Arriving in Katete

We have now been at St Francis’ for just over a week.  We travelled here on Wednesday 2^nd January and were welcomed to Zambia by an almighty downpour of rain which followed us along the Great Eastern Road as we were driven the 100km from the border to the hospital.  On arrival we were impressed to find a nice little studio which is to be our home for the next six months (complete with double bed, fridge, cooker and hot water!!)   Now with the addition of our filter coffee machine and 2kg Malawi coffee, we are only one guardian subscription away (I don’t think they deliver here) from a very pleasant existence.  For food, our evening meals are provided by the Doctors’ Mess, where Patrick and his team cook up an excellent selection of Goat stew and rice, chicken stew and rice, Fluorescent-red sausages and spaghetti, and of course the quintessential Sunday chicken roast – sort of (Becca)

After a day to settle in, we started work on Friday, and had to fight it out between Medicine and Paediatrics.  Becca won (LOST!! – Becca) and has spent the week on the Paeds Ward, opting for the baptism-of-fire approach to African Medicine.  With Fi (a GP trainee who has been here for 6 months) as a tutor, she seems to have become quickly quite confident, and her language skills in local Chichewa have come on a lot more than mine (although I can now ask about coughs, diarrhoea, and tell people to sit up and lie down). 

The adult male medical ward has become my main place of work, and is fortunately not too alien an environment.  There are some similarities with the UK (you have to get along with the nurses, drug charts go missing, and most people go home eventually, although some die).  The differences are mainly the underlying conditions, with most being HIV positive, often newly diagnosed with advanced HIV, and most patients being the same age as me.  It has been a good challenge, diagnosing and treating without the benefit of many investigations, and reassuringly our management does seem to work in most cases (learning a bit of Tropical Medicine in Liverpool has certainly helped). 

After ward rounds we head to the outpatient department (OPD) which has taken a bit of getting used to, but is quite good fun.  Patients turn up in the morning and join the queue for clinic, turning up with anything and everything, in all conditions from being completely well to moribund.  There are usually 3-4 doctors sitting in one room with a patient each, and a couple of translators providing interpretation, as well as, I think, a good measure of their own advice.   The whole thing seems somewhere between General Practice, A&E and a medical clinic, which gives a good amount of variety.  The lack of confidentiality is quite something to get used to as everyone hears everyone else’s problems in details, and sometimes even gets involved themselves!

I think we will enjoy our next six months in Katete, as I think the clinical work will be good fun and interesting, and the doctors mess has a great social atmosphere.  I hope that as well as providing clinical care, although more challenging, we will have a positive impact on the educational and organisational side of things, although we are realistic about the likelihood of this happening.

Our House (the outside)

Our House (the inside)