Amelia Wiggins’ Blog

Mduku

for the last 3 thursdays i have gone to a clinic in the town of mduku. it’s about an hour away. this has become my favorite day of the week. for starters we get to go somewhere in a car (with AC!) and then we stop at the local store and buy cinnimon buns, coke, and chocolate to snack on! it’s great. once at the clinic there are about 35-40 patients to see. i usually have a translator which means i get to see my own patients. over the 3 weeks i’ve seen a couple of the patients more than once. it’s nice to see how they are getting along. more than that though i’ve built relationships with the nurses. the nurses here are very different from back home. most do not have any higher education, some don’t even have a high school diploma. regardless, because there is a shortage of docs and an abundance of patient, they function as doctors 4 out 5 days a week. doctors only come to clinics once a week but nurses and hiv counselors are there everyday. it it their job to triage. they take a history and either initiate treatment, have them see us thursday, or send them to the hospital. with such little training they typically send anything somewhat complicated or confusing to us but they still manage a good number of patients on their own. 

today i gave a lecture to our nurses in mduku. they deliver babies there on their own. so they had questions about cord prolapse and hypertension in pregnancy. i know you’re proud mom! but don’t get too excited it was by far the simplest talk i could give. very basic things for them to do until the patient can get to a hospital.

i have a lot of respect for these nurses, and yet i am scared for the patients too. luckily they do have a low threshold to refer a patient. the bottom line though is that doctors are needed.

at the clinic today i saw an 83 year old woman! you do not see elderly people here so i was really excited. the poor thing is weak, but in good spirits. the family was concerned that she was weaker than usual and thought she needed to go to the hospital, but they didn’t want her to go because they figured she was at the end of her life and wanted her to die peacefully at home. on exam i didn’t find anything wrong. just an 83 year old woman who had lived 83 good hard years in africa. so we sent her home, the family was so excited. i really liked this patient, i have no idea what her name is and though i told her to come back next week so we could check up on her i doubt i’ll see her again. but i wish i could’ve gotten to know her. i wonder what kind of stories she has. think of what she has seen. when she grew up hiv/aids wasn’t around. so while she is untouched physically she has seen it affect her children, grandchildren, community… not too many people in the generations below her will live to be her age. she has probably out lived the majority of her own children already. and to go through the aparthied era and see nelson mandela take office… 

it was nice to be able to send her home. in the States i think we would have admitted her for no good reason other than we don’t like it when people die. and who knows she may have a long time yet to live, she sure seemed like she had some life left in her!

dad, i also saw a patient today with afib. a young woman probably about 25. we did admit her to the hospital because her INR was out of wack and the only way we can make sure it levels out and to know that we have her on the proper coumadin dose is to have her sit in the hospital until it normalizes. anyway made me think out you!    

next week us doctors are having a squash tournament! i’m really looking forward to it despite the fact that i have never played squash before. it should be fun though! if any of you have played squash i would love any tips