Friday, February 6, 2009


I'm working with 12 interns at Nysambya hospital, four of whom are currently rotating through the department of Obstetrics. They all graduated from medical school last year and their level of training is somewhere around that of a final year medical student and a first year resident in Canada. They are on call one in four nights just like residents in Canada. The day after their call, they go home at 1pm (in Canada we get to leave at noon). I've sensed a certain coldness from some of these interns. I can imagine many possible reasons for it. I'm doing this elective on their turf and while I'm slightly senior to them in some respects, they have much more experience than me in others. Plus, they work one in four call, so they're bound to be grumpy.

Luckily, on my very first day, I was assigned to work on the labour ward with Godfrey. It was also his first day of rotation in Obstetrics. So, we helped each other out. He showed me how to use a fetoscope (insert photo of 19th century medical device here) and I told him how to treat deep vein thrombosis in pregnancy. I could tell Godfrey was solid. He was quick to ask me about my family and tell me about his. His father had three wives and about 15 children between them. He grew up living with his mother and three siblings. Most of the other 15 were much older than him.

On day 2, we were back in labour and delivery and it was busy. We made a pretty good team as Godfrey would take the histories (in various Ugandan languages) and I would perform the physical assessments. Godfrey was stressing all morning about the fact that it would be his first night on call. I don't blame him. The first night on call in a new rotation is stressful. At lunch, we were sitting in the interns meal room and chatting with some of the other interns. I learned that the goal of most of the interns was to move on to a postgrad program- preferably in Europe, Canada, or the US. Doctors at the hospital in their first year of practice make about $500 a month. In Fredericton, when I stay at the hospital for an overnight call, I make an extra $75. When these interns do call, they make about $15.

Godfrey's cell phone rang part-way through lunch. He stayed at the table while he spoke. When he hung up he said, "Oh! I've just lost my father." There was a general, "Ohhh. Sorry." From everyone around. He explained that this wasn't his biological father, but an uncle who had been the man who raised him. It was sudden and the cause of death wasn't clear. After about a minute of attention being paid to this news, everyone turned back to their own conversations.

Later that afternoon, Godfrey told me that someone would probably have switched call duties with him had he asked, but that it actually worked better this way because being post-call meant he would finish at 1pm and be able to make it back to his village in time for the burial at 4 O'clock.

These events reminded me of how easy come easy go life can be in this part of the world. One of the midwives mentioned to me that I shouldn't ask expectant mothers about whether they had names picked out for their babies. She said, "They don't like to count their chickens before they are hatched."

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