South Africa is a country rich in diversity - from the geography to the people - with a fascinating history and contemporary evolving democracy. The opportunity to interact with all kinds of people, from blacks and coloureds to Africaaners and european transplants was invaluable giving a glimpse of the true triumph that peaceful reconciliation represented back in 1994. The chance to experience international medicine as a student is unique as my role was largely in assisting and observing, asking and at times explaining "western" medicine in the US. From C-section deliveries to lumbar punctures there were ample times to practice procedures under expert and watchful eyes, but more importantly were the times spent discussing treatment rationale, the difference between approaches to medical treatment, and the unique system in the First/Third world environment of South Africa. I return knowing that primary care is essential and that we have much to learn from our international colleagues. This experience has inspired me to make international medicine a part of my career and to encourage all medical students and residents to take advantage of opportunities for international study and service. My time in South Africa gave me a new perspective on medicine! Instead of prompt lab results and CT/MRI down the hall, we relied on clinical exams and the expertise and experience of the doctors in treating everything from diarrhea in newborns to miliary tuberculosis in the setting of advanced AIDS. Doing more with less was a must - there was nothing in the hospital that wasn't able to be re-used or carefully conserved. I also gained a new sensitivity for patients whose treatment was dictated by socioeconomic constraints. Through effective public health programs based in local clinics we could ensure TB treatment compliance, chronic disease management through close follow up, and education on issues from nutrition to infectious disease prevention. The dedication and hard work of the 8 doctors who ran this 250 bed hospital, staffed the ER, clinic and ran the operating room was amazing and inspirational. | |
