Dr. Nat's Journal

Most people have had to listen to someone from an older generation reminisce over the good old days, with a conversation that starts something along the lines of “back in my day…”

In the medical world, this kind of conversation occurs when a ripened consultant talks of the pitfalls of the modern NHS. They harp back to ‘their day’ when they worked 48-hour shifts and lived on hospital site, when matrons ruled the ward, and doctors really knew the meaning of continuity of care.

The more time I spend at St Francis Hospital, the more I believe that when I boarded the airplane at London Heathrow, it wasn’t really a plane, but a time machine that has transported me to a bygone era of doctoring.

Read on…

St Francis’ Hospital is a large and busy hospital serving the local population of Katete District (over 200,000 people) and receiving referrals from all over the Eastern Province of Zambia (about 1.5 million people).

In Zambia, the concept of a GP or family physician only exists in the private sector. The public health system provides primary care through health centres, staffed by clinical officers, nurses and ancillary staff. These people have been trained to identify and manage common clinical presentations such as malaria, but they are not doctors. The patients who are referred to the hospital to see a doctor usually have had little or no treatment started. Therefore, although my work involves seeing patients in a secondary care setting, it has a feel of primary care to me.

Read on…