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Medical Elective – Jennifer Paskins

I have completed rotations on adult medicine, obstetrics and gynaecology and I am now at the children’s hospital within Jinja Hospital, Uganda. The mortality rate for children under the age of five is far greater than that of the UK due to malaria, pneumonia and diarrhoea. I have seen many presentations of these illnesses at the children’s emergency department amongst a host of other rarer conditions such as congenital abnormalities and paediatric cardiac failure. I have had the opportunity to take histories, examine and present patients to the doctors and discuss plans too.

This is excellent practice for me because it has allowed me to improve my knowledge and skills in paediatrics and infectious diseases. I have also had the opportunity to review patients by myself and provide teaching on the ward round to the clinical officer trainees and nursing students. I hope to provide some more teaching on how to examine children in the next few weeks.

There are significant differences between Ugandan and British healthcare systems. For example it is more difficult to confirm suspected diagnoses because laboratory tests are too expensive, unavailable or the lab is closed therefore doctors tend to provide blanket treatment for all suspected diagnoses.

Antenatal care is also very limited so conditions such as Down’s syndrome and holes in the heart are often only picked up after the child has been born. The experience and exposure have been very good so far and I look forward to completing my attachment in paediatrics and moving on to community care.