Monday, 25 February 2013

The End of The World

This weekend we headed to Newara Eliya, up in the hill country. It is a beautiful town often called Little England. The weekend was packed and I ticked a good few things off my Sri Lanka bucket list.

I visited a tea factory
We went to Hortons Plains National Park and did a 9.5km walk that took us to World's End (where the cliff suddenly drops away in a 880m sheer drop that you can lean right over), Little World's End and Bakers Falls (spectacular waterfalls)
I took a 7.5hr journey on a Sri Lankan train where we waited 2hrs for a seat, saw stunning scenery, listened and joined in with the locals who played and sang lively music the whole way, dealt with a suspected heart attack and generally had an extremely memorable time!

Today is the monthly public holiday due to the Poya (full moon) so we have come down to the beach at Hikkaduwa.

Amazing weekend with lots of new and memorable experiences!

Thursday, 21 February 2013

Cream crackered!

This week has been pretty tough for me emotionally. I had my first venture into a surgery on Monday. Here's how it went:
  • Got kitted out in scrubs, rubber clogs, a hairnet and surgical mask-very exciting and took a few sneaky pictures!
  • Headed on into the Minor Operations theatre and had a look around. 
  • There are two beds so two patients were brought in
  • I stayed by one and his wound was uncovered. He was a 13-year-old boy with an infected and very painful looking sore on his upper thigh.
  • They started injecting saline all around the wound to flush it out without using any anaesthetic, local or otherwise. The boy was shaking and crying in pain and all of a sudden my stomach didn't feel like it was where it should be, I had buckets of sweat running down my face and I had to run out. I collapsed against the wall outside for a few minutes before a confused nurse found me and took me for a sit down in the doctors' room. 
  • After cooling down, having a cold drink and resting for a good 20 minutes I headed back into the theatre.
  • Queue next patient and his wound. It was on his foot and he was missing half a toe and the rest was messy and rotting. "Ok," I thought, breathing deeply, "this is gross but it's fine." They started to flush it with saline, the man cried out and once again my stomach turned. I didn't faint this time but I knew what was coming so I went to the doctors' room.
  • I panicked. Sitting in the room, taking deep breaths, all I could think was "I'm never going to be a doctor. I'm definitely not going to be a surgeon like I was sure I wanted to be. I won't even be able to be any kind of doctor. I'll never make it through medical school if I get ill from this!" It was one of those moments where the future you had seen vanished.  I felt like I'd wasted the last however-many years of my life trying to get into medical school only to realise now that it had been a waste. 
I spent the rest of that day feeling quite miserable. I tried to reason with myself. It was my first ever surgery, it was in Sri Lanka where the conditions are questionable (think hot theatre, two patients, clinical waste just dropped onto floor etc), the thing I was finding hardest was knowing the patient was in pain etc. It worked a little.

I also emailed my amazing sister who reassured me that I was just human, every medical student goes through it, it doesn't by any means stop you from going through medical school etc. With her words and my good old determination, I went back into surgery the next afternoon.

This time it was the Major Operations theatre and they were doing hernia repairs. I was terrified. I edged up to the locally anaesthetised patient, peered cautiously at where the surgeons were operating and took a breath. I felt fine. No stomach turning, nothing. I stayed in that theatre for 2 hours and saw 2 hernia repairs. I was fascinated, I didn't want to leave. There is something very different about a surgery where the cutting is clean and intentional and a known procedure is being carried out. I loved it and have been in such a good mood ever since. I even popped back into Minors to see some wounds and, although it was still really gross, I managed to stay and watch the procedures (I didn't enjoy it half as much but I was so proud I did it).

Today I was back in and saw a couple of manipulations of dislocated joints, a removal of an cystic ovary in a 12 week pregnant lady and 2 cesaerean sections.

The ovarian cyst case was an emergency procedure and the surgeon had been on-call when he was summoned. The cyst was putting strain on the woman and if the ovary wasn't removed immediately she would definitely miscarry her 12-week-old feotus. When we first went in we were told by a nurse that the mysterious mass (actually the ovary that was swollen to the size of two fists) that had just been chopped out and dumped in front of us was a feotus from an extrauterine pregnancy. We were somewhat relieved when the surgeon told us that, no, it was just a necrosed cystic ovary.

The Caesereans were an incredible experience. I have never seen a real birth before and, although the delivery conditions in Sri Lanka are pretty horrible and Caesareans are not ideal in the first place, it was magical. I won't lie, a few tears escaped, seeing the miracle of new life being brought into the world. I am really looking forward to going to the Labour Ward next week!

So yes, a very testing week so far but right now I am feeling so happy, very proud of myself and fascinated by the things I have seen and experienced. I am learning so much about myself out here and finding out things that will stay with me for life!

On another note, last weekend I spent a day in Colombo (very nice and enjoyable) and then a morning at Bentota beach. On Sunday afternoon I went to a cafe in Panadura to say goodbye to Liv and Sophie, two fab volunteers from the UK who have headed off to continue their adventures! Jeanie and I have a new housemate, Lisa, from Holland. This weekend is a Poya Weekend (bank holiday on Monday due to full moon) so we have been busy planning! Speak soon!

Thursday, 14 February 2013

Kalutara General Hopsital

So just a quick mid-week post. I started my rotation on the surgical ward today and it was awesome. Will be going into theatre next week! I thought I'd tell you some...interesting...things about the hospital where I work.

  • EVERYTHING in the hospital is handwritten. This doesn't surprise me much, I didn't expect technology. Patients' notes are kept in supermarket-bought school notebooks that the patients look after themselves. And EVERYTHING has a separate bit of paper. I don't know how more doesn't get lost...
  • Speaking of true doctor style, all of the Consultants, Registrars and Senior House Officers have completely illegible writing. Strangely though, any House Officer or junior doctor will have impeccably neat writing (nice for us English who gain a lot of info from the notes!) Maybe they are taught it in med school here now?
  • Patients often share a hospital bed (top to toe)...they tend to have very different (often infectious) conditions...and a lot of urinary incontinence seems to be present on the wards...sounds fun no?
  • On the General Medical ward I was extremely surprised when going through patients' notes to find very frequently the phrase "Patient missing since..." often written at a time 12 hours or so later...
  • They play the National Anthem (it's long but jolly) through crackly speakers every morning just before 8.30 and EVERYTHING stops. Any patient who can struggles to stand and nothing happens for a good 4 minutes...I'm pretty sure they'd stop CPR if they were in the middle of it! (Well, not quite but you get my jist)
  • I have seen a doctor wash their hand all of once. And I have seen no gloves. They stare at me like an alien as I rush off to the sink every ten minutes and frequently whip out my hand sanitiser...
  • Nurses use a pestle and mortar to grind drugs...they tip what they can into a separate pot for the patient to take then grind the next pill...without washing the pestle and mortar...
  • One of the paediatric doctors was wearing a Christmas tie...on February 8th...I'm not sure if it was a joke or a genuine mistake...
Working in the hospital is an incredible experience. In some ways the hospital does not have as poor conditions as I was perhaps expecting. Don't get me wrong, lives would be saved if things were changed but the doctors are brilliant (mostly) and really care for the patients and know what they're doing.

Side note:on Tuesday Jeanie and I had a little evening adventure down to a Turtle Hatchery in Kosgoda where we had the most amazing time seeing how the project cares for the eggs, lets them hatch and releases them into the sea (lots of hands on help happening here, wow!) They also look after injured or sick turtles they have found. It was incredible especially as while we were on the beach releasing them the sunset was glorious!
Two just hatched
Setting them off

Baby turtles off into the sunset

Sunday, 10 February 2013


This weekend was so good! It was a very different weekend to last, much less packed and planned and more relaxed. I went to Galle with Jeanie (my new roomie from Denmark who is at the same hospital as me and is lovely) and some of the other volunteers who I had not met yet. We got the bus and met the others there. Finding a room was very hard as everywhere was full but eventually 4 of us managed to get into a room intended for 2. We watched the sunset from the fort walls, went for dinner and explored the quaint and quiet streets. In the morning after breakfast at an arty cafe we explored the fort some more before splitting up. Some went home while some of us explores the main city then got a bus to the touristy beach town of Hikkaduwa. We found room then watched the sunset from the beach this time. A thunderstorm started and we danced down the road getting soaked on the way to dinner! This is most unlike me!
This morning we headed down to the beach early and spent the day sunbathing, swimming and being hurled around in the waves and chatting. Katryn and I went to a rotty shop for lunch. I had pineapple and they were cooked right in front of us! This evening I am supposed to be getting a lift home with my host family on the way back from their weekend but am still waiting to hear from them. For now chilling in a beach bar and nicking their wifi!
Was very nice to have a chille weekend and very good to meet some other volunteers. We are goof to meet up after work during the week and travel some more together at the weekends!

Tuesday, 5 February 2013

Laura the Explorer

Wow, it feels like so long since I've written because I've done so much! The hospital is going well and I am enjoying it and learning a lot. Getting used to the heat so I make it through ward rounds now and also went to the outpatient clinic last week which was good.

This weekend was a long weekend in Sri Lanka (it was Independence Day yesterday) so Bianca and I planned a hectic weekend! We left on Friday straight after lunch and got buses to Dambulla. I'll keep it quite brief but:
Saturday: Off early to Sigiriya (Lion Rock, Asia's oldest garden and temple complex, supposedly 8th wonder of the world) climbed to summit, had amazing views, saw wall frescoes, mirror wall, palace gardens at summit, amazing views and lots more. We also went to the museum which was good. Travelled back to Dambulla and visited the buddhist Cave Temples (very unlike the cave temples Mum and I saw at Elephanta Island) and Golden Temple. Travelled to Kandy.
Sunday: Took a tour of Kandy in a tuktuk. First went to a Herb and Spice Garden 27km out where we saw the herb and spice trees/plants and had a talk/ demo from an Ayurevidic spa expert. We also got mini massages from his students. Ayurvidic medicine is fascinating. For every general hospital here there is an Ayurvidic one and people swear by it. I'm a little skeptical but he put a tiny bit of cream made only from jackfruit milk, aloe vera and saffron on a patch on my arm and 10 minutes and no tingling/smelling later, the hair just wipes off! Next we went to the Elephant Orphanage at Pinnawala where we saw all the elephants they care for, learnt about them and rode one bareback! We then went to a Sri Lankan gem shop followed by visiting the Sacred Tooth Temple. It supposedly holds one of Buddha's teeth. It was incredibly busy with lots of Buddhists going there to pray but had some good museums and I just love the amount of incense burning in there! We then sat by the lake for a little bit before heading for Delhousie (base camp of Adam's Peak) Had a nightmarish 3 bus rides, we were meant to have one. Was so squashed on the last bus winding around the mountains that I thought I would suffocate! All good fun!
Monday:Up at 1.30am to set off to climb Adam's Peak (Sri Pada). It is a pilgrimage route and is a 7km long climb and is 2243m high. The climb was tough. It is made up of very steep, rough, uneven steps in unending streams. My thighs were screaming from the outset! We were climbing with another couple from our hostel which was good fun. It was very hard and several times I was so tempted to stop and give up but we all egged each other on. Seeing elderly Sri Lankan ladies doing it, barefoot, being half carried kind of inspired us. We had been climbing non-stop over 2 hours and were under an hour away from the summit. We were sure we were going to make it now. We would push ourselves and see the sunrise from the top as we had planned. However, very suddenly we hit a queue that filled the entire pathway. We stood in it but did not move an inch for over 45 minutes. We eventually realised that there was no way we would make it to the top for many hours. We would miss the sunrise and would not get up there till about 9am. We were so upset! Seriously disappointing but we decided we would try and find a spot just below here we were to see as much of the sunrise as we could. We were absolutely freezing after standing still for so long. We climbed out of the queue, over a wall and into one of the little tea stops that lined the path. We huddled there until it was time to find our spot. We walked down and saw the sunrise. We were a little around the side of the mountain but it was still good. After the sun was up we walked down quite slowly, taking in all the breathtaking views that you do not get in the dark. The hill country in Sri Lanka is absolutely stunning. We were also stunned by the amount of steps we had apparently climbed! There are 5000+ in total and we must have done about 4000. Not the top but what an achievement! After a quick breakfast, Bianca and I headed back home to Kalutara.

It was an incredible weekend and introduced me to a whole different side of Sri Lanka. It was jampacked and hectic and just the way I like it! I am planning a beach weekend for the next one...could barely walk home from work today, my calves are agony!