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RÊRM, RIAN, RÁK (BEGIN, LEARN, LOVE)

Filed under: GEMx Regional Exchanges

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Post by Henil Upadhyay, a medical student at Pramukhswami Medical College who completed an elective exchange in Internal Medicine at the Faculty of Medicine, Srinakharinwirot University (SWU) in Thailand through the GEMx-SEARAME Regional Exchange Partnership.

With Dr Sirapat Tulthamaki in the Internal Medicine dept

RÊRM: The Beginning My elective program at the Faculty of Medicine, Srinakharinwirot University (SWU), Thailand was the beginning of a new adventure as this was my first elective experience. On reaching Bangkok and watching “The City of Angels” rise at dawn on route to SWU was truly exhilarating. On arriving at the university I met Ms. Sureerat Ruangsri from the International Relations Office and Dr Woro Ariandini an elective student from Indonesia. She briefed us about our elective and we took a tour of the university. I had two week electives each in Internal Medicine and Pediatrics at HRH Princess MahaChakri Sirindhorn Medical Center (MSMC). The SWU campus is wonderfully designed and comprises of a large lake and multiple canals. We were provided accommodation in the medical student’s dormitory.

With Dr Woro Ariandini, GEMx elective student from Indonesia

With Dr Woro Ariandini, GEMx elective student from Indonesia

RIAN: The Learning Phase My first elective was in Internal Medicine where I met my supervisor Dr Sirapat Tulthamaki. It was an absolute pleasure to work with her. My daily schedule in the Internal Medicine department consisted of attending OPDs, grand rounds, conferences, and ICU rounds. I was able to observe a wide range of diseases both infectious and chronic non-infectious diseases. Interestingly, both India and Thailand share common epidemiology for a lot of diseases. Language is one of the barriers any elective student faces in a foreign land and while most of the patient communication took place in Thai the medical students and professors stepped in whenever possible and helped me overcome this barrier. Along with enriching my clinical knowledge the OPD clinics of various sub-specialities such as Pulmonology, Haematology, Rheumatology, Chronic Kidney Disease (CKD), etc. gave me a new insight on patient care and an understanding of the health care system in Thailand. My most memorable experience was in Chronic Kidney Disease (CKD) under Dr Siriphar Chang Sirikulchai. She has been very passionate in teaching medical students and providing comprehensive care to Chronic Kidney Disease patients.

With Dr Vatsal, Dr Ariandini and Dr Maliwan

With Dr Vatsal, Dr Ariandini and Dr Maliwan

The CKD clinic was being run very efficiently by incorporating teamwork from both medical and non- medical staff. They also arranged various activities for dietary counseling, pharmacological counseling, and lifestyle practices. In the afternoon conferences a team of resident doctors would present a clinical case to medical students and a panel of professors who would discuss the case with students at the end. I found that this was a very effective method of teaching clinical subjects as it teaches us how to approach a patient in clinical practice rather than just theoretical knowledge of the subject.

At the Wat Mahathat meditation center in Bangkok

At the Wat Mahathat meditation center in Bangkok

My second elective was in the Paediatrics department under Dr. Patamakom Pruengprasert. My daily schedule was attending ward rounds, OPD clinics, and conferences in the afternoon. Dr. Patamakom was very keen on teaching medical students. After ward rounds, were posted in NICU where premature and very sick babies were being kept so that they can receive round-the-clock care and supervision. In the afternoon I attended the paediatrics OPD under Dr Sombun Chansakunporn and Dr. Panit Taksinstien. The pediatrics department had also started a Well Baby Clinic every Wednesday where all the children were examined for adequate growth and immunization status, and the parents were counseled about the physical and mental growth of the child and the importance of regular follow-up. These electives taught me a lot about Thai culture such as the norm of greeting professors with the traditional “Wai” which I believe inculcates respect for them. Also observable was the high nationalist sentiment in Thai citizens for their country and monarchy. Learning and integrating into Thai culture and customs was truly an exhilarating experience.

RÁK: Love from Thailand We got the opportunity to explore Thailand away from the hospital during weekends. Dr. Nakharin and Ms. Nhoi helped us a lot in making travel plans. I was very fortunate to meet Mr. Maliwan at SWU who became my lifesaver in Thailand. He made sure that we didn’t face any difficulty in our trip due to the language barrier and he even accompanied us on our weekends to Bangkok. My most frequent trips were to Bangkok of course. Public transport in Thailand was easily accessible and it made our trips untiring. Bangkok’s diversity was transcendent. From the Grand Palace’s majesty to the Wat Mahathat’s simplicity and from Chatuchak’s noisy market to Chao Phraya’s serenity. Bangkok had it all. While in Bangkok I got the wonderful opportunity to attend a course on Vipassana meditation at the Wat Mahathat temple. The experience at the Wat Mahathat meditation center has made a profound impact on my mental and spiritual health and has given me a new direction in life.

With Dr Maliwan in Ongkharak

With Dr Maliwan in Ongkharak

My next visit was to Pattaya city. It is located about 100 kms southeast of Bangkok in the Chonburi province. Pattaya which is a peaceful beach city in the day quickly turns into a party spot at night. After spending the day at the Art in Paradise 3D museum we wandered off to the beach in the evening. Pattaya gave us a wonderful experience indeed but it was nowhere near to the trips in Bangkok. One of my major concerns before coming to Thailand was regarding food. I must say initially I was very apprehensive regarding Thai food but soon I was in love with it. The fine balance between different spices to produce that umami taste was only possible in Thailand. The medical students and Leo made it a lot easier for us to understand the Thai menu and they even took us to new places to set our taste buds on fire. I would like to thank ECFMG|FAIMER for their generous contribution towards funding my elective. I greatly appreciate the support of my professors here in India, Miss Elise Moore from GEMx, and Dr. Amarin Narkwichean. I would also like to thank Mr Maliwan for helping us in every possible way during our stay in Thailand and filling it with new adventures. Thailand’s diversity and its all-accepting culture have made me fall in love with it.

To Durban and Back: A Family Medicine Adventure

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Post by Punam Ajay Raval and Grace Vugutsa Magada, medical students at Kenyatta University, Kenya who completed an elective exchange in Family Medicine at the University of KwaZulu-Natal School of Nursing and Public Health (South Africa) through the GEMx-AFREHealth Regional Exchange Partnership.

Our four-week elective at Wentworth Hospital, Durban remains one of the most clinically and culturally-enriching experiences we have had.  From exploring our interests in Family Medicine; a specialty well-established in South Africa, to learning essential clinical skills under highly experienced health professionals; and forging invaluable personal and professional ties, all while relishing the beauty that is the golden coastline of Durban – ‘fulfilling’ might be an understatement!

The Beginning

Our arrival in South Africa was marked by a warm welcome by our host, Vivienne Venter, and her family. In our planning, the resourceful GEMx regional team had provided a list of accommodation options and Viv’s was the most cost-friendly, trusted and reliable. She had hosted several other groups of GEMx elective students and was well-versed with the program. The premises were, admittedly, a bit of a distance from Wentworth, but we were soon acquainted to the public transport system – kumbi, minibus taxis that are much like the Kenyan matatu.

With our home school, Kenyatta University (KU), University of KwaZulu-Natal (UKZN) and the regional GEMx teams having fully guided us through the application process, travel logistics and clinical placements, we were well-prepared for the program that awaited us. We would be rotating within the different departments of Family Medicine at the Wentworth Hospital in eThekwini health district for a four week span. Each week would have its clearly-outlined set of practical objectives, Continuous Medical Education (CME) sessions, ward work and clinical assessments.

Orientation at Wentworth Hospital

Wentworth Hospital, founded in 1943, is a district hospital that is part of primary healthcare provision in the eThekwini health district, which serves a number of patient catchment areas. The hospital focuses on provision of services that not only restore health, but also facilitate wellbeing of the person and community in its Family Medicine practice. As such, students from the Nelson R Mandela School of Medicine (University of KwaZulu-Natal) benefit from the hospital during their Family Medicine block. It also has Physiotherapy, Psychiatry, Psychology, Social Work, Dietetics and Occupational Therapy departments among several other community health outreach projects. Additionally, the Accident and Emergency Department receives and handles acute emergencies from the nearby areas. This setting served to expose us to an undeniably holistic system of patient care.

With the South African-Cuban exchange students at a teleconference session

With the South African-Cuban exchange students at a teleconference session

Our elective began with a comprehensive orientation by Professor Mergan Naidoo, the GEMx Elective Coordinator at UKZN and Dr. Mukhinindi, a Family Medicine registrar at Wentworth Hospital. They gave us a detailed brief of the respective clinical areas, our schedule and objectives as well as the running of the South African health system.  This understanding would be crucial in our set activities for the next month.

We received a comprehensive logbook that included rotation sites for every week, meetings and bedside tutorials to participate in. On our list of tasks was the formulation and presentation of a Quality Improvement Project (QIP) on the topic of care of Chronic Obstructive Pulmonary Disease (COPD) patients.  In an interesting and fun twist, we were also tasked with bingo cards with several objectives to be completed in different departments and programs of the hospital. This was organized in a bid to gain understanding on the importance of a multidisciplinary approach in the healthcare setting.  With plenty of tasks at hand and learning to do, we were ready to hit the ground running in all things Family Medicine for the next month!

The Clinical Experience

For a week each, we rotated in the Outpatient Department (OPD) & Procedure Rooms, the Acute Medical Ward & High Care Ward, the HIV Masibambisane clinics as well as the Accident and Emergency department. We assisted the interns in drawing blood, inserting intravenous lines, doing lumbar punctures, ascitic taps, incision and drainage, suturing and removal of sutures. As a result, we gained confidence in these essential clinical skills. We clerked patients with a variety of conditions and were assessed by the medical officers in our data gathering, diagnosis, therapy and counselling in several Mini-Clinical Evaluation Exercises (mini-CEX) that kept us on our toes. Indeed, we were sharpening our skillset all through.

In the medical wards, we attended two ward rounds each day, one with a Family Medicine physician and another with a specialist, Medical Officer or Registrar. During the ward rounds we would discuss the aspects of history, presentation, clinical exam, diagnosis and management of different patients. After the rounds we would assist the interns and nurses in procedures like ECG placement and interpretation, peak expiratory flow measurement as well as drawing blood. In addition to the highly beneficial teaching rounds, we had several individual and group tutorials by the Family Medicine Registrars on commonly-occurring conditions. At this point in time, we had been joined by a second group of elective students from Zimbabwe as well as the South African-Cuban exchange students. This made for very lively learning and discussions, with input on different countries’ clinical spectrum of illnesses.

Our participation in the HIV clinics and perhaps our favorite part of the clinical rotations was nothing short of enlightening. With more than thirty years of the HIV epidemic, despite no cure or effective vaccine, there have been major advances in its treatment. South Africa carries a large proportion of the global HIV burden, but with the availability of antiretroviral therapy, what was initially a fatal disease has been transformed to a manageable condition. Dr. R. Ryan, the experienced Medical Officer in charge of the clinics guided us through the initiation of HIV positive patients on antiretroviral therapy, the treatment of common opportunistic infections in these patients as well as the country’s approach to their care. In this light, we were also honored to meet Professor Thumbi Ndung’u, key player within the Africa Health Research Institute (AHRI) at the UKZN Main Campus, to discuss his progress in cutting-edge HIV research. In addition, we attended an informative lecture on the role of dolutegravir in antiretroviral therapy by Dr. Richard Lessels, infectious diseases specialist and group leader at the KwaZulu-Natal Research Innovation and Sequencing Pattern (KRISP) at UKZN.

For our fourth and last week at Wentworth, we were placed in the Accident and Emergency department.  It was here that we perfected our triaging skills and got to fully understand, respect and participate in the management of emergency cases. All through this period, we received excellent guidance from the nurses, interns, registrars and physicians who were always willing to pass down their knowledge and take us under their able wings. We remain indebted to them for their time and kindness.

Durban, the Gem by the Sea

Blessed with seemingly endless golden beaches, wonderful warm weather and a uniquely multicultural heritage, Durban offered us quite the amazing experience for our weekends away from the hospital.

The Young Christian Surfers’ Group

The Young Christian Surfers’ Group

With our hosts, and dear friends made along the course of our electives, we were able to happily make a dent in our to-do list of tourist fun!  We walked along the Golden Mile, a beautiful beachside promenade lined with restaurants, curio shops and the iconic Moses Mabhida stadium. Along this stretch is also the uShaka Marine World, an aquarium set on replicas of four shipwrecks. Getting up close to the marine life through the impressive underground viewing galleries was surreal!

A favourite was our visit to the oldest surviving garden in Africa – the Durban Botanic Garden, as well as the walk along the Umhlanga pier and nature reserve with medical interns from Wentworth. It was after this that we experienced one of the traditional Indian delicacies that Durban is famous for: Bunny Chow. Often referred to simply as a bunny, this a South African fast food dish consisting of a hollowed-out loaf of white bread filled with curry. Warning: the levels of spice in this are not for the faint-hearted!

Our host was part of a volunteer group, the Young Christian Surfers, and we enjoyed spending some Sundays helping out with the great work they are doing in taking care of the less fortunate as well as teaching young children to surf along the town beach.

Lastly, one of our most enjoyable and uniquely Durban experiences was our ride on the Rickshaw tour-bus, a visitor’s lovely three-hour introduction to city centre and its surrounding suburbs. It was an excellent way to get insight into the city’s rich history and culture.

 

The uShaka Marine World        

The uShaka Marine World

The Ethiopian Experience

On our journey to and back from South Africa, we were fortunate enough to have nearly day-long layovers in Addis Ababa, Ethiopia – a country which is a cultural revelation in itself. We explored the National Museum, complete with the history of man’s origins, visited the Addis Ababa University and even had traditionally brewed coffee with injera and sirowat. Very special thanks go to Dr. Tehetena, family medicine physician at the Tikur Anbessa Specialized Hospital, for being a lovely host and companion during our day’s adventures.

Siyabonga… Thank you!

Our heartfelt gratitude goes out to everyone who worked diligently to make this opportunity possible for us. The GEMx global and regional teams; Justin Seeling, Eunice Kamami, Faith Nawagi and Phionah Kinwa efficiently guided us through the application process, addressing all our concerns at each step of the journey.

A Day in Ethiopia with Dr. Tehetena

A Day in Ethiopia with Dr. Tehetena

The Kenyatta University management and Dean, School of Medicine ensured that our application process was smooth and travel logistics were well in order before our departure. We thank Dr. Titus Kahiga and Dr. Ongecha as our home GEMx team, who ensured that we gain the most out of the experience. They as well as Mr. Vincent Maganga and Ms. Dorothy Nyapil, through the Projects Office, supported us and assisted in the processing of required documents both for visa application and the exchange process. They served as a link between us and the UKZN team. For this, we are very grateful.

On the UKZN front, we thank Professor Mergan Naidoo, an excellent mentor and supervisor right from the planning phase to the end of our exchange. He and the warm student teams, interns, medical officers, registrars and departmental staff at Wentworth made our elective an exceptional learning experience.

From Nairobi, to Addis, to Durban and back, we appreciate all the wonderful individuals who went out of their way to make us feel at home. As we duly learnt, Ukuhamba kukubona. (Xhosa)

Travelling opens a window to the world.

GEMx Supports the 5th CICoM Student Competition in Mexico City

Filed under: From GEMx Staff, GEMx News, GEMx Sponsored Events

I recently had the opportunity to travel to Mexico City, Mexico to from February 3-7 for the 5th Edition of the of CICoM (Concurso Internacional de Conocimientos Médicos), taking place at Universidad Nacional Autónoma de México’s (UNAM) Campus.  UNAM is a GEMx partner and has maintained a membership in the GEMx global network since the pilot of the program in 2013.  Through this partnership, the GEMx staff has forged long-standing relationships with leadership at UNAM, including Dr. Melissa M Islas Upegui, who oversees the International Program at the Faculty of Medicine, Movilidad Académica y Vinculación Interinstitucional (Mavi), and Dr. Irene Durante Montiel,  Secretary-General of the medical school.

GEMx was proud to be a sponsor for the fourth consecutive edition of the event, and it was an honor to witness the competition and observe the impressive display of medical knowledge demonstrated by student participants was hugely impressive.  As part of GEMx’s sponsorship, we were given the opportunity to present on GEMx global exchange network and other ECFMG | FAIMER service during the competition.

About CICoM

CICoM was launched in 2014, and has been taking place annually since its commencement (the quiz was canceled in 2017 due to the earthquake that hit Mexico City).  The event is student-run, with a self-elected organizing committee responsible for organizing and coordinating the competition.

This year, 28 teams participated from across Latin America, with six students per team, and a least one faculty member accompanying them to the Mexico City.

Quiz Format

The contest is divided into multiple rounds.  Each round includes the 15 questions, with 60 seconds provided to teams to huddle and decide on their answer to each question.  Teams then have five seconds to appeal to the jury, consisting of six medical professionals practicing in Mexico City. After the first round, the 16 top-scoring universities advance, with the remaining universities participating in the “Repechage”  or “consolation” bracket.

This tournament format continues over the next three days, ending in a head-to-head round competition between the remaining two teams.

The final standings of the 2020 CICoM competition were:

Fourth Place – University of Sonora, Hermosillo (Mexico)

Third Place  – Autonomous University of the State of Morelos (Mexico)

Second Place – Universidad del Rosario (Colombia)

First Place – CES University (Colombia)

Congratulations to all participants in this year’s CICoM event, and a special “felicitations” to the winning team from CES University in Medellín, Colombia (a GEMx partner!)

Feedback from Student Participants

Student Video Interviews with the Organizing Committee:

 

“I feel very happy, since it is a very positive experience that is full of learning, not just about Medicine. It is an opportunity to make new friends. ”Diana Marcela Lizate, University of Manizales,
Colombia.

“For my team and for me, it was a great pride to be here, representing our state and our faculty in this house of studies. We are very happy to have this experience. ” Oscar García Carbajal, Veracruzana University, Mexico

Cultural Activities in CICoM

In addition to the medical knowledge competition, quiz participants enjoyed various cultural activities, such as guided visits to the archaeological zone of Teotihuacán, to the Historic Center of Mexico City, and the School of Medicine building.   Students also had the opportunity to take in performances by UNAM’s  Mexican Folk Company, as well as the UNAM orchestra.

Interested in Participating in Future CICoM Events?

CICoM is open to all medical schools internationally.  If you are a medical student interested in participating in a future edition of the quiz, message CICoM through one of their social channels (Facebook, Instagram, Instagram) and a member of their organizing committee will be able to provide information and next steps in registering a team from your institution.

Veni, Vidi, Amavi (We Came, We Saw, We Loved)

Filed under: GEMx Global Network, GEMx Student Ambassador Network, GEMx Student Reflections

By: Shin Loong Soong,  GEMx Student Ambassador from RCSI-UCD Malaysia Campus who participated in an internal medicine elective at Kasturba Medical College Manipal.

Located in Karnataka, India, Kasturba Medical College (KMC) Manipal is a constituent of Manipal Academy of Higher Education. Since its establishment by TMA Pai in 1953, KMC Manipal has held on to the mission of training competent, compassionate, and caring physicians by providing exceptional clinical teaching. With quality medical graduates practicing worldwide, along with having a college campus and a hospital here, as such Malaysians are no strangers to the name “Manipal”.

 

As part of the RUMC curriculum, an elective component was made mandatory for students prior to graduation, promoting medical knowledge exchange through learning from a system, settings and practices not familiar to the student however, what excited me the most, was the opportunity to travel and experience a cultural exchange. I can still remember attending a sharing session by the RUMC GEMx Ambassador, Dr Low Yik Chin back when I was a fresh third year student in RUMC. Being inspired by her experience, I decided to do my elective at KMC Manipal. As such, I submitted my application in February 2019 and was offered a place in KMC Manipal shortly after the submission of my application.

 

My elective journey in KMC Manipal began in December 2019, where I was attached to the Department of Internal Medicine, under the guidance of Dr Mukhayprana Prabhu, Professor of Medicine and Head of Unit 8 within the department. During the elective placement, I was given the opportunity to join the students in ward rounds and clinical bedside teachings by Dr Prabhu and the resident doctors. This gave me the opportunity to enhance my knowledge on appreciating clinical signs and symptoms as well as opening my eyes to rampant tropical diseases which were not commonly seen in Malaysia. Seeing rare diseases like these was a learning experience of a lifetime. Also beyond my expectations was the opportunity to write a case report on a rare facial fungal infection, working with Dr Prabhu and other authors, which we intend to submit for a journal publication in the future.

 

Physicians used to rely on their senses; seeing, hearing, smelling, and feeling for physical anomalies to guide their diagnosis. Technological advancement has slowly superseded the role of a clinical examination in reaching a diagnosis, and although they are more sensitive and specific, they could also cause harm to patients, e.g. pain during blood taking and radiation exposure while taking an x-ray. However, this doesn’t demean the importance of these investigative tools. As such, the recipe of a good doctor would be having a strong foundation on the wisdom of modern medicine in appreciating clinical signs and symptoms and to apply evidence based practices effectively.

One of the biggest challenges that I have faced during my elective placement is the language barrier. Despite having the teaching and discussions conducted in English, most of the patients admitted were unable to converse in English, and with my inability to converse in Kannada, I was initially fearful that this compromised my learning, as clinical learning relies on communication with patients. However, the challenge was easily overcome with the help from my peers and the resident doctor, Dr Poonam Kamath, who have willingly took some of their valuable time to translate and explain the patients’ conditions to me.

With Malaysia being a big cultural melting pot that consists of three major race groups (Malay, Chinese and Indian), I was exposed to different cultures from a young age, and have always loved Indian cuisine. There are many things that I enjoy and like about India, the colourful sarees, the smell of incense and spices, the scenery comprising animals like cows and dogs roaming freely in the streets, the taste of delicious and authentic Indian cuisine, and the amazing Indian hospitality. As I travelled to India alone, I initially experienced some culture shocks and difficulty in adapting to life in India. But it is due to their amazing hospitality, and the kindness from a stranger who later become a friend, that I never felt lonely and my journey in India turned out to be amazing.

 

More than an opportunity for academic and clinical knowledge development, my elective journey in KMC Manipal, India has allowed me to expand my social networks and form many valuable friendships. Strong bonds were created even though it was just a short 4 week elective. Multiple life lessons have impacted me and lead me to count my blessings. I would like to take this opportunity to thank Dr Prabhu, the resident doctors, and my fellow peers who made this elective journey a fruitful and memorable one. Some feelings are hard to express in words, so to conclude my elective journey in KMC Manipal, I would say “Veni, Vidi, Amavi”.

 

Elelective Experience in Managment of Paediatric Emergencies and Neonatal Resuscitation at Arthur Davison Childrens Hospital in Ndola, Zambia

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Blog by Suubi Mariam, medical student from Mildmay Institute of Health Sciences, who has completed her elective in management of pediatrics emergencies and neonatal at Arthur Davison Children’s Hospital in Ndola, Zambia through GEMx.

On 20th July 2019, I set off from Entebbe, Uganda for Ndola, Zambia. Upon my arrival, I found Mr. Alex who showed me around, first to Arthur Davison high cost hospital on Lopiri street, then to Arthur Davison school of paediatrics and child health nursing before I went to Arthur Davison Childrens Hospital where I was going to be accommodated. He handed me over to the senior nursing students who I found in my room and were all glad to receive me. They all introduced themselves like and we became friends from that instant. It was an exhilarating moment for me that made all the anxiety and tension loosen which made me feel more comfortable.

TRAINING

I was given a brief history of when the hospital started and introduced to the staff who oriented me about the different departments. I joined fellow students to Arthur Davison school of pediatrics and child health nursing for the workshop that lasted for 4 days.

The workshop was about Emergency Triage, Assessment and Treatment(ETAT) and Neonatal Resuscitation.The major objectives of the workshop were to; Equip us with the uptodate knowledge about how to triage children and categorise them into those with emergency signs, priority signs and non urgent signs so that we are able to meet their needs as quick as possible and according the available resources. The ABCDE concept and how to intervene appropriately and proficiently. Appreciate the principles related to facilitating physiological transition at birth as a basis for understanding when to intervene.

HOSPITAL EXPERIENCE:

My hospital experience at ADCH started on 6th August 2019. Ms. Mwango Berrice picked me up from the hostels and took me to the hospital where she handed me over to Dr. Kikonde a medical intern. There was always a hand over meeting chaired by a senior doctor. In this meeting, doctors post call gave a report of the number of patients managed overnight, discussed interesting case and the challenges faced for about 15 minutes, thereafter, one medical topic of choice was discussed by the doctor scheduled on the time table. This helped me to refresh and learn more from the Doctors.

I spent the second week in Muchinga where I practiced fluid calculation for dehydrated children and those with severe acute malnutrition. I got a chance to refresh on the feeding and general management of malnourished children under the kind guidance and supervision of Dr. Daka, Dr. Nyanta, Dr. Machona, Dr. Nonde and the Sisters.

For the third week, I was in Kafue ward which is majorly surgical and ICU. Here, I was with Dr. Ngose when he was reviewing post-operative patients with conditions such as fractures, hernias, severe burns, AVSD, frozen abdomen. I also saw patients with CKD and nephrotic syndrome in the ICU.

FOOD

Unlike Uganda where a single meal comprises a variety of foods, here they prepare one type of food which is normally Nshima (maize mill) which is served for lunch and dinner and they don’t seem to be bothered about it. Nshima is served with any other type of sauce like beef, minced meat, chicken, tomato sauce, lepu, silver fish and others. However, the amount of served on the plate was shockingly small that I had to take water so that I don’t choke on the Nshima.

PEOPLE AND LANGUAGE.                                                                              

Zambians are very warm, receptive, generous and jovial people and they are aware of it. I was always received by infectious smiles wherever I went, from the airport to the local people, the students, at the hospital, the kitchen attendants, the Senior Medical Superintendent and even some of the patient attendants.

There are about 72 languages spoken in Zambia, but Bemba is the most commonly spoken. However, I could Identify a bit with Bemba because most of the words are like Luganda, Swahili and Runyankore hence to me it sounded like a mix of languages in one. On this note, I could perhaps pick a word or two when the doctors were clerking the patients and they never hesitated to interpret for me if I asked.

WEATHER.

I was unaware that Zambia experiences “snowless” winter seasons. The winter season is usually between June and late July which is I usually very cold. I was greatly challenged by the weather because I packed light summer clothes only. All thanks to my friends Kafunya, Miriam and Sarah who helped me with some warm clothes until when I did some shopping and they always checked on me to ensure that I am okay.

SOCIAL LIFE

My friends and I used to stroll around town for ice cream and shopping especially over the weekends. However, one Saturday very early in the morning, we set off for Kitwe with Miriam, Sarah, Kafunya, Eunice and Sandra for Mary’s Chilanga Mulilo, a famous traditional ceremony mainly and strictly organized by women where the bride’s family prepares all types of food and takes to the groom’s home as a sign of being welcome to the bride’s home. It was fun to witness how Nshiima was mingled by the bride as the aunt whispered words I never heard into the bride’s ear.

I will always be humbled and grateful to be a part of this great learning experience. I have achieved all my objectives from the training and hospital practicum. I appreciate the Global Educational Medical Exchange for the opportunity Ms. Faith Nawagi the African GEMx representative and Ms .Phiona Kinwa for the kind guidance throughout the process as far as documentation is concerned , my facilitators at the host school, Ms. Sibeso Kamwi, Mrs. Chitimbwa, Ms.Berrice Mwango, Ms.Chisenga and Ms. Michelle.

Thank you is not word enough to express my sincere gratitude to my school, Mildmay Institute of Health Sciences, Ms.Mudoola Janet the GEMx coordinator at my school and the team, my tutors for the support and facilitation. Lastly but not least I would like to thank Mr. and Mrs. Magezi for the mentorship and support. May the Lord bless you abundantly! NATOTELA LESA AMIPALE.