Rambling comments without a picture

It's Wednesday morning here and I'm downtown to pick up a chicken that I "reserved" at the market yesterday afternoon. It was still living and moving when I left it. Hopefully today it is de-feathered and at quartered. The plan is to make chicken curry tonight in our little kitchen.

So far most of my medical activities have been spent on the ward rounds of the general medical ward. The ward has about 60 beds total - though people will sometimes be on the floor if it is crowded. There is a male and female side. There are four teams that split up the patients, each consisting of an attending, a post-graduate, and intern, and a bunch of medical students. For the intern and students, scutwork consumes most of their lives, usually to detriment of learning. The attending formally rounds on M-W-F and I try to join one of the teams on those days. I have minimal practical input to provide but try to add someting useful. Unfortunately many of the best cases (sick patients where we don't know what's going on) have often died by the time I round again.

I spent yesterday in the general medical clinic, which was interesting. It's a combination of "our" diseases - hypertension, diabetes, etc, and "their" diseases - TB and HIV. It's good to see that low back strain is ubiquitous in the world. A younger woman had fairly severe rheumatic heart disease, which is uncommon in the U.S. these days. In some ways this is similar to the UW hospital, in that many patients are referred, often from private practitioners, because they can't figure out what's going on or they need tests done. The hospital itself is connected to MUST - Mbarara University of Science and Technology, so there's a lot of other students here. Mbarara generally is a well-off area. Most students are relatively economically advantaged, and there is a fair amount of economic activity here, including a Coke bottling plant.

Tomorrow I hope to round on the pediatric ward with a pediatrician from the UK. Otherwise at the hospital there is a TB ward, an OB ward, surgery ward, diabetes clinic, HIV clinic, ER, ICU (3 beds). There is also a hospice organization that comes to the hospital and does home visits. It's funded externally and so is sometimes the only source of morphine. Ironically, we referred a gentleman to hospice so they could pay for chemotherapy for his Burkitt's lymphoma. Of course most people still die here before they even come to get medical attention, much less a referral to hospice. I'm hoping to visit the hospice office next week.

Have you stopped reading yet? If not, then I'l continue with one more factoid. I bought local wine yesterday, made from fermented banana and pineapple. And to tchris : No, I haven't found a wine store yet.
Bye!