Browsing "Medical Talk"
Jun 10, 2013 - Medical Talk    3 Comments


As my time in Zambia draws to a close, I’m starting to feel an ache at the thought of leaving. I can’t imagine not being surrounded by the colour and vibrance of day-to-day African life anymore, and I can’t imagine not spending my days amongst everyone I have come to know and care about at St Francis Hospital.

The cultural anthropologist Margaret Mead said “Never doubt that a small group of thoughtful committed people can change the world. Indeed, it is the only thing that ever has.” Whilst the current bunch at St Francis Hospital may not have changed the world, her quote still resonates. Of late I have been stealing moments to look around me at work… and as we clear through a packed outpatient clinic or attend to a ward emergency with the smoothness of a well-oiled machine despite all the challenges of a rural African hospital, I wonder if there’s anything we couldn’t do as a team if we put our minds to it.

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Apr 19, 2013 - Medical Talk    2 Comments

Managing as a manager

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…

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Jan 31, 2013 - Medical Talk    3 Comments

Malaria season

Given that Zambia’s average life expectancy is 52 years, and that 119 out of every 1000 babies born here are not expected to live beyond 5 years of age, I knew that I was going to have to face a lot of unwell and dying patients out here in Zambia… but as rainy season gets into full swing, and the anopheles mosquitoes come out in full force, the numbers of deaths climb to new highs.

In malaria endemic areas such as Zambia, most people who reach adulthood have developed a partial immunity to malaria; reducing the risk that malaria infection will cause severe disease. Children on the other hand are still developing this partial immunity, leaving them vulnerable to malaria.

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Jan 17, 2013 - Medical Talk    2 Comments


HIV/AIDS tends to be the first disease that springs to mind when thinking about Africa. However, on speaking to an infectious disease consultant in July 2012 for some last minute clinical advice before my big move to Zambia, it was Tuberculosis (TB) that dominated the conversation.

After I finished picking his brain about some of the things I might encounter in Zambia, his exact words were “you do know what the biggest threat to you is out there?” to which I quietly mumbled the correct answer: “TB…”

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Nov 28, 2012 - General, Medical Talk    4 Comments

The hospital tour in photos

I have been working at St Francis Hospital for over three months now.

When I first started here, everything was very different to what I was used to. I would walk through the wards glancing at the three children sharing a hospital bed in Paediatrics, or see the X-rays hanging up to dry on a washing line, and wonder what era I had stepped into. I was regularly shocked by the lack of seemingly essential resources. I could frequently be found asking in a shocked tone of voice “what do you mean we can’t measure sodium or potassium levels here?” or “what do you mean the hospital has run out of IV fluids?”

It is amazing how quickly I have adjusted to my new environment. I recently had my first visitors from home this month and as I took them on a tour of the hospital, I was reminded of what a fascinating place this is.

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Nov 19, 2012 - Medical Talk    1 Comment

Chronic diseases in Zambia

Everyday at work, I see patients with stereotypical infectious diseases such as typhoid fever, malaria and tuberculosis. However, practicing medicine in Sub-Saharan Africa today requires more than just managing tropical infections. On a daily basis, I also see many patients with non-communicable diseases such as diabetes, heart failure and high blood pressure.

These chronic diseases are often referred to as ‘diseases of the rich’, but in recent years have become increasingly common and problematic in developing countries.

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Oct 18, 2012 - Medical Talk    6 Comments

Infection control challenges

In 1847, an Austrian obstetrician (Ignaz Semmelweis) figured out that hand washing in hospitals saves lives. On trying to persuade the medical profession of this fact, he came up against considerable resistance, with public ridicule and dismissal from his post at Vienna General Hospital. Nonetheless, in 1861 he went on to publish ‘The Aetiology, Concept and Prophylaxis of Childbed Fever’, and his legacy lives on today as the pioneer of hand hygiene in clinical practice.

150 years have passed since Semmelweis’ seminal work on hand hygiene, and the world today is much more accepting of his findings. It is widely agreed upon that hand hygiene helps in the prevention and control of communicable disease. Nowadays, all healthcare workers receive training about the importance of infection control measures such as hand washing. However, is it always practiced?

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Sep 27, 2012 - Medical Talk    4 Comments

HIV/AIDS in Zambia

Before arriving in Zambia, whenever anyone heard about my plans to move here to work in a hospital, the conversation would usually move onto the topic of HIV/AIDS.

Non-medics: “Is there a lot of AIDS there?” “Are you sure you want to go there with all that AIDS?” “Do be careful!”
Medics: “Are you taking PEP (post-exposure prophylaxis) with you?” “Don’t forget to double-glove!”

I worked at Ealing Hospital in Southall, London for 3 years, and I thought I had seen plenty of HIV/AIDS there. Since arriving in Zambia, I realize that prior to my arrival here, I knew almost nothing about HIV and the potential devastation it can bestow on a person if diagnosed late or not treated.

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Sep 12, 2012 - Medical Talk    3 Comments

Decision making

When watching me try to decide what to order in a restaurant, it would be easy to assume that I am a person who is incapable of making a decision. I sit on the fence pondering over the chicken burger or the pasta of the day… At work, faced with slightly more pressing issues, I leave the indecision at home. Doctors need to make decisions, and quickly.

In the UK, the complexity of the decisions that a doctor is required to make increases with the doctor’s seniority and prior experience. That concept is tipped on its head when you uproot to an understaffed, rural hospital in Zambia.

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Sep 4, 2012 - Medical Talk    4 Comments

Lost in translation

Communication (from Latin “communis“, meaning to share) is the exchange of thoughts, messages, or information, as by speech, visuals, signals, writing, or behaviour.

For two people to fully understand a conversation that has taken place, as well as words and actions, there needs to be a rough awareness of the cultural and social context of the other person.

One of the big challenges in doctor-patient communication is that doctors tend to ask about objective symptoms, trying to sort and sift problems in order to formulate diagnoses. Patients, on the other hand, want to tell you about their illness and its effect on their life. Communication breaks down if the doctor doesn’t understand the patient’s world, and the patient doesn’t understand the doctor’s question.

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