Part of the reason I decided to go into medicine was for the opportunity to travel and work in exciting places and to have something positive to offer while doing it. My husband James (also a doctor) and I decided to abandon career progression and mortgage repayments for a while, and took a year abroad doing various voluntary projects. We spent the last five months working in St Francis Hospital, a missionary hospital in the Eastern province of Zambia.
With few local doctors available, volunteers are relied on heavily and the number of fully trained medical staff fluctuates from between four and 12. Due to the high workload you have to be independent and make most clinical decisions unilaterally because there is not a big team on each ward. James worked in surgery and obstetrics, and I was on the hospital ward. At least it looked vaguely like a hospital ward, even though the side was open to the elements and there were relatives washing on the verandah. A week shadowing the departing American oncologist, lots of urgent swotting up on malaria, TB and HIV and thousands of questions later, I was on my own.
I quickly developed skills of managing with minimal history –— no trained translators in this corner of Zambia — basic, and often unreliable, laboratory tests and misdirected X-rays. Clinical examination became key — that and the realisation that I had to make a decision and act on it. Sometimes it worked, sometimes it didn’t.
Zambia trains 50 doctors a year at its medical school in Lusaka, of those fewer than 10 stay in the country, mainly in Lusaka where they work privately and have a more western quality of life. This leaves rural areas short of doctors.
Emotionally, it was incredibly hard to cope with the suffering, poverty and injustice we saw on a day-to-day basis, but the volunteers all looked out for each other.
By the end of our stay I had gained confidence in making independent decisions, a honing of my clinical skills, a good working knowledge of tropical medicine and management of people living with HIV.
Add to that the experience of living and working among people from a completely different culture; with a fatalistic attitude to life and death, a resilience to get by despite the odds and a population surviving without the necessities we rely on in the UK.
Fitting voluntary work into the new Modernising Medical Careers pathway will be increasingly difficult. Having deferred our GP registrar training to be able to travel, we are now home, continuing with our careers and starting a family, but we will certainly be keeping our eyes and minds open to possibilities that come up.
I do feel that our time away was invaluable, careerwise and personally and has made me reflect on what is important in life and to appreciate the simple things.