Hospital bits for the week:

Posing outside the hospital

We seem to have settled into a routine for the hospital, and while it may change next week when I’m the only student around, it seems to work fairly well at the moment.

First thing in the morning is General Ward rounds. Very similar to those in the UK, where we just go from bed to bed, seeing how the patients did overnight and discussing any potential change in management. However, unlike in the UK, we’re actually asked for our opinions – and not in an ‘I’m-asking-for-your-opinion-so-I-can-grill-you-on-your-knowledge’ kind of way. There have been quite a few times when they’ve changed their management because of what we’ve said. Quite daunting at first, but it does keep us on our toes and means we don’t tend to fall asleep whilst they’re talking about things. One thing we do have to keep in mind is what more can actually be done, seeing as they don’t have even the most basic of blood tests (no LFTs, U&Es and only rudimentary FBCs). There isn't a CT scanner in the whole of the Solomon Islands!

After ward round, we head over to the maternity ward, where we do the ward round and baby checks on all the newborns. I had been told they get about 30-50 births per month, but think that’s a bit low – it’s probably closer to 75, so 1-2 babies to check every day. Syphilis is very common here, so they always check for that, and mom and baby often need to have a course of antibiotics. Ironically, the nurses don’t seem to understand the disease very well, so one doctor asked me to get out some of my lecture notes on it and give a tutorial on Monday – (I’d never seen a case until I came out here).

After baby checks we go and see what’s happening in theatre. On Tuesdays and Thursdays they tend to schedule operations so on other days there may be the occasional urgent appendicectomy or something, but it’s mostly just dressings of large wounds that might need to be done under ketamine or local anaesthetic. I say ‘just’ but in fact some of those wounds are incredibly large and nasty. Don’t get diabetes in a humid, tropical country let me tell you! I won’t subject the squeamish amongst you to the photos I have, but I will have a large folder full for those of you interested when I get back. Lucky they haven’t invented cameras to record smells yet.