GEMx Blog

GEMx Exchange to UKZN

May 9, 2018

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Post by Nancy Binsari and Tendwa George, 5^th year medical students from Kenyatta University who’ve completed an exchange at University of KwaZulu Natal (UKZN).

Tendwa and Nancy ready to go on their exchange

Introduction:

This elective is an opportunity to find out more about yourself and what you want to do in the future. The elective allows you to explore a particular area of medicine or something different, such as research or teaching.

The two of us were selected to participate in the elective term through the GEMx program. Our home school, Kenyatta University was enrolled into this program through the regional platform in Africa for the first time in 2017. Being the pilot group, we were privileged to get a chance to participate in our elective at our host school UKZN (University of KwaZulu Natal) at Wentworth Hospital. Two of our other colleagues also participated in the GEMx program, and were sent to Makerere University in Kampala, Uganda to the cardiology centre.

We had 4 weeks of rotation in the department of Family Medicine in Wentworth hospital, one of the hospitals for UKZN clinical rotations. Family medicine, formerly “Family Practice” is a specialty devoted to providing comprehensive health care for patients. Family medicine is a three-dimensional specialty, incorporating knowledge, skill and process.

Dr. Mergan Naidoo, the head of department of family medicine at UKZN was our contact person and took us through the orientation at the hospital as well as our clinical rotations in our various sections. With the aid of a well-put logbook, Dr. Mergan Naidoo took us through our objectives for the clinical rotations and also guided us on a quality improvement project that we undertook during our stay at the hospital.

Tendwa, Nancy, Dr. Naidoo and Kenneth at the Department of Family Medicine

Week 1: Out Patient Department (OPD)

Our first week was in the outpatient department (OPD) which is divided into the chronic and acute sections. In the acute section, we clerked patients and presented to the senior doctor in charge, Dr. Oyebola who guided us and corrected us accordingly. We had an opportunity to familiarize ourselves with the South African guidelines on management of common conditions of patients in the OPD. We were able to experience a variety of conditions and were tasked to identify or at least make out the differential diagnosis of the presenting complaints.

Of the patients seen, a majority suffered respiratory diseases with TB and community acquired pneumonia leading. We also noted that the country had a large burden of HIV and it was therefore not a surprise that it was in the background in most of the TB infections. We were provided with masks to prevent acquisition of TB in patients. Other conditions we encountered in the OPD were hemorrhoids, gastroenteritis just to mention a few.

Week 2: Accident and Emergency  

Nancy and Tendwa outside the accident and emergency department.

The second week of our elective term was at the Accident and Emergency department. This was under the supervision of many doctors. Our task here was again to see patients and clerks, suggest investigations and come up with a management plan. We would then present this to the doctor on call as well as the intern doctor for approval of our approach and advice on what we missed out on. This turned out as a very good way of learning as sometimes they pointed out that we have the theoretical knowledge but need to put more practice into applying it to the patient and seeing them as a whole. We were trained to act like investigators and see beyond what the patient is saying. It was quite interesting because no matter how busy the floor got, the doctor’s would never rush us both in clerkship and in presenting to them. We got really good insight on what it means to be part of a health team and experienced what role we had as doctors.

Week 3: Acute Admission Ward

During our third week we rotated in the acute admissions ward. This is where all acutely ill patients admitted from Accident and Emergency department are transferred for high care and monitoring till they are stable enough to be discharged or transferred to other medical facility or surgical wards. It is during this rotation that we familiarized ourselves with the protocols and guidelines of South Africa for the management of acutely ill patients during the acute phase.

Week 4: HIV Clinic

We spent our final week in Wentworth hospital was spent in the HIV clinic. Here, we learnt under the supervision of Dr. Ryan, we saw newly diagnosed patients as well as follow ups and got to experience first-hand the countries’ way of combating the high levels of HIV infection in the area.

A thorough examination of the patient was also well covered to examine symptoms the patient brought up as well as anything they would have missed e.g. skin rashes or mouth lesions. The consultation would end with the patient understanding all the information being presented and patients were asked to come back for another visit. We had to update them with a full summary of what was discussed in terms of patient health and progression or regression of HIV.

Tendwa and Nancy at the HIV clinic

Challenges:

One of the challenges was the language barrier. It was difficult to communicate with some patients who could only express themselves fully in Xhosa or Zulu. To combat this challenge, the doctors and nurses went out of their way to translate whenever possible and give us English speaking patients to clerk.

Acknowledgment:

1) We would like to thank Dr. Titus Kahiga for his exemplary role in making our exchange possible. He conducted regular meetings with us, guided us every step of the way, and took great measures to ensure we gain the most out of the experience. He acted as a link between us students, the university and the GEMx program. We are not sure that if we were under anyone else our exchange would have even been possible.

2) We would also like to extend our gratitude to Dr. Faith Nawagi. She was always present to respond to questions and concerns right from the first day we began the journey. She was always efficient in communication channels and would reply to emails within a very short time. This helped us with our planning and preparations. We are positive that the program will see greater heights with her commitment and passion for the students.

3) We extend our hearty gratitude to Professor Mergan Naidoo. The professor provided very good mentorship right from the planning phase to the end of our exchange. He also made time for regular interactions to address any concerns we may have had. We would also like to extend our gratitude to Mr.Ifukho, Mr. Vincent and the projects team in Kenyatta University as well as Ms. Anitha from UKZN. They were quite helpful in the processing of required documents both for visa applications and for exchange purposes.

4) We would like to thank the individuals who stood out in our elective term. These individuals managed to take time for us students and gave us an exceptional learning experience.  The staff’s enthusiasm and warmth remains entrenched in our memories as well as their motivation to providing us with a good amount of knowledge. These people include Dr. Ayubola, Dr. David, Dr. Daniels, Dr. Mbaiza, and Dr. Ryan.

5) Our sincere gratitude to the office of the Dean at Kenyatta University school of Medicine and our Dean Prof. Agina for ensuring we had all we required during our stay at KZN, as well as selecting the two of us to represent the school for the elective program at UKZN, South Africa.

6) Lastly, we thank the nursing staff as well as the interns who helped us settle in each department and allowed us the opportunity to help wherever we could.