Monday, May 20, 2013

Guest blogger: And besides it was the hottest part of the day & Fellow fellows!

Two more updates from guest blogger Dr. Katy Rivlin, NYU fourth-year Ob/Gyn resident writing from her Global Health rotation at Korle Bu Hospital in Accra, Ghana.


5/15 --> And besides it was the hottest part of the day

    Lured more unsuspecting victims into my snare today, Titus the resident who giggles a lot when questioned by his “bosses” (or attendings) and Brittany the 2nd year resident with a gap between her teeth and red tinged hair. As far as I can tell, she is the only one on rounds who know anyone’s gestational age. The biggest (and most obvious) success was Maala, the other sort of white woman. She just finished medical school in London and goes for a jog at 5 am every morning. Once we’d spotted one another across a crowded room, what could we do? Now we’re semi attached and already have plans to visit Cape Coast together this weekend. Sadly for Maala, the long ward rounds in the midday heat are taking their toll on her. I’ve kept her alive with sips of water from my Nalgene and Chocolate Mint Cliff Bars. At least I’m providing some kind of medical care. 
    As for myself, I have the thickened (or thinned?) blood of a Southerner and can hold my own on post partum and antepartum rounds with the strongest, most heavily clad Ghanian.  I even laughed at the right time once or twice!
    I ate red red with fried fish tail and plantains for lunch today. This is very likely the dish Evangeline tried to teach me yesterday, and I see now how far off I was. My first forage into Ghanian cooking was about as successful as my first bucket shower, except the consequences may last longer for myself and for Sari.  Also in my lunch was a white powder that looked like quikrete. Dr. Samba said it’s made of maize and meant to thicken my red red. But I feared spilling red red and quikrete on myself and all the bosses, so I kept everything to itself. In other gastric news, all milk is  condensed or sweetened, tomatoes come as a paste, and spices end up lumps of chalk in their bottles. I must bend my brain and my stomach, if they aren’t bent already. 


5/16 --> Fellow fellows!
     Dr. Samba extracted me from Maala’s hip after M&M this morning and took me to the Center for Reproductive Health and Family Planning. I was shown into Emmanuel’s office, air conditioned with a computer. It didn’t take us long to realize that the fellowship I will be starting next year is the same one he is doing now!  He even had the Family Planning fellowship pamphlet to show for it. Unfortunately for Emmanuel, the American donors who used to fund his fellowship and the fellows before him now expect Korle Bu to be self sufficient. He has little to no access to up to date information on contraceptive practices. Dr. Ades has already promised to help me put together a curriculum which Emmanuel can adapt to Korle Bu. My first project that feels useful!
    Then we spent the better part of the day swapping stories about the Ghanaian and American health care systems. I wowed him with stories about bariatric bend extenders and Big Gulps, he parrying with a house officer who caused arm necrosis in a baby by forgetting to remove a tourniquet. Geeeeeze. 
    Every once in a while a nurse entered, asking if it was safe to put an IUD in a woman 8 weeks post partum after a c-section and whether or not a woman’s blood pressure was too elevated for depo provera.  Emmanuel would give his answer and she would leave, off to plan families, the two of us still giggling about teen pregnancy and diabetes. Then we went to the wards, saw one post partum patient and calmed down a panicked house officer who had just seen a cervical foley “drop out” of a woman’s (very dilated) cervix. I’ve learned quickly that this is a pantsless, drapeless society when it comes to women and their doctors. No one seems to mind too much, it’s all smiles when we come around. 
    In other culinary news, turns out it’s true, mangoes in Africa are unbelievably good. Also turning out to be true, if you travel here, you will get diarrhea. In the grand tradition of ending on the state of my intestines, I will end here. Oh, and there is a goat just outside of my window who may be in the throws of death. Or just making normal goat noises. 

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