Today was our
first day working at Kitona Referral Hospital, which was nerve-wracking in its
own right. It means that the MEDRETE has officially started, and there’s
nothing we can do about it now.
For the mornings,
we’re paired up with DRC military physicians, to see patients with them. My
physician partner is the equivalent to a first lieutenant (one rank behind me),
but he’s older. He also has a wife and five kids in Kinshasa, which came up in
conversation before our first patient arrived.
We spent more time
on the first patient than we should have, given how many patients we had to go
through. I think maybe the physician I’m partnered with was unsure about my
level of education or what my role is, because he explained things in much more
detail than necessary, instructing me on listening to heart and lung sounds
(medical student-level instruction). I didn’t say anything, but I should have,
because it made things drag on much more than necessary and didn’t really
accomplish anything. Tomorrow, I’m going to tell him that I’m okay on physical
exam, and what I really want to do while we’re working together is talk about
what he thinks the diagnosis is and why, and from there, to discuss the
differences (or similarities) between those symptoms in the States and in DRC.
I guess we’ll see if I have enough of a backbone to do that tomorrow.
The first case was
interesting, though. It was a young man, maybe 23, a college student with pain
with urination. My immediate thought was chlamydia or gonorrhea, both sexually
transmitted diseases. However, the physician I was working with didn’t ask
anything about sexual history (beyond “are you married?”), and definitely
didn’t ask the “men, women, or both?” question that I was taught in medical
school. He was leaning much more toward a urinary tract infection, which is
fairly rare in grown men in the US, outside of some other medical problem (HIV,
cancer, etc) or men who have sex with men. However, he said that UTIs are
common in men in DRC, due to poor hygiene, poor sanitation, and relative
dehydration.
The rest of the
morning was fairly routine cases, and then it was time to break for lunch (me,
not the DRC physician… they don’t eat as many meals as we do and don’t mind
working through the day). In the afternoon, we were supposed to have didactics,
but there was such an influx of patients from the community that none of the
DRC military physicians were able to get away. We found out afterwards that
that was because there was a message that went out on the radio saying that the
Americans would be here and would be giving out free medical care.
In other words,
the exact opposite message that we wanted to go out, which was that we would be
training in public health and infectious disease along with the DRC military
physicians.
Instead of doing
academics, we hammered out a schedule for the week we’ll be here, with what
we’re going to talk about on any given day, and then it was time to go back to
the hotel. This morning, the hotel manager told our logistics people that they
don’t have enough money to keep taking care of us (electricity, food, etc) for
eight days, especially with the list of needed repairs that we gave them
(showers not working, AC out, etc). We gave them one night pay each ($100 x 10
people) to help out before we checked out. When we got back from the hotel, we
found that they had repaired all the plumbing issues we brought to their
attention (for example, the switch deciding shower or bath in my shower was
broken, causing there to be a slight trickle of water from both) had been
repaired, and they had moved everyone who’s AC was broken into new rooms.
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| Landscaping at the Prosper, new since March |
Apparently, when
you give money to a business in the developing world, they reinvest it in their
business, instead of just lining somebody’s pocket, as usually happens in the
State. It was nice to see a hotel operating to provide hotel services, and not
just a profit.
Well, it was a
long day, and after waiting far too long for our food at the restaurant (as
usual), I’m ready for bed. I hope tomorrow goes smoothly.
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| Dinner tonight: lobster :) |
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