Monday we went back to the medical ward, it was great to see how some patients had really improved since we were last on this ward, we also felt useful, knowing how the ward rounds worked and how best to assist and be part of the team. I saw a lady with gangrenous fingers of unknown cause that the consultant and I got to analyse and clinically evaluate together and Amy saw a 15 year old girl with the most shocking cardiac signs she had ever seen! The girl had a visible heave and thrills all over her chest, her heart murmur could be heard in her back it was that loud, another thing that drives home the severity and prevalence of rheumatic heart disease in Vanuatu.
We went back for clinic the afternoon which ended up being our only 'on call' of our placement. We followed Dr Sale to emergency helping to clerk a patient with heart failure in, Amy smashed his cannula in like a complete pro whilst I labelled blood bottles and wrote in the notes. A lady came in with really bad diabetes, almost in a coma, this at home would have been a really scary high pressured situation but here it was dealt with meticulously but in a very calm manner. Nothing was rushed, with a lack of medical tests and facilities the doctors rely entirely on their own judgement and their own skills and knowledge base. Within half an hour the lady was talking and responding to pain whereas before I had stabbed her (unsuccessfully) with a needle and she hadn't even winced. This was a late shift but a really cool day! Definitely a good way to end our time
In medicine in Vanuatu. We went back to munch on our new favourite dinner. TACOS!
The following day we had arranged with Dr Dyxon to go back on the surgical ward with him. The ward round was amusing as usual with a lady being treated with two lines of Cadbury fruit and nut for low blood sugar before actually checking her blood sugar which turned out to be 28 (normal being 3-7!!) needless to say I'm sure the poor lady enjoyed that treatment anyway!
We watched some debridements and a breast biopsy and I got to assist with the skin graft. It brought back memories of City hospital but there was a definite shortage of working equipment on this occasion, that being said the result was still impressive, the ladyy being given a new covering of skin to her foot.
Amy in theatre
Sharps bin!!
That evening we went into town for one of our last meals out of the trip. We had read brilliant reviews of a place we walk past all the time so decided to give it a go as the view was said to be spectacular. It certainly didn't disappoint, the sun may have gone behind the clouds but watching out over Port Vila harbour never seems to get old
We had delicious food for a really reasonable price and an amazing dessert of the tallest chocolate soufflé we had ever seen!
I had spicy chicken wings with blue cheese sauce and chips!! YUM!
Shock at the height of the pudding!
So tasty!
We may have to come back to Chill before the trip is over, it was probably a good thing for our waist lines and our bank balance that we haven't found this place sooner!
The next day we went back to theatre having had a bit of a disaster with our visas. For the last 5 days we have been here illegally having outstayed our tourist visa! We were under the impression, as we had queried this a number of times, that or elective supervisor was going to extend it for us. We checked this a final time on Tuesday to find that it hasn't been done as she needed our actual paper passports to do this! Wednesday morning was a passport collection mission before making it in to pop into Dr Dyxons theatre.
Our experience in theatre has been a brilliant one, everyone is in such high spirits, there's always reggae playing that everyone struggles not to bob along to, so many laughs and so many jokes and yet very few errors appear to be made. We were encouraged to get fully involved, both of us having acted as first assistant in our last two days. Amy did her foot skin graft, getting to stitch and assist, again throwing us back to times as a CP1 student. I (finally) put a cannula in successfully and assisted the anaesthetic assistant Michelle with his intubation. The whole day was great, we truly felt like part of the team, the operations we had wanted to see didn't take place In the end though.
We had hoped to watch a laparotomy and a mastectomy but a surprising barrier was in the surgeons way. The lady with the laparotomy needed blood on standby just in case something went wrong, similar to the process in England. The surprising thing to us was that this meant they had to wait for someone to come in and donate blood, normally family members, this blood then has to be screened and tested for compatibility. -all this was supposed to happen by lunchtime apparently, sadly it didn't happen so the operation got postponed again. The lady who was having the mastectomy got a bout of pneumonia so her operation too had to be postponed. This didn't dishearten us though as our other experiences had been so involved and memorable.
Amy assisting in a debridement (or two)
Surgery in Vanuatu has dramatically changed both of or impressions of it as a specialty. There is a completely different vibe in the operating theatres in Vanuatu, one that is generally a much more pleasant place environment to work in. We both feel these have been some of our favourite days of our elective, something we never would have anticipated. What a great few days to finish on
Dr Dyxon, consultant surgeon
Michelle the hugable anaesthetic assistant (and chief of Pango, Efate!)
We went to thank Dr Kevin for always checking up on us during our time here.
We headed into town to celebrate finishing placement with a proper ice cream sundae from Jills Cafe. It was delicious and a lovely place to see the sunset and reflect on our last few weeks
THANKYOU Vila Central Hospital
For a completely fantastic placement
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