Monday, July 11, 2011

Rethinking outreach

My first outreach clinic was last Thursday in Mahalapye and I will be honest: it was nothing like I expected. When I lived in Malawi, I worked M-F in rural sites where we assessed and treated pediatric malnutrition. We got up at dawn, drove for hours (half the time on unpaved, muddy roads), set up our clinic in a school or under a tree, saw anywhere from 30-200 children and got home in the evenings. When I heard outreach clinic, I suppose my expectations were more in line with that sort of experience. Imagine my surprise when an “early start” turned out to be 6am and two hours later we pulled up at an incredibly nice looking hospital.  Here’s a series of comparison pictures so you get a sense of how my expectations meshed with reality:
Typical clinic from last year (under a tree).
Clinic facilities at Mahalapye.

Yah....the toilets were much nicer at Mahalapye :)

We started our day with a talk from one of our own. Doug gave a lecture on eczema/atopic dermatitis and it was so great! I learned quite a bit and was furiously scribbling in my little notebook the whole time. Turns out that showering too often (which is terrible for atopic dermatitis because it washes away the natural “cement” that holds skin cells together) is a major problem in Botswana where the custom is to shower two times every day! I’d already seen evidence of that in clinic when Doug’s recommendation to cut down to one shower a day was basically met with abject horror. 

But I digress. Despite the cush surroundings, the patients at Mahalapye hadn’t seen a dermatologist in four months. We got to see some truly amazing patients. Leprosy, albinism, hair loss, genital warts etc etc. I was pretty much in heaven and I was kind of upset that we had to stop for a 20 min lunch break. Before I knew it, the day was over and we’d seen 36 patients. My most important job throughout the day? Distributing stickers to our pint sized patients :) 

On the way home, Jen and Doug fell asleep and I used my smartphone app to look up the cases that we’d seen that day. 


As it was Jen’s second to last night, we all went out to Indian food, which proved to be a delicious reward to a long but fulfilling day. 

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