Showing posts with label STDs. Show all posts
Showing posts with label STDs. Show all posts

Tuesday, June 11, 2013

6-11-13: Last Day at the Hospital

Today was the last day in the hospital, which was good. I think I’ve seen just about as much of that place as I can handle. For now, anyway.
                
There was some initial confusion about which doctors the three physicians were going to work with, with Dr. Patrick being in surgery and nobody really that trilled about working with the triage physician. Finally, Dr. Lesho bit the bullet and went with the triage doctor, and both Dr. Mann and I worked with the pediatrician. Since there weren’t any patients waiting to be seen, we went upstairs for rounds and saw the kids on the inpatient wards.
                
After rounds, I worked with my translator on my presentation about HIV in the US Military, and then it was time for a tour of the nursing school. It’s a military nursing school, with most of the students in the military, and a few civilians who pay tuition. We actually interrupted their finals, which I felt a little bad about.

The group outside the nursing school

The school itself wasn’t too bad, although outdated. They actually still have an iron lung in the clinical simulation center, which has got to be the oldest one still around. I don’t know if it’s still operational or not; somehow, I wouldn’t be surprised.

Iron Lung

After the tour of the nursing school was lunch, and then we had the last day of academics. We had two lectures on blood security and blood transfusions, one about the program and stats at Kitona, and one from LTC Cannon about WHO standards. I was actually surprised at how robust the program is here—they don’t pay anyone for donations, which is good, and test every unit of blood for HIV, syphilis, hepatitis B, and hepatitis C. It’s not nearly as many as we test in the States, but it meets WHO recommendations, which is always good. They do have a strange policy where they only transfuse matched blood—an A patient will only get A blood, etc. I feel sorry for their AB patients. There aren’t many of us out there.
                
The third lecture was about sexually transmitted diseases at Kitona, and then I wrapped up academics with my presentation about HIV in our military. It actually started an argument between the hospital commander and the deputy commander of Kitona Base, who was there to present the completion ceremonies. The hospital commander asked why all the recruits at Kitona didn’t get tested when they joined, the way our recruits do (and according to DRC policy, as we learned yesterday during academics), and the general said that it’s the hospital commander’s responsibility to do it. There were angry words flying around in French all over the place, but hopefully they’ll figure something out to get the testing done.

My presentation on HIV in the US Military

After the awards ceremony (read: speeches and certificates), we headed back to the hotel, and then down to New Cliffs restaurant (our usual dinner place) for a final Muanda dinner. We invited our translators and the hospital commander, and hired a music/dance group. It was a lot of fun to hear and see traditional music and dances from Bas Congo, and everyone got up on the dance floor at least once. Yes, even me, but I really hope there are no pictures of this out there.

Dancing

I gave Lt. Olivier, my translator, a gift at the end of the night: my Army Medical Department regimental crest. I brought it with the intention of giving it to the doctor I worked with, but I didn’t end up forming any sort of bond with any of the doctors, and Olivier and I got to know each other fairly well. I told him that it was what American Army doctors wore on their uniforms, and after translating for me all week, he was practically a doctor and should have it. I think he appreciated it.

Tomorrow we fly back to Kinshasa, and then there’s a couple of days of stuff that we have to do for the embassy before we head home on Friday night.


Final group picture in front of the hospital


Tuesday, August 5, 2008

Can we make this any more awkward?

Actually, to be fair, STD clinic wasn't nearly as awkward as I feared it would be. Most of the guys (and the vast majority are guys) have been through this before and know what to expect. Most also realize that them being there is their own fault.

I saw three patients today, and they were all pretty straightforward--one got a phone call last night saying someone he slept with tested positive for chlamydia and he should go in for treatment, so we ran some labs and gave him some medicine. The other two were a few days early for what we jokingly call "green light Friday". They don't have any symptoms, don't have any contacts with anyone with an STD that they know of, they just want to be screened to make sure everything is okay. So we draw blood and take a urine sample and give them a phone number to call if they don't hear from us first.

After that, the day was significantly less exciting. I went through the CDC's online TB course (which mostly consists of reading mind-numbingly boring powerpoint-type slides and answering questions) and then went over the first chapter in the epidemiology textbook with one of the residents. Then I went to the DA's online smallpox vaccine course (more powerpoint slides, more questions). Those were even more mind-numbingly boring than the CDC's TB stuff, and not even laughing at whatever the interns were talking about was helping me stay awake. It didn't help that our office was probably over eighty degrees even with the fans on.

Since I overslept this morning (my cell phone for some reason froze at 4:45 am, so there was no alarm), I didn't get to run before work, so I tried running after work, when it was almost ninety degrees outside. Needless to say, I didn't run far. Hopefully there will be no repeat performance from my cell phone, and I'll be able to run when it's still cool out tomorrow.

Thursday, July 31, 2008

STD day

No, I didn't get an STD, I just spent the entire day reading about them. Seriously, I probably read 150 pages of information about STDs in preparation for working in STD clinic (which is the biggest clinic we have; it runs every morning).

In between articles and guidelines for STD treatments, I worked on other things, like my journal club presentation for tomorrow. Sure enough, on the paper to fill out to "guide our thinking" (read: questions we will be asked about), the last category was "impact on clinical practice". So I stared at that for awhile and then figured if I did something else, it would come to me. The article I chose was about how people order at fast-food restaurants when the calorie information is visible while they're in line, so I couldn't figure out what that would have to do with a clinical practice. When nothing came to mind, I asked Captain Peik (one of the interns) what I should put. After describing the results, he said "Oh. Just put 'require fast-food restaurants to post calorie information at point of purchase'." That's right, I can do that; this is preventive medicine. My 'clinical practice' has nothing to do with one patient, but rather one community (such as an Army base) and about making changes that would make everyone healthier.

And after I did that, it was back to STD reading.