Siaya District Hospital
PERSONAL DETAILS
| Name | Maddie Trott |
ELECTIVE DETAILS
| Country | Kenya | City | Siaya District |
| Setting | Rural | ||
| Local languages spoken | Swahili, English | ||
| Dates of elective | December 2009 | ||
| Year level during elective | 5 | Expected level of knowledge | Graduate |
DETAILS OF INSTITUTION
| Name | Siaya District Hospital | Population served | Catchment over large rural region of western Kenya, southern Uganda and north-western Tanzania |
| Size | 200 beds | ||
| Departments/specialties available | General medicine, general surgery, obstetric/gynaecology and paediatric wards, and clinics. | ||
| Further description | Siaya represents one of the poorest districts in Kenya, where most live below the poverty line. Many patients present to the hospital after having walked for many hours or an exhausting journey by matatu. For this reason, and owing to the small number of inpatient beds, patients are often acutely unwell or suffering in the terminal stages of HIV infection. HIV prevalence is estimated at 51% and malaria is a huge issue. Infectious and tropical medicine is rampant! The hospital is incredibly basic – no running water, very few pharmaceutical supplies, crude surgical techniques and very confronting medicine – but the resident doctors do some amazing work. You will be expected to get involved and get your hands dirty! | ||
| Student responsibilities | International final year students are essentially treated as junior doctors. Ward work, emergency clinics, assisting in theatre, delivering babies, much procedural work (lumbar punctures, chest drains) | ||
| Teaching availability | Very little – staff are too few on the ground. Bring your Oxford clinical handbook. | ||
| Elective contact | Adventure Alternative UK. This NGO has a longstanding arrangement with Siaya District Hospital. Medical students are placed at the hospital, housed and supervised by the company in an agreement which supplies much-needed external funding and support to the hospital and local orphanage. Independent placements at SDH are unlikely but Adventure Alternative is a fantastic company to work with so this is a good system. | ||
| Application process | Very simple – via Adventure Alternative website | ||
| Donations brought/grants | Anything you can get your hands on. EVERYTHING is needed at this hospital, from the basic to the specific: dressings, medicines, theatre equipment, financial support. We organised lots of physical equipment as well as funding for new baby scales and portable examination lamps for the wards (as there is no permanent lighting). Organising the transport of these goods was difficult but eventually achieved through the benevolence programs of the airlines we flew with. | ||
TRAVEL, ACCOMMODATION, FOOD, LEISURE AND EXPECTED COSTS
| Accommodation options | A secure house in nearby Wagai village is supplied by Adventure Alternative. Staying outside of this house would be very difficult. | |
| Accommodation details | Very basic Kenyan living. Mosquito nets supplied! No running water. Long-drop outhouse. Cold shower. Intermittent electricity. Not for the faint hearted! | |
| Travel to location (including necessary documentation) | Flights from Adelaide-Qatar-Nairobi reasonably simple. Bus journey from Nairobi to Siaya (seven hours) was organised by Adventure Alternative. | |
| Transport within location | Local matatu buses | |
| Food allowances | US$100 per week, paid in pre-determined cost of elective through Adventure Alternative, given to us in local currency (Kenyan shilling) | |
| Social activities | Difficult due to need for chaperone at nearly all times. Social opportunities with other health students on placement with the company at local orphanage. | |
| Recommended vaccinations | EVERYTHING your travel doctor offers – you will be in rural Africa. Malaria prophylaxis essential. | |
ADDITIONAL DETAILS
| The good | Amazing medicine in a beautiful part of the world. Living in a traditional Kenyan village in the middle of the countryside. Hands on experience that you may not get until 2 or 3 years post-graduate. |
| The bad | Extremely emotionally demanding. Challenging in terms of the limitations of care in a third-world hospital. Death and disease are much more extreme than in Australian hospitals. Risk of HIV exposure. |
| Further descriptions, comments or advice | Definitely go in a pair or three – you need the opportunity to debrief. Take post-exposure HIV prophylaxis meds (can be organised through RAH infectious diseases, or your travel doctor, and also provided by Adventure Alternative). Take as much personal protective equipment as you can carry (gloves, alcohol gel, masks, eye shields) and be vigilant in practicing safe personal protection. In hindsight, we experienced a mind-blowing elective, though at the time it was extremely challenging and very confronting. We were glad to be travelling in a group of 3, exceptionally glad to have had the support of Adventure Alternative, and ready for a break after 3.5 weeks. This elective is not for the faint-hearted but definitely worthwhile! |
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