I have been meaning to write about this for a while. My university has a community service program called “Maties Community Service.” It encompasses several different community service projects. There are literacy projects, small business management projects, orphanage project.
The Health Sciences Faculty was originally called USCOR – University of Stellenbosch Clinical Organisation (as one of my friends put it, the doctors of yesterday were not particularly original).
The aim is to provide underprivileged communities in the area with primary health care in the form of clinics. These clinics take place during the weekends and evenings. Very often the overflow from day hospitals come our way. The very junior students do the initial screening – blood pressure, blood glucose, brief history and so on. The older students do consultations and physical examinations. There is always a senior doctor (or two) available, to whom students present their patients. Medication is provided free of charge. Students from the Allied Health Sciences – physiotherapy, speech therapy, dietetics and occupational therapy – also participate and have patients referred to them.
The first time I attended such a clinic was at the end of my second year. I did screenings and since then I have never had trouble determining a patient’s blood pressure or getting a big enough drop of blood for glucose tests.
It was a scary experience, initially. I consider myself to be liberal and accepting, however the truth remains that my skin colour alone seperates me from certain geographical areas. And causes me to stick out like a sore thumb. So especially the first time I was a little scared – mostly of the drive there. Once there one gets too involved to be afraid.
My most recent clinic visit was the first time I assisted a fifth year student with consultations. Probably one of the most valuable skills I learned there was how to write concise clinical notes. My first set of notes were attrocious – a mess of black on white and if anybody was looking for something, they would have to read the notes from front to back before finding it.
One of the patients I saw was familiar. I had seen her September last year with a very painful toe, which I easily(and correctly) diagnosed as an ingrown toenail. The poor child had been rubbing betadine on her toe for six months, while it kept getting worse. So I got to write my first referral letter (yes, I am a total loser for being excited about that) and I consoled her that all would be alright.
Because she is fourteen, she also kept asking me questions about weight loss and-and-and, so I experienced a little bit of the unchartered waters for doctors and tried to teach her a little something about self-esteem and what fat is and is not. That felt good.
Later the evening we had a patient who presented with signs of (very) early chronic obsturctive airway disease. She was hyperresonant with possible signs of wheezing, but no signs of infection whatsoever. The doctor came over and helped us council her on quitting. I think she might actually quit because she WANTS to. Who knows, but she said she was going to try. The doctor didn’t prescribe any medicine. He told us,
Be very careful of giving a pill for every ill.
He was one of the best doctors I’ve met on these clinics. He drew pictures for patients to explain their conditions to them and went out of his way to teach the students valuable practical lessons.
MSF won’t allow students to work for them, but this is like my mini-MSF. And I learn so much, it kind of feels like I am the one being served, not the patients.