Dr. Nat's Journal

Back in the UK, a doctor of my age and experience would tend not to be involved in many hospital management decisions. I have sat on committees during my school and university years, but the decisions we were making were about what charity we should raise money for, or where the end of year social should be held.

Here in Katete, with so few doctors, there is really no option other than getting involved in hospital management… and when I say involved, I don’t just mean showing up for a meeting or two…

Currently at St Francis Hospital covering medicine and paediatrics, there are five doctors (myself included). We are all about the same age and have all been doctors for roughly the same amount of time.

On a pretty regular basis, we find ourselves frantically trying to devise contingency plans because the pharmacy has run out of insulin, or the full blood count machine has broken, or the blood transfusion stocks have been used up. As crazy situations unfold all around us, I often take a moment to marvel at the problem solving and innovating that we’re doing despite our inexperience.

It isn’t all excitement though, and there is no way to avoid paperwork when getting involved in management roles. The administrative task of notifying the ministry of health of all cancer diagnoses at the hospital has fallen upon me.

There is also no avoiding leadership. The matron for the medical wards cornered me a few weeks ago, and asked me to chair the medical department budgeting and directorate meeting. She handed me a stack of papers with spreadsheets about equipment ordering and estimated spending for the next three years. She asked me to propose an agenda and schedule a meeting. Although I was somewhat daunted by the endless tables of numbers, the issues that arose about our limited resources and ever increasing patient numbers made for an interesting meeting. It felt nice to be discussing changes and improvements that will last beyond my time here.

Although I will always be first and foremost a doctor, this year at St Francis Hospital is equipping me with skills beyond the clinical that are bound to come in handy wherever I may find myself in the future.