Article Text

  1. P. Louie,
  2. A J. Macnab
  1. Vancouver, BC


Background As medical professionals, our skills are portable. Few other professions are welcome or capable of working throughout the world regardless of conditions, language, culture, or availability of resources. Our residency program offers an elective experience in Uganda to raise the awareness of our residents of the issues and priorities involved in medicine in the developing world.

Educational Highlights We report the experience of our most recent resident in on this elective in Uganda. His responsibilities were included being responsible for patient care and medical student teaching on three pediatric wards. There were 70–90 patients and 2 nurses. The experience was valuable and intense. Multi-tasking is the norm as illustrated by our resident being called while managing an unconscious child with meningitis to attend seizing 3 year old. The cause was hypoglycemia. We required D10W, had to mix D50W with D2.5W, but no 50 mL syringe could be found initially. Once found, and the bolus given (10 minutes later) the child stopped seizing. The same week, a well nourished five month old died of bronchiolitis, a 13 year old girl fell out of a tree and died of tetanus, a 5 year old developmental delayed boy wandered around the hospital with minimal care after being abandoned, and a 29 week premature infant died when his oxygen concentrator was preferential given to a 4 year old with severe pneumonia.

Discussion Working overseas was a valuable and humbling experience. The clinical skills learned are invaluable. The lack of diagnostic tests and any advanced pathology facilitates the learning of these skills. This setting also allows a motivated adult learner to become actively involved in patient care and medical student education, and build confidence through independent decision making. Importantly, it also generates a healthy appreciation for the standard of healthcare we enjoy in North America.

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