Push and shove, worms and malaria…10/30/09

This past week I finally started shadowing at the hospital!! WOOOO Praise God! Anyway…This week I followed Dr. Balde because Dr. Dah (who I’ll normally be shadowing) had to be at meetings all week. Dr. Balde is a general physician who likes pediatrics. So in the morning he does his rounds in the pediatric wing. I guess he’s going to switch to peds?? I’m not sure how that works here. But….it was interesting to see some of the differences in health care. Such as…

• Cleanliness, has a whole different meaning here. Most of the rooms are small and have multiple patients in them. The rooms we visited had 2 or 3 or sometimes more patients in them depending on the size of the room. Privacy is nonexistent here. Also the rooms are very closed in. There are windows but no one opens them, not sure why. When we go on rounds in the morning sometimes the doctor or nurse will open the window to air out the smell, but I think that might be the only reason they open the windows …because of the smells. It’s kinda hard seeing all the closed windows and dark rooms when there’s so much fresh air and sunshine outside. I’m telling the people at church home important these things are but at the hospital they don’t even crack the window for fresh air unless it stinks. I don’t have much say at the hospital so I keep my mouth shut, plus I don’t speak enough French to tell them. But I can tell the people at church..and you! Open your windows!! Sunlight and fresh air are good!!!!
• There aren’t really private practices here. Everyone goes to the hospital and the doctors see you in their offices and diagnose you or refer you to the lab or the pharmacy or somewhere.
• There’s no such thing as appointments. So basically the best strategy is to get to the hospital as early as possible and get a consultation type paper. That gets you in to see the doctor that deals with whatever your problem is. Then you go to their office and hand them the card and they call you in when they get to your card. Having an appointment means nothing. Getting your card into the hands of the doctor first means everything. Sometimes when you open the door to call the next patient a flood of arms come at you with papers and cards and trying to get them into your hand first. Sometimes they even try to push themselves in or they’ll walk in while you’re in the middle of examining or talking with another patient…that’s why they lock their doors here. They WILL knock you down to see the doctor and tell every kinda sob story to try to get in quicker.
• Being an “El Hadj” or older man gets you in to see the doctor fast…even if you have no papers. That’s Muslim culture. I mean what can you do if an older, revered man comes and wants to see you right away…you can’t turn him away. Either because he’s a respected religious leader or he’s the old man who watched you grow up and will still reprimand you.
• There’s a prescription for EVERYTHING. It doesn’t seem like many tests are done to confirm things. Like if you have the symptoms of malaria they just write you a prescription for medicine…even though it’s usually malaria since this is a malaria hot spot, but still. So whether its worms, malaria, sore throat, cough…whatever you’ll get a prescription. One incident that I thought was funny was that the doctor sent someone to have an x-ray of their sinuses because they were congested and stuff but no one is sent to the lab to confirm malaria or worms or stuff. Funny huh?

I guess I can kinda see why things are done this way. There’s a lot of malaria, worms, sickle cell, and malnutrition related sicknesses here. Not much deviation so why bother looking for something that’s not obvious. Maybe that’s their reasoning. Anyway I like it so far. Working with Dr. Dah will be interesting because she deals with HIV and infectious disease patients I think. So we’ll see what happens next week.

Nothing new outside of that really. Health talks are going well. Tomorrow I do a talk about Air. Last week was Sunlight. I think they’re receiving it well so far. Anyway its almost 4:30p here and we have to leave to go to church soon. Until next time… ~Alex