Now it starts to get interesting.............

12th January

Did my first night as 1^st on call for obstetrics (& gynaecology) last night and finally feel as though I might be earning my keep. The night was busy with not much sleep opportunity and I was rather "wired" in the bits were I did get back to my room so sleep was fitfull even then- hence the short blog entry as I need to catch-up as the on-call is at best 1:2.  It all feels a bit like being a junior doctor again as this is a whole new way of doing things.  I am gradually adjusting to the reality of trying to manage things without any investigations and with none of the usual medications. Add to this the fact that they use the American version of many of the drugs that I am familiar with and you can begin to imagine the issues. Managed not to need to call on the local doctor (who definitely deserves a night off as he works a 1:1) but there were some moments of uncertainty.

I did a caesarean section this afternoon on a woman who came in from an external clinic and had been trying to push a baby out in a breech position for 12hours with a foot  (and scrotum) visible. Amazingly when she arrived the baby was still alive and he doing well on the ward after delivery.

As I expected the feelings of homesickness are abating as I get to know everyone and find my niche. There is a lot that could be done here but many basic resources are lacking (medical comment- we can't even dip stick urine for protein as there are no reagents!) and I am very certain I am not going to be bored!

Many of the other "faringe" have worked in Africa for a while or before and so there  is plenty of support and advice (the Orthopaedic surgeon from Canada worked in Burundi where they regularly ran out of sutures to allow caesarean to be done and knows all sorts of  ways out of trouble). Everyone is also very sociable and they have also come up with creating cooking solutions for the limited ingredients here (there is no dairy produce of any kind and aonly a small selection of seasonal vegetables) with someone making a delicious carrot cake yesterday. There is one problem I foresee, is that as I am surrounded by North Americans-you may have to forgive me if the occasional non- English syntax slips in!