First hospital day I went on whats called a GUNS clinic - no idea what it stands for! But it's a small group of nurses that go out to remote villages. This time we went on a little boat over very rough seas to a tiny village on Kolombangara island to do a school visit. Unfortunately the school was having exams so half the kids the clinic was aimed at werent tehre! but for the few that were we did head to toe examinations checking or any abnormalities with any kind of system basically! One of the kids had a booming heart murmur - but the reality is that although we referred him to hospital on the main island, there isnt actually anything they are likely to be able to do! If he goes to the capital - which is unlikely because of the distance, they have only one day of the week where an echo might be able to confimr the type of murmur...but there isnt any surgery that can be done for him now... We also checked that they had had their BCG vacc and gave them tetanus and polio vaccination.
After we'd seen all the kids there, we packed up and went over to one of the nurses houses to wait for the tropical rain to stop! Dodged some pretty huge spiders along the way and hoped not to see any crocs!
Spent today in A&E Gizo. What an experience that was! There was just me and one otehr med student running the place... my medicine/common sense is surprisingly good when it needs to be! I ended up prescribing drugs, most of the time which werent even available from the phamarcy - including basica antiobios. WISHED i'd brought my BNF. Luckily, the Oxford Handbook has a surprising amount of info in it! Saw lots of interesting cases, had to tell some pts to wait and come back another day when a doc was around becasue there was nothing i could confidently do to help them! I ended up using tyhe light on my mobile phone as a light for doing female speculum exams - because there is no light in A&E. Its SO basic! Theres just no equipment - there are barely any sterile gloves, the one sink doesnt always have running water, crazy. Learnt TONS though, esp dosages of drugs that were regularly being needed - the nurses came in SUPER handy for that info too!
xx
Tuesday, 17 August 2010
A&E adventures Honiara
I forgot to mention my last friday in Honiara was spent in the A&E dept. Surgery is quiet on Fridays, so wondered over to the ED. It was SUCH a good day, I learnt loads and wished i'd spent more time there! Started off clerking patients which is always fun when you are left to do it on you own in a foreign language! The gesturing really came into it's own! I was very much left to devise my own care and treatment plans for the patietnts i'd seen...which was a little scary but I enjoyed the responsibility...at the time I didn't realise what Gizo would involve...thats another story for my next post.
A&E in Honiara is actually quite a new building with air con (thank god!) and is kept relatively clean with alcohol hand gel in at least 2 of the dr consultation rooms. GASP! I spent some time writing discharge summaries, prescriptions ready for the doc to sign, and then more clerking and pt examinations in the afternoon. It was interesting to learn a bit about requesting ultrasound scans, xrays, bloods etc. There are only very few tests that can be done and if you dont request it before about 3pm then it basically doesnt get done until the next day because staff go home!! It also wont get done between teh hours of 12-1 becasue staff go on lunch. Very frustrating at times when patients begin to back up A LOT! Similar frustration at thelack of drugs...again - 10 times as bad in Gizo. I did an 8-4 day for the first time since being here probably! Definitely going to do more when I go back for the last few days in Honiara.
A&E in Honiara is actually quite a new building with air con (thank god!) and is kept relatively clean with alcohol hand gel in at least 2 of the dr consultation rooms. GASP! I spent some time writing discharge summaries, prescriptions ready for the doc to sign, and then more clerking and pt examinations in the afternoon. It was interesting to learn a bit about requesting ultrasound scans, xrays, bloods etc. There are only very few tests that can be done and if you dont request it before about 3pm then it basically doesnt get done until the next day because staff go home!! It also wont get done between teh hours of 12-1 becasue staff go on lunch. Very frustrating at times when patients begin to back up A LOT! Similar frustration at thelack of drugs...again - 10 times as bad in Gizo. I did an 8-4 day for the first time since being here probably! Definitely going to do more when I go back for the last few days in Honiara.
Sunday, 15 August 2010
spiffing time at the birtish high commissioners
Hello from Gizo!
We arrived in the Western Province yesterday on a rickety little plane with no air conditioning - not pleasant! Although they did give us a very nice chocolate wafer biscuit. Ha! We got here in the pouring rain and soon realised that on a sunday taxis dont run. not a great start! we managed to contact our accommodation and they came and picked us up in their jeep with no working clutch which surprisingly got us all the way up the huge hill to phoebe's resthouse which is where we're staying!
Anyway, before I start raving about Gizo - we had a very eventful last few days in Honiara. On one of ourmany days at Honiara pool some of the girls bumped into the British High Comissioner of the Solomon Islands! Who knew they even had one! He was a very well spoken Cambridge graduate (of course!). Lovely young 'chappy', who has had the pleasure of meeting generations of medical students it seems! He invited us to use his house (which is more like a work of art) for showers, washing, food, guitar hero... We later got an invite to a cocktail party at the 'Residence of the British High Commissioner' (theres a very posh sign outside). We turned up and had to be buzzed through the huge securtiy gtes, it was a very posh affair, and we spent the evening mingling with other high commissioners of new zealand, people working for the world bank, people from various different ministries and political stuff! needless to say we felt very out of place in our slightly unclean, well travelled clothes! But a few champagne cocktails in the moos soon lightened up! We ended up on guitar hero until early hours of the morning! It was a very surreal night! And a nice change from our usual ventures to club extreme! (which we did later end up at on this same night...!)
We made some Fijian friends at extreme who were also keen to offer their house for showers and washing! It's a shame we're leaving honiara really just as we've made a load of new affluent contacts!
So, Gizo - Phoebe's Resthouse is a very sweet shack in the middle of a mini jungle type setting - perfect for mosquitoes as im beginning to find out! The view is stunning from the balcony. We met upwith some of the med students we first met in Honiara who moved to gizo a few weeks back which was nice.Theres also some others here who we are bonding with! There is a tv! GASP! and a shower with running water - although this is apparently very temperamental.
Internet and life generally is even more expensive here than in Honiara. Brilliant. But its much quieter and way more like what I would imagine the Solomon Islands to be. We are venturing to the hospital tomorrow.....
We arrived in the Western Province yesterday on a rickety little plane with no air conditioning - not pleasant! Although they did give us a very nice chocolate wafer biscuit. Ha! We got here in the pouring rain and soon realised that on a sunday taxis dont run. not a great start! we managed to contact our accommodation and they came and picked us up in their jeep with no working clutch which surprisingly got us all the way up the huge hill to phoebe's resthouse which is where we're staying!
Anyway, before I start raving about Gizo - we had a very eventful last few days in Honiara. On one of ourmany days at Honiara pool some of the girls bumped into the British High Comissioner of the Solomon Islands! Who knew they even had one! He was a very well spoken Cambridge graduate (of course!). Lovely young 'chappy', who has had the pleasure of meeting generations of medical students it seems! He invited us to use his house (which is more like a work of art) for showers, washing, food, guitar hero... We later got an invite to a cocktail party at the 'Residence of the British High Commissioner' (theres a very posh sign outside). We turned up and had to be buzzed through the huge securtiy gtes, it was a very posh affair, and we spent the evening mingling with other high commissioners of new zealand, people working for the world bank, people from various different ministries and political stuff! needless to say we felt very out of place in our slightly unclean, well travelled clothes! But a few champagne cocktails in the moos soon lightened up! We ended up on guitar hero until early hours of the morning! It was a very surreal night! And a nice change from our usual ventures to club extreme! (which we did later end up at on this same night...!)
We made some Fijian friends at extreme who were also keen to offer their house for showers and washing! It's a shame we're leaving honiara really just as we've made a load of new affluent contacts!
So, Gizo - Phoebe's Resthouse is a very sweet shack in the middle of a mini jungle type setting - perfect for mosquitoes as im beginning to find out! The view is stunning from the balcony. We met upwith some of the med students we first met in Honiara who moved to gizo a few weeks back which was nice.Theres also some others here who we are bonding with! There is a tv! GASP! and a shower with running water - although this is apparently very temperamental.
Internet and life generally is even more expensive here than in Honiara. Brilliant. But its much quieter and way more like what I would imagine the Solomon Islands to be. We are venturing to the hospital tomorrow.....
Tuesday, 10 August 2010
checklist of important things
- number of times I wish I'd bought my own hair straighteners; at least 7
- number of days the water supply has been off at Kiwi house so far; 10
- number of hangovers;...I wouldnt like to divulge this information
- number of mosquito bites; 30-ish
- number of arguements between me and Alex; surprisingly few! maybe...2. over very mundane things.
- number of hours spent at Honiara Hotel pool; 100 odd
- number of hours spent at the hospital; significantly less than the figure above
- number of times i've had cheese and crackers for lunch; every day. i am not at all bitter about this
to be continued....
And so the fun begins...
I managed to get signed off today by the head of surgery here (who's seen me all of about 3 times) but he ticked excellent for all the boxes so I must have made a good impression : ) It's tempting to take the rest of the time off, but I have been learning a lot, so will probs last the rest of the 2 days in Honiara hospital before we move to placement in Gizo.
Went to a surgical referral clinic this morning which is basically potential surgical patients that have been referred from the island provinces with problems which may not be able to be treated in the province but need to be seen in honiara. I sat in and saw some very interesting cases to do with the thyroid and complications of this surgery, ltos of query pyelonephritis and kidney stones, was good practice for doing GI examinations and examining hernial orifices - which there were also lots of.
Weds pms on surgery are quiet so to avoid spending the afternoon doing nothing I'm going to sit in on a paediatric clinic (assuming the doctor lets me).
Other exciting news - the market has been restored with its pineapple supply : ) so I just bought a huge one!
xxx
Went to a surgical referral clinic this morning which is basically potential surgical patients that have been referred from the island provinces with problems which may not be able to be treated in the province but need to be seen in honiara. I sat in and saw some very interesting cases to do with the thyroid and complications of this surgery, ltos of query pyelonephritis and kidney stones, was good practice for doing GI examinations and examining hernial orifices - which there were also lots of.
Weds pms on surgery are quiet so to avoid spending the afternoon doing nothing I'm going to sit in on a paediatric clinic (assuming the doctor lets me).
Other exciting news - the market has been restored with its pineapple supply : ) so I just bought a huge one!
xxx
hot bread kitchen pizza...hmmm
WHY I have only just discovered the title of this post I do not know. but on my wonderings around honiara today i made a standard visit to said kitchen and they had PIZZA!! and its amazing, and cheap. and makes for a much more exciting lunch than cheese and crackers (which, by the way, have become part of my staple diet!).
Placement in the surgical department has improved having stuck with it. Monday afternoon I admitted new patients which made me feel useful, it also led to some very interesting consultations with patients in quarter english, quarter pijin and half gesturing - which when you're trying to ask about breast lumps and bowel habits, can prove to be difficult. It's only when the first patient was laughing hysterically at me that I reliased how it might have looked! haha!
After admissions I scrubbed in for a psoas abscess drainage procedure and got to suture the drain in, the wound etc so I felt I'd had a productive day.
This is my third day in a row on the internet which has caused great excitement for me : ) As has washing my clothes.... IN A WASHING MACHINE!! Never have I been quite so thrilled to wash my clothes; whites were becoming greys, darks becoming white. And the smell...well. (joke) One of the guys that we've become good friends with lives in a very posh hotel apartment with a washer and tumble dryer. So Alex and I took all our washing round in bulk and spent the night putting on loads! We ended up there untill quite late and having consumed several bottles of red, we ended up in the hotel pool at ridiculous hours in the morning. Security weren't impressed! Oops!
The next day I wasn't feeling great....
Placement in the surgical department has improved having stuck with it. Monday afternoon I admitted new patients which made me feel useful, it also led to some very interesting consultations with patients in quarter english, quarter pijin and half gesturing - which when you're trying to ask about breast lumps and bowel habits, can prove to be difficult. It's only when the first patient was laughing hysterically at me that I reliased how it might have looked! haha!
After admissions I scrubbed in for a psoas abscess drainage procedure and got to suture the drain in, the wound etc so I felt I'd had a productive day.
This is my third day in a row on the internet which has caused great excitement for me : ) As has washing my clothes.... IN A WASHING MACHINE!! Never have I been quite so thrilled to wash my clothes; whites were becoming greys, darks becoming white. And the smell...well. (joke) One of the guys that we've become good friends with lives in a very posh hotel apartment with a washer and tumble dryer. So Alex and I took all our washing round in bulk and spent the night putting on loads! We ended up there untill quite late and having consumed several bottles of red, we ended up in the hotel pool at ridiculous hours in the morning. Security weren't impressed! Oops!
The next day I wasn't feeling great....
Sunday, 8 August 2010
Savo island
Hello again!
This weekend all the residents of Kiwi house (which is now a total of 7, including 2 new girls from cardiff uni) went to Savo island. Its a very small island which was supposedly only and hours boat ride from honiara....WRONG! it was an hour and 40 minutes on VERY rough waters in a tiny tiny boat not really designed for 7 passengers! it was very entertaining for the first half hour...but eventually the bumps, sea spray and scorching heat began to take their toll! we all wobbled off the boat at the end feeling quite abused by the elements! luckily we were greeted on the shore by the staff of the lodge we were staying in with coconuts with little flowers poked in the top - definitely not the type of service we have been used to in honiara! the lodge was situated right on the shore of a beautiful pebble beach. It had amazing snorkelling really close to the shore, we only realised afterwards that we had spent all afternoon snorkelling in shark infested waters! apparently they are only littlies though... I saw one roaming around the place whilst sat on the shore.
Saturday - I went on a little walk (much more manageable than the previous waterfall hike!) to nearby hot springs (savo has 2 active volcanoes), which i actually found fascinating! the locals apparently cook over the steam of the springs because its so hot.
In the afternoon we went swimming with dolphins which was AMAZING! i loved it, despite the numerous jelly fish stings which weren't so fun! The only down side to savo was the abundance of flies! absolutely everywhere.
The boat ride back was much less traumatic! and we spent the entire of sunday afternoon at the honiara hotel pool - where else!
In terms of other general news - we have found a resident 'dad's band' within the hospital compound - they were playing at the end of one of my shiftsthe other night so I went over and they had a full set of drums, a keyboard and 2 electric guitars with a whole crowd of people that eventually gathered to watch. it was really nice to shill with the locals! they askled if i could play anything, i had to say no, but jokingly offered to sing, and then REALLY wished I hadnt! ha! i managed to get out of it. they played requests - lots of bob marley!
Kiwi house is still standing, but the water supply becomes more and more temperamental as the days go by... I';ve taken to showering in the hospital operating theatres most days now!
This morning I have been to book flights to Gizo - a western province island where they have another small hospital which Alex and i will be working in for 2 weeks (in between diving and snorkelling!). So we're flying there on the 15th august and coming back to honiara on the 30th august for a last few days before oz!
Theres been a general election going on throughout the Solomon islands the past few days, there has been lots of speculation about whether any trouble is likely to kick off, but as of yet only a few ballot boxes have been burned... apparently any potential trouble will start when they announce who the prime minister is out of all the elected candidates for each region...luckily, by that time I will be in Gizo which strikes me as somewhere which has a less significant mob culture! There is a big police and army presence around at the moment though in case anything kicks off so I think it should be fine!
Spent last night in 'club xtreme' again last night....its becoming a regular occurence! but the music is just so good! shame about the expensive drinks though...but this problem has been solved on several occasions by befriending certain expats who throw their money around!
All in all, things are still all good, and we are loving the Solomons but REALLY looking foward to a change of scenery in Gizo.
xx
This weekend all the residents of Kiwi house (which is now a total of 7, including 2 new girls from cardiff uni) went to Savo island. Its a very small island which was supposedly only and hours boat ride from honiara....WRONG! it was an hour and 40 minutes on VERY rough waters in a tiny tiny boat not really designed for 7 passengers! it was very entertaining for the first half hour...but eventually the bumps, sea spray and scorching heat began to take their toll! we all wobbled off the boat at the end feeling quite abused by the elements! luckily we were greeted on the shore by the staff of the lodge we were staying in with coconuts with little flowers poked in the top - definitely not the type of service we have been used to in honiara! the lodge was situated right on the shore of a beautiful pebble beach. It had amazing snorkelling really close to the shore, we only realised afterwards that we had spent all afternoon snorkelling in shark infested waters! apparently they are only littlies though... I saw one roaming around the place whilst sat on the shore.
Saturday - I went on a little walk (much more manageable than the previous waterfall hike!) to nearby hot springs (savo has 2 active volcanoes), which i actually found fascinating! the locals apparently cook over the steam of the springs because its so hot.
In the afternoon we went swimming with dolphins which was AMAZING! i loved it, despite the numerous jelly fish stings which weren't so fun! The only down side to savo was the abundance of flies! absolutely everywhere.
The boat ride back was much less traumatic! and we spent the entire of sunday afternoon at the honiara hotel pool - where else!
In terms of other general news - we have found a resident 'dad's band' within the hospital compound - they were playing at the end of one of my shiftsthe other night so I went over and they had a full set of drums, a keyboard and 2 electric guitars with a whole crowd of people that eventually gathered to watch. it was really nice to shill with the locals! they askled if i could play anything, i had to say no, but jokingly offered to sing, and then REALLY wished I hadnt! ha! i managed to get out of it. they played requests - lots of bob marley!
Kiwi house is still standing, but the water supply becomes more and more temperamental as the days go by... I';ve taken to showering in the hospital operating theatres most days now!
This morning I have been to book flights to Gizo - a western province island where they have another small hospital which Alex and i will be working in for 2 weeks (in between diving and snorkelling!). So we're flying there on the 15th august and coming back to honiara on the 30th august for a last few days before oz!
Theres been a general election going on throughout the Solomon islands the past few days, there has been lots of speculation about whether any trouble is likely to kick off, but as of yet only a few ballot boxes have been burned... apparently any potential trouble will start when they announce who the prime minister is out of all the elected candidates for each region...luckily, by that time I will be in Gizo which strikes me as somewhere which has a less significant mob culture! There is a big police and army presence around at the moment though in case anything kicks off so I think it should be fine!
Spent last night in 'club xtreme' again last night....its becoming a regular occurence! but the music is just so good! shame about the expensive drinks though...but this problem has been solved on several occasions by befriending certain expats who throw their money around!
All in all, things are still all good, and we are loving the Solomons but REALLY looking foward to a change of scenery in Gizo.
xx
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