Settling in Gaborone- one week down

I just finished my first week of work, and I am looking forward to the weekend on Safari at Madikwe, South Africa.

The students that I am teaching are a real pleasure to work with, and I am not just saying that. They were very welcoming to me, and were easy to engage. They ask very thoughtful questions, and seem much more interested in the material compared to the majority of the Penn medical students that I have worked with. They are all 4th year students, which puts them at about 21-22 years old, and they are all from Botswana. Yesterday we had a PBL (problem-based learning) session, and the students put a lot of effort into their presentations, and I learned a great deal about Psychiatry in Botswana, and how that differs from Psychiatry in the US. They put my PBL presentations from medical school to shame. The students don't even seem to be bothered by the sweltering classroom.

IT'S HOT!!!

The temperature has been in the mid 90s everyday, and our classroom has no windows and no air conditioning. On my way home today, I bought a fan, that I hope will cool down the classroom at bit. On Tuesday, I was giving a presentation on the mental status exam, and had to sit down in the middle of it because I thought I was going to pass out. I think coming from the winter in Philadelphia to the summer in Gaborone was too much for my body to handle. But since then I have done a better job staying hydrated.

We are based at Sbrana Psychiatric Hosptial in Lobatse, but today we visited the outpatient clinic of Princess Marina hospital. The patients have a variety of diagnoses, and not all of them had severe mental illness, which is what I was expecting. However, the last patient I saw today was profoundly psychotic gentleman. I will refrain from giving details of the case for privacy reasons. In the US, this man would be considered a straight-forward admission, who a resident would admit without calling the attending. However the psychiatrists here were reluctant to admit him, and sent him for further evaluation. It really highlights the disparity in resources, which is also evident in talking with the psychiatrists here. The psychiatrist in the clinic, Dr. Nguni is from Zambia, and will be returning there in August.

Dr. Nguni: There is a shortage of psychiatrists in Zambia
Me: Isn't there a shortage of psychiatrists in Botswana also?
Dr. Nguni: Well there are 4 doctors here, 1 in Maun, one in Kasane, one in Francistown, there is one in every hospital, so that is enough to take care of the population
Me: (dumbfounded and trying to hide it in my face) Oh

I have to wonder what he would think about the so-called physician shortages in the US.

Socially, things are great here. I haven't eaten a meal alone since I got here. I eat breakfast with my roommates, lunch with my attending from Penn, and dinner with my roommates. Mostly we cook in the apartment, but last night we went out to eat, and I had fish and chips which were delicious. They have a delicious tea called Rooibos that I have been treating myself to frequently.

Sorry I will not be able to add photos to this blog, the wifi at our flat has been down for the past 3 days. I am able to connect from my phone for brief periods at restaurants, and right now I am at an internet cafe, so I am able to get by. When the wifi comes back, I will be sure to upload plenty of photographs.

xoxo,

Adrienne