During the two weeks rotation in Lesotho, I will be placed at Motebang Hospital, the northern regional hospital of Lesotho. I will have opportunities to round on both children’s medical ward and the nursery, which includes a high-care unit. I will be working with interns and medical officers under the direct supervision of a US-trained and licensed pediatrician – Dr. Jill Sanders from the Lesotho Boston Health Alliance. In addition to inpatient services, I will have opportunities to provide child health care at the Maternal Child Health clinic providing preventive care for children under five years of age as well as the pediatric outpatient clinic providing acute care services for children and adolescents. Presentations and discussions on important child health topics will be conducted. Finally, there are opportunities to contribute to quality improvement projects related to malnutrition, dehydration and congenital heart disease screening.
During the two week portion of the rotation in South Africa, I will round on patients hospitalized in the pediatric respiratory ward of Tygerberg Hospital for one week and patients at the emergency medical center at Khayelitsha District Hospital, in collaboration with Stellenbosch University and the Desmond Tutu TB Centre. In both settings I will be working alongside local medical officers, pediatricians, and nurses, and will be under the supervision of Dr. Eric McCollum, a US-trained and licensed pediatrician and pediatric pulmonologist who is faculty at Johns Hopkins University School of Medicine, Department of Pediatrics. I will also give two 30-45 minute lectures to the local health care teams at both hospitals during educational sessions.
This experience serves resource limited pediatric populations in both the Lesotho and South Africa in order to better train both the rotating residents and board licensed physicians who will attend but also the home institution learners and faculty as well. These two unique populations, while both under-resourced, face different cultural and community barriers to care.
The knowledge sharing will allow for better clinical care to be given to not only the patients at both the Lesotho and South Africa hospitals, but the patients who we will serve after returning home to Baltimore.
My education will benefit from experiencing clinical care through a different setting and cultural lens. This training opportunity will teach me how to effectively execute medical care in a resource limited setting. My only exposure to resource limited care has been my outpatient clinic where I serve in a federally qualified health center. All my other clinical experience has been in a resource-rich academic center. This four-week elective will give me intensive training to further develop the skills to be able to provide better care to my current and future patients. I also aim to better hone my physical exam, observational, and history taking skills as I will not be able to rely on advanced diagnostics. I will also be exposed to a culture and population very different from my own. This will allow me to practice cultural humility and the skills needed to navigate interpretation services. The population I currently serve in my outpatient clinic and plan to serve after graduation will be a mixture of many different cultures and races who speak multiple languages. The ability to navigate through these barriers as a physician will help me provide fully competent and complete care to all; something I am excited to develop further after spending time in South Africa and Lesotho.
For two weeks, I was in Lesotho working in Motebang Hospital located in the city of Leribe. I spent most of my time working with the pediatrics team in the nursery and floors. There, we treated many children suffering from respiratory illnesses that ranged from simple pneumonia to TB and advanced HIV. The nursery was home to premature infants above 30 weeks gestation with some needing more advanced support including umbilical lines for fluid administration, NG tubes for feeding advancement, and CPAP to help with respiratory distress.
Then I spent two weeks working in Cape Town primarily at Tygerberg Hospital, one of the public hospitals. There, we spent time in the ED department, rounding with ID team, and HIV outreach clinics. It was a special experience because I got to learn so much about TB and HIV care as Lesotho and South Africa are some of the most endemic countries for HIV infections. South Africa has the most people living with HIV in the world. As someone who wants to establish part of my career caring for people living with HIV, it was truly meaningful. It was incredible and I’m lucky to have been able to have had this experience!
