Health and Such

Hello All,
This week I finished my first three days observing in a clinic. The experience has been extremely interesting, and I'm seriously considering becoming pre-med now. (Then again, I'm also seriously considering getting dreadlocks, so goodness knows where my head's at. Any advice on either would be greatly appreciated!)

You may find it amusing to hear that we've been told to wear white lab coats to the clinics to identify us as "student-doctors" or something like that. It's amazing and a little disconcerting to see that, in spite of the fact that I have zero medical training, people are willing to undress and discuss their health problems while I'm in the room...as long as I have that coat on. Stanley Milgrim, you have been proved correct yet again.

In brief, everything in this clinic is on paper- people carry their health records with them in folders to the doctor, and the doctors mark everyone who comes in a huge registry book. If someone forgets to bring a prescription, or any previous file, the doctor/nurse seeing them is at a huge loss to figure out what their story is. (This was particularly an issue in the AIDS section of the clinic, where previous medications are especially important.) They take blood pressure and temperatures the old-fashioned way, and the ante-natal check-ups are limited to listening for fetal heartbeat with a plastic tube. There's always a doctor in the AIDS section, but only twice a week for the general clinic; the nurses hold down the rest. They begin each day with a long prayer session. (Sidenote: These people can SING. Not only has every single person I met had an amazing singing voice, but they seem to be able to effortlessly fall into five-part harmony. I have no explanation, but I'm jealous.)

All of these things would seem to be huge, red-flag indicators of an efficient, broken system- yet it works, so far as I've seen, amazingly well. "Doctor's handwriting" wouldn't really fly here, and each of the nurses are skilled enough at what they do that nothing takes too long. If anything, the real issue (both in what I've observed and what we've been learning in class) seems to be the patients themselves.

In spite of the government's anti-HIV efforts, there's still a huge stigma in even discussing the disease. No one wants to admit having had sex, including pregnant women. The only place where people speak about HIV openly is on that side of the clinic (which is a separate building from the general clinic). When giving babies a check-up, (don't worry, I was only recording the information and not handling anything too complex) I was told not to ask whether the babies were HIV-positive or not...even though there was a section on every sheet to mark their status. Unless the results of the test were in the baby's file (which nine times out of ten they were not), I just wrote "unknown." In spite of the fact that about one-third of adults 18-59 in the country have AIDS or another STI, it's completely taboo to mention the disease even in a clinic.

I don't mean to be a downer; the experience has been quite positive so far. After spending the first day with the babies, I observed the AIDS clinic on Tuesday, and hung out with pregant women on Wednesday. Bewarel I'm starting to think in kilograms and meters.