Princess Marina

We finished our first week in the hospital. Princess Marina is organized as a series of freestanding buildings, each housing a separate ward of patients. The main medical wards are divided into cubicles, each with about 8 patient beds in a open room. Curtains separate the patients, but they are usually left open. There is no air conditioning in the hospital so the windows are all open and the fans are running.

I’ve been surprised by the mix of patients I’ve seen. I thought I would deal with a lot of complications of HIV, but, even though almost everyone has HIV, most of my patients are there dealing with other issues - heart failure, renal failure, stroke. By far the biggest issue is tuberculosis. Almost everyone in the hospital has TB. The TB and HIV treatments seem to be pretty standardized throughout the country, and they seem to have fairly good systems in place to make sure that everyone stays on their therapy.

The doctors at the hospital are an interesting mix of people. Many of the “specialists” are internal medicine trained docs who have just chosen to focus on a particular area (cardiology, nephrology, etc) without any formal training. Even so, I think the patients are getting good care within the limits of the therapies available here.

To be honest, I was completely frustrated and overwhelmed for most of this first week. It wasn’t clear who was doing what on rounds. We never really talked about the patients out loud, instead someone would just write in a chart and we’d move on to the next patient. It was cool to watch everything, but I didn’t really feel like I was adding anything, and it was frustrating to feel useless. By today, though, I think my team was warming up to me (and I was warming up to them). I definitely do more procedures here than I ever have in the US, but today I also really felt like I made some decisions and suggestions that contributed to patient care. As hard of a time as I was having earlier this week, I’m now kind of sad that I only have 3 weeks left at this hospital.

I am not sad, however, that it’s Friday. Tomorrow we are going to a local game reserve for a mini-safari and we’re going out to a bar tomorrow night with another Penn student who has been here a few months. Saturday a bunch of Penn residents move into our flats so we’re planning on grilling and sitting by the pool. I am very happy to be missing winter.