outpatient clinics. My range of activity included assisting in abdominal surgery and observing cataract operations but most time was spent in Emergency where differences with home were stark and conditions rarely seen observed. A very efficient A&E Centre where staff worked long shifts for high patient volumes. Eerste River has a huge HIV/TB caseload so learnt about fascinating treatement developments for both.

I learnt practical skills ahead of my study timetable, eg assisting in surgery and completing intra-abdominal suturing and lumbar punctures.

In Takoradi, Ghana I worked with Work the World, at Effia Nkwanta Regional Hospital in A&E and general medicine where A&E was open plan and patients often brought in by taxi. The most common pathology was cardiovascular emergencies e.g. strokes, malaria, sickle cell crisis, and road accidents. Resources were minimal and so witnessed many things never seen at home, needle re-use on the same patient to avoid shortage, and if a patient could not afford a treatment, he did not get it. In Ghana, direct care of the patient, (washing, turning to avoid bedsores and feeding), are all the responsibility of the patient's relatives. Due to severe lack of resources many investigations e.g. CT/MRIdo not exist, Doctors rely on clinical skills and judgement. Symptoms that I'd read in textbooks were suddenly everywhere.

Overall an incredible experience learning and seeing so much, thank you DHSA for making it possible.


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