First day on the wards

Today I met my supervisor to discuss my project. However I spent most of the time on the paediatric ward, and had a great day- funny, for someone who claims to not enjoy clinical medicine too much. Maybe its because it means I'm now occupied from an external source.

The system in the MRC is very British but healthcare staff hierachy is less obvious. Everyone was incredibly accommodating and I saw lots of interesting and sad cases. For example, a young baby presented with malnutrition because his mother had died so he had no suitable source of nutrition. His great aunt was looking after him but obviously couldn't give him breast milk and formula costs more than the typical Gambian weekly earnings. Other conditions I saw today were beriberi, prune belly syndrome (it really does look the way you'd expect it to), hepatocellular carcinoma, molluscum contagiosum, and as you'd guess, HIV/AIDS, TB, and marasmus.

I've already surrendered my clip-on alcohol gel spray to a nurse who was fascinated by its dispensing mechanism. Even though this is a well-funded hospital for its location, there is still great need, even for tiny things- for example, the clinic's tourniquet was in shreds- I wonder how it could ever have created enough pressure to bleed even an end arteriole.