Thursday, 11 June 2009

Dogs and Cancer

This Monk, as far as I can, tell had been put on the list for a cataract operation by a visiting doctor. He was very excited and kept pointing to his name on the list.

After 4 days at the clinic I'm pretty exhausted. On top of the intensity of the work, keeping me awake is a large population of wild dogs living around my house who get very territorial at night. From my room it sounds like epic battles with the barking and snarling of maybe 4 or 5 dogs, ending in wailing from the loser. Unfortunately their territorial instincts at night mean that cycling back from dinner or the Internet cafe or whatever, they go for me which is pretty frighting. Some of the Medics at the hospital enjoy a good meal of dog meat. I wish they'd come and eat those dogs...

The clinic is pretty frustrating. We have a small handful of blood tests available and no X-ray/ultrasound/microscopy (although in some cases we can request X-rays from the Mae Sot's main hospital). We have such a small number of different medications that I can pretty much memorise them all. Over the last couple of days I've seen a number of nasty cancers and the only thing I could do was send them back to Burma with 20 paracetamol tablets for Pain. The clinic cannot afford to get Biopsys/Endoscopies/Mamograms/ and while the patients may pay for these tests back in Burma, they almost never have the money to do so.

The Medics here don't seem very keen to break bad news to patients so I can never be sure if they know the severity of their conditions when they leave but today, a man with throat cancer who spoke very basic English. Clinically it was obvious what was going on and he brought with him an Endoscopy and Biopsy report (some do manage to scrape the money together) both of which diagnosed oesophogeal carcinoma...yet nobody had ever told him. So I had to break the news, something I didn't expect to have to do until much further on in my career.

I seem to be focusing on all the doom and gloom...I think it's the lack of sleep. On a happy note, a 2 year old girl I admitted 2 days ago with massive periorbital cellulitis (swollen, infected eye) in her left eye which was beginning to spread to her right, can finally see again. I made it my business to keep a watch on her as these can develop into meningitis and the medics here wouldn't let me give her drugs intravenously.

And now I'm off back home, to brave the dogs...

The entrance to our consulting room. There is a barefoot policy throughout the hospital...

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