Day Three
Hospital & Clinic
"It's a privilege- we're truly caring for the poor." - Dr. Clement
Today was our first full day at Bethany.
Bethany is divided into an Outpatient clinic and Inpatient Area that includes an intensive care unit, male and female inpatient units, isolation ward, mother & baby unit, labor & delivery suites, operation "theater" room and an emergency room type "casualty unit".
Bethany is divided into an Outpatient clinic and Inpatient Area that includes an intensive care unit, male and female inpatient units, isolation ward, mother & baby unit, labor & delivery suites, operation "theater" room and an emergency room type "casualty unit".
After morning inpatient rounds with the team, we divided and worked in various areas of the outpatient clinics:
Christina with Dr. Muralidar, Site Director, Internist and Cardiologist
Jen with Dr. Mary Chako, site Gynecologist
and
Vanessa with Dr. Clement, site Orthopedic Surgeon.
One of the most fascinating things about this trip was the opportunity to compare and contrast the local pathology with what we see in the various areas of the United States in which we've practiced or shadowed.
Some similarities we saw today were:
Alcoholic Cirrhosis ("long term liver damage due to alcohol usage")
Myocardial Infarction ("heart attack"- what differed here was the treatment of major heart attacks or STEMI's. In the states, access to PCI or cardiac catheterization enables doctors to open your vessels in a quick, minimally invasive-non surgical way. In rural locations, we use thrombolytics or major blood thinners as a second line in hospitals without a cath lab. Due to the rural location of Bethany and the financial restrictions of these patients, they must use thrombolytics as a first line of therapy. The price of a CABG "bypass or open heart surgery" converts to roughly $350 American dollars )
Appendicitis
Gastroenteritis ("stomach bug"-In the states we can typically send patients home after IV fluids, due to the distance that these patients travel, they needed to be admitted for observation because their village was too far away)
Diabetes (Very prevalent! But in many cases very advanced- we admitted a woman with severe diabetic ulcers on her legs that was going to be admitted for debridement and antibiotics.)
Osteoarthritis ("arthritis"- knee and joint replacements aren't nearly as prevalent here due to the cost)
Some other unique things we saw today were:
Myxedema coma and Thyrotoxic crisis (These are really advanced hyper and hypo functioning thyroid disease- we typically do not see this advanced stage disease in the states, but this is where limitations in access to healthcare can truly make life saving a difference!)
Christina with Dr. Muralidar, Site Director, Internist and Cardiologist
Jen with Dr. Mary Chako, site Gynecologist
and
Vanessa with Dr. Clement, site Orthopedic Surgeon.
One of the most fascinating things about this trip was the opportunity to compare and contrast the local pathology with what we see in the various areas of the United States in which we've practiced or shadowed.
Some similarities we saw today were:
Alcoholic Cirrhosis ("long term liver damage due to alcohol usage")
Myocardial Infarction ("heart attack"- what differed here was the treatment of major heart attacks or STEMI's. In the states, access to PCI or cardiac catheterization enables doctors to open your vessels in a quick, minimally invasive-non surgical way. In rural locations, we use thrombolytics or major blood thinners as a second line in hospitals without a cath lab. Due to the rural location of Bethany and the financial restrictions of these patients, they must use thrombolytics as a first line of therapy. The price of a CABG "bypass or open heart surgery" converts to roughly $350 American dollars )
Appendicitis
Gastroenteritis ("stomach bug"-In the states we can typically send patients home after IV fluids, due to the distance that these patients travel, they needed to be admitted for observation because their village was too far away)
Diabetes (Very prevalent! But in many cases very advanced- we admitted a woman with severe diabetic ulcers on her legs that was going to be admitted for debridement and antibiotics.)
Osteoarthritis ("arthritis"- knee and joint replacements aren't nearly as prevalent here due to the cost)
Some other unique things we saw today were:
Myxedema coma and Thyrotoxic crisis (These are really advanced hyper and hypo functioning thyroid disease- we typically do not see this advanced stage disease in the states, but this is where limitations in access to healthcare can truly make life saving a difference!)
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