Our days would begin whenever the doctors were free to do rounds (patient to doctor loads here are quite high and they are very busy). During these rounds we noticed a difference from the privacy we are used to as doctors openly discussed cases with patients and anyone else around. For example one patient was informed he would need a leg amputation to prolong his life another 5 years. Other patients and families listened and waited for their turn to speak to the doctor. Another patient was admitted for an attempted suicide, the doctors pep talk included pointing to other patients who were less fortunate and we're going to die of illness. We were shocked as passerbyer's joined in with conversation. At home a conversation with this sensitive subject matter would be handled much differently.
As we wandered down the ward we passed a man who was packing up his belongings we noticed how uncomfortable the bed was he had been sleeping in. All we could think about was the luxurious remote controlled beds and requests for additional pillows we have at home. This is just one example of the stoic nature of the Zambian people. These patients are very sick and not once did we hear them ask for anything. Most of these patients have more then one terminal illness, and when asked how they felt they replied "fine".
In Canada we have not realized how spoiled we are with resources. This can be anything from having IV bags on hand so surgeries can carry on as scheduled to having the luxuries of special diets (heart healthy, diabetic, gluten free, clear fluids, etc.) as the only diet served here for breakfast is rice, cooked up and served by a a family member on the ward and served to everyone.
What we have taken away from this week is amazement and awe of what doctors do with minimal resources. They have become so proficient that they are able to rely on clinical judgment skills vs diagnostic tests. As reflect back to our practice we hope we remember to bring back with us the message that sometimes less is more. We wish that everyone could have this amazing experience as it has put life and medical care into a whole new perspective.