13 minute read
To Uganda, with SCOPE
Text: Eleonora Cerutti
You are only in your first years of medical school, you don't know anything about medicine yet. Why are you going to Africa?
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There are many many reasons. Kagando Hospital gives the opportunity to any medical student, who is either in their early years of training or is already well experienced (or everything in between of course), to have a unique experience - to see a completely different hospital system, and get to experience the African culture, which is so different from the one we have here in Switzerland.
That is why I would advise any student interested in this field to get out of your comfort zone, and out of this beautiful little country called Switzerland, and see how the world works elsewhere.
Kagando Hospital is a small community hospital in the west of Uganda in the Kasese district on the border with the Democratic Republic of Congo (DRC), a few kilometers from the equator. It is surrounded by the magnificent Queen Elisabeth National Park where you can go on safari whenever you want to take a break from hospital routine.
At the end of June 2022, I left for a month to visit Uganda. The organization of the trip was simple enough.
First of all, you need a visa: better to take it as a tourist rather than as a student, because then you would need a permit from the university etc. and to have a yellow fever vaccination. Repeating other vaccines e.g., hepatitis vaccine, can also be a wise thing. The planning is crucial and probably I could have done better myself. This is why just a week before my exam session started, I found myself in a tricky situation: I had to receive vaccines for everything possible and imaginable … I had to get 7 vaccines in one go. I still wonder how I didn't get sick afterwards…
Finally, the hospital charges a residence tax of about CHF 75 per week with board and lodging (which is extraordinarily good value, although not luxurious!).
The journey to the hospital takes two days from Switzerland because it takes nearly a full day of driving to get from the airport to the hospital. In Uganda there is only one international airport in Entebbe. Since it is strongly recommended not to travel at night, I spent the first night in Entebbe.
Already during the journey, you can recognize that you are in a developing country. Mopeds designed to carry one or two people, in reality carry a family of 5 plus luggage. In the city, the houses and hotels are all surrounded by barbed wire and armed guards. The further you get from the city, the poorer the people become, houses with roofs are harder to find, and the roads change from paved to dirt roads with many potholes.
After the long journey I finally arrived in Kagando. The first surprise as soon as I arrived was a small tarantula in the room. Fortunately, a maid, who
Nature around Kagando
looks after the different homes of the hospital staff came to help me chase it out of the room. And she told me “Oh that is just a baby tarantula”, but that was the biggest spider that I had ever seen.
On my first day at the hospital, I went into the pediatric ward. I entered this big building with only one common room where there were cots in every corner. When the ward was at its least capacity, everyone was lucky and could get a bed to sleep on. But the nurses there explained to me that if the hospital was very full, there would often be patients on the floor.
The normal day starts at 8am in the chapel with a short service for staff, students, and visitors. All are encouraged to attend (but this isn't compulsory). This service includes introductions, notices, and information about the program for the day as well as forthcoming events in the hospital and local community.
Then around 8:30 wards round start, which lasts until all the patients have been seen (so the ending time is very variable, on short days at 12:00 while if there are a lot of patients it can go on until 14:00).
Once the round started, I joined the doctors, and everyone was very kind and ready to explain to me the clinical situation of each patient and the reasons for the prescribed treatment.
I was always assisted by the doctors there, who gave me plenty of opportunities to try and do things myself first with their support and then on my own. Basically, a great way to learn! The doctors there are all from different parts of Uganda and most of them are just finished with their studies (interns). It is also super interesting to speak with them and understand how their schooling system works.
After a few days they started to give me small tasks, such as auscultation and then explaining what I was hearing, but also looking at X-rays and explaining what I thought the problem was, abdominal palpation, or helping to put in or take away some stitches in surgical patients.
An example that comes to mind is that of a child who was admitted to the hospital with Hirschsprung's Disease, which is a congenital condition
Paediatric ward
One of the three operating theatres in Kagando
that results in missing nerve cells in the muscles of the baby's colon. Without these nerve cells stimulating gut muscles to help bowel movements, the contents can back up in the colon and cause blockages in the GI tract. I had the opportunity to carry out a rectum wash twice a day: in Kagando this is simply done with soap and water rather than with warm saline and lubricating gel due to lack of supplies.
Due to malnutrition, especially in adolescence, many girls do not fully develop the bones of the pelvis, which therefore remain too narrow. Once they get pregnant and they approach delivery with the start of contractions, they arrive at the hospital and many of them then need a cesarean section because their pelvis is too narrow to deliver the baby naturally. And one thing they taught me at Kagando is for example how to do a vaginal examination and determine whether the baby will be born with a natural birth or a cesarean (of course this is only one of the many parameters for choosing cesarean or not).
Or finally I remember one time when in the surgical department there was a 50-year-old patient who was hospitalized for Elephantiasis and one of my tasks during the round was to remove some worms from the surgical incision.
Then after the morning round you had time to relax a bit (which is much needed because of the hot temperatures) and in the evening I used to go back to the hospital to check if there were some new patients and if everyone was stable. Also, in this case, I was always accompanied by another doctor.
Unfortunately, not everything was easy. I was confronted with death sometimes and I found this very challenging and almost unbearable at times. I would like to remember a little angel by telling his story.
One evening I arrived at the neonatal ward and the nurse asked me to confirm that one of the babies had stopped breathing for a while. The baby had passed away. Next to the cot was the father who had already understood the situation. And as soon as I informed him of the baby's departure, he looked at me with tears in his eyes and said: 'thank you, thank you for everything you did, thank you for taking care of my baby'. At that moment I had to leave the ward with a mixture of emotions such as anger and sadness. I was helpless, I hadn't done anything for that newborn, I didn't even know what pathology he had. Yet the father said thank you to me, the least deserved thank you of my life. I had done nothing; I had not been able to do anything, and he was grateful.
People in those areas of the world are different from here. In the hospital I have never heard raised voices or stressed people, you work together, everyone cares about each other. The support is strong.
Alongside hospital life there were also many other projects going on. Throughout my stay I was very lucky to have met two wonderful people Chris and Chris, with whom I was able to experience this trip together. They allowed me to go through with them the different projects they have in
Uganda. All of whom, supported by acomplishtrust.uk, such as distributing medicine against epilepsy in a huge area of western Uganda or supporting schools for children with disabilities. Obviously, if you would like to look at one of these projects during the time you spend in Kagando you could do so by visiting the website.
One of the most positive aspects of this hospital is that it is extremely flexible, and you can visit the different departments in which you are interested. All the doctors, medical staff and team are ready to teach you patiently, as well as explain what goes on. For example, I spent the first few days in pediatrics, neonatology intensive care, then moved to maternity and finally to surgery. But there are so many other departments: HIV Clinic, male wards, intensive care, eye clinic, dental clinic…
Kagando, as well as the experience of working and making friends in a developing country is something that will remain in my life forever. I saw and learnt about a completely different culture, and about diseases that we do not have at our latitudes such as Malaria, Elephantiasis, enteric fever, …
I think it is important to go there with the mindset of learning not only in the hospital but also from outside about a new culture and a different way of life. The most important thing is not only that you are there to visit the hospital but also to get in touch with the people there. For example by visiting the schools (and there are many interesting projects!). And always remember when you are there you are visiting Kagando as a guest and it is important to respect and show appreciation for all the work that they do.
The people I want to thank, especially for this experience, are my family, Chris Acton and Dr. Chris Harris.
Se siete arrivati fino in fondo a questo articolo e sono riuscita a suscitare un po’ d’interesse in Kagando non esitate a contattarmi al seguente email: ele.cerutti@icloud.com
Wenn Ihr es bis zum Ende dieses Artikels geschafft habt und ich Euer Interesse an Kagando wecken konnte, dann könnt Ihr mich unter der folgenden E-Mail-Adresse kontaktieren: ele.cerutti@icloud. com
Si vous êtes arrivés jusqu'à la fin de cet article et que j'ai pu éveiller votre intérêt pour Kagando, vous pouvez me contacter à l'adresse e-mail suivante : ele.cerutti@icloud.com
Has tHis story awaken your interest? it's now your turn! SCOPE: For professional exchanges to one of over 100 countries, for students who have completed their 3rd year.
Find more information at: https://swimsa.ch/exchanges/
MEDISERVICE ? INTERESSIERT MICH NICHT!
Text: Marc Schällebaum | Geschäftsführer MEDISERVICE VSAO-ASMAC
Kontaktieren Sie uns unter:
MEDISERVICE VSAO-ASMAC Bollwerk 10 Postfach 3001 Bern Telefon 031 350 44 22 info@mediservice-vsao.ch www.mediservice-vsao.ch
mediservice vsao-asmac? Sind das nicht die Versicherungen und den Krankenkassen? Das interessiert mich nicht. Ich wohne noch zuhause. Meine Eltern bezahlen das alles, solange ich noch studiere.
Sollten Sie so oder ähnlich denken, verstehen wir Sie. Versicherungen, Krankenkassen und ähnliches sind etwa so verführerisch wie Gebrauchsanweisungen für Staubsauger. Dennoch lohnt es sich auch für Studierende, mediservice etwas besser kennenzulernen.
Die Dienstleistungsorganisation soll ihren Mitgliedern in allen Lebensphasen vor allem in Versicherungsfragen zur Seite stehen. Daneben bietet mediservice eine weite Palette von andern Dienstleistungen an. Eine davon, das vsao Journal, haben Sie vielleicht schon in den Händen gehalten.
Sie wohnen noch zuhause, ziehen aber bald aus? Ihre Eltern zahlen noch bis zum Ende des Studiums Ihre Krankenkasse, doch der Studienabschluss rückt näher? Höchste Zeit, sich mit den leidigen Versicherungsfragen auseinanderzusetzen.
Und höchste Zeit für mediservice!
Das auf der Homepage von mediservice aufgeschaltete Lebensphasenmodell informiert Sie bei jeder privaten und/oder beruflichen Änderung, worauf Sie versicherungstechnisch achten müssen.
Dank unseren Kollektivverträgen können wir Ihnen vorteilhafte Angebote bei verschiedenen Krankenkassen und weiteren Versicherungen (Haftpflicht, Mobiliar, Rechtsschutz, Fahrzeug etc.) unterbreiten. Da wir einzig unseren Mitgliedern verpflichtet sind, können wir Sie unabhängig beraten und die für Sie beste Lösung suchen. Als Dienstleistungsorganisation für Ärztinnen und Ärzte (angestellte und selbstständige) sowie Medizinstudierende, können wir das von uns erwirtschaftete Geld in verschiedenste Projekte zugunsten von vsao und swimsa einfliessen lassen. Als Platinsponsor unterstützen wir die swimsa in diversen Bereichen und sind immer offen für neue Ideen, die wir zusammen umsetzen können. Gemeinsam mit dem vsao organisieren wir alljährlich den Laufbahn-Kongress medifuture, der sich insbesondere an angehende und junge Ärztinnen und Ärzte richtet.
Auch auf Ihrem weiteren Berufsweg, z.B. beim Schritt in die Selbstständigkeit bis hin zur Pensionierung, steht Ihnen mediservice zur Seite. Sie sehen Dienstleistungen in allen Lebensphasen. Von daher lohnt es sich wirklich, uns besser kennenzulernen.
Als Medizinstudierende können Sie das übrigens ganz einfach: Werden Sie kostenlos Mitglied bei vsao und bei mediservice und profitieren Sie von allen unseren Angeboten. Wir freuen uns darauf, Sie besser kennenzulernen!
Contactez-nous à :
MEDISERVICE VSAO-ASMAC Bollwerk 10 Case postale 3001 Berne Téléphone 031 350 44 22 info@mediservice-vsao.ch www.mediservice-asmac.ch
MEDISERVICE ? CELA NE M’INTÉRESSE PAS
Text: Marc Schällebaum | Directeur MEDISERVICE VSAO-ASMAC
mediservice vsao-asmac? Ce ne sont pas ceux des assurances et des caisses-maladie? Cela ne m’intéresse pas. J’habite encore chez mes parents. Tant que je suis aux études, ils paient tout.
Si telle est votre attitude, nous vous comprenons. Les assurances, les caisses-maladie et ce genre de choses sont aussi attrayantes que des modes d’emploi d’aspirateurs. Pourtant, même pour les étudiants, il vaut la peine de s’intéresser d’un peu plus près à mediservice.
L’organisation de services accompagne ses membres dans toutes les phases de vie, notamment pour les questions d’assurance. En plus de cela, mediservice propose une large palette d’autres services. Vous avez peut-être déjà tenu entre vos mains l’une de nos offres, le Journal asmac?
Vous habitez encore chez vos parents, mais allez bientôt quitter le domicile familial? Vos parents paient encore votre caisse-maladie jusqu’à la fin de vos études, mais la fin de celles-ci approche? Il est donc temps de se pencher sur les désagréables questions d’assurance et de s’intéresser à mediservice. Le modèle des phases de vie présenté sur le site web de mediservice vous informe sur les points à observer en matière d’assurance lors de chaque changement de nature privée et/ou professionnelle. Grâce à nos contrats collectifs, nous pouvons vous proposer des offres intéressantes auprès de diverses caisses-maladie et autres assurances (responsabilité civile, ménage, protection juridique, véhicule, etc.). Comme notre engagement est réservé à nos membres, nous vous conseillons en toute indépendance et cherchons la meilleure solution pour vous.
En tant qu’organisation de services pour les médecins (employés et indépendants) et les étudiants en médecine, nous pouvons investir les recettes générées dans différents projets en faveur de l’asmac et de la swimsa. En tant que sponsor platine, nous soutenons la swimsa dans différents domaines et sommes toujours ouverts aux nouvelles idées que nous pouvons mettre en œuvre ensemble. En collaboration avec l’asmac, nous organisons chaque année le congrès de carrière medifuture qui s’adresse notamment aux futurs et jeunes médecins.
Pour la suite de votre parcours aussi, p. ex. lors de l’ouverture de votre propre cabinet et jusqu’à la retraite, mediservice sera probablement à nouveau à vos côtés. Vous voyez, ce sont des services pour toutes les étapes de vie.
Il vaut donc vraiment la peine de mieux nous connaître. En tant qu’étudiant en médecine, vous le pouvez très facilement: adhérez gratuitement à l’asmac et à mediservice et profitez de toutes nos offres. Nous nous réjouissons de faire votre connaissance!
