Hospital Visiting Time

Government hospitals in Delhi are heaving with patients each morning. Doctors finish at 1pm to have lunch, so the pressure is on to get seen before then.  Visiting hospital is a family affair. The ratio of family supporters to a patient might be as high as five to one. This adds up to hordes of people.…

Light Greens

This is a not a self portrait. He looks green with envy. This is a mask from NE India, in the National Museum in Delhi. Taken with my Lumix LX100 shutter speed 1/10th second, f5.6, ISO 1600. On a more serious note, the clinic where I work in Jahangir Puri, North Delhi, for Medecins Sans…

Time for a change

Early next month, I start work with Medecins Sans Frontieres (Doctors Without Borders) in Jahangir Puri, a slum area in North Delhi, at their new sexual and gender based violence clinic, Umeed Ki Kiran. The contract is for a minimum of 12 months. From the clean air and pleasant climate of South Luangwa in July,…

And POTUS begat PEPFAR

“And POTUS begat PEPFAR” sounds like a passage from the Old Testament. In 2003, George W Bush (POTUS) set up the President’s emergency plan for AIDS relief (PEPFAR) to combat HIV/AIDS. This initiative has saved millions of lives by providing medication, training, supporting labs and infrastructure. But there needs to be accountability, to find out…

Kakumbi Clinic – my final days

Yesterday, as I drove to the clinic, I saw a man at the roadside, flagging me down. Normally, I wouldn’t stop (the medical association discourages picking up hitchhikers), but this man was in uniform. And he was carrying a very large rifle. I pulled over and he got into the cabin. We greeted each other…

Marketina

“There is a belief in Zambia that if you are HIV positive and you sleep with a mad person, you will be cleansed of the infection, ” said Nurse Zulu. “That is why three quarters of the mad people are HIV positive.” Living with severe enduring mental illness in developing countries is bad enough even…

Excrement

Several months ago, I mentioned in a blog that an infusion of elephant dung is a traditional remedy to treat hypertension. About half of what elephants consume passes through its intestines without the nutrients being digested or absorbed, so it is just possible that vegetation could contain chemicals with an anti-hypertensive action. But I would…

Can you hit my head some more?

“Can you hit my head some more, Dr Ian?” Last month, I diagnosed a young lady with cervical cancer. Her symptoms of lower abdominal pain, vaginal bleeding and an offensive discharge had been repeatedly treated “syndromically” – in other words, treating the common diseases which would cause these problems without making a specific diagnosis. She…

Where there is no psychiatrist

Mental illness happens everywhere in the world. I have seen Zambian patients with depression, anxiety, obsessive compulsive disorder, psychosomatic conditions and hysteria. Being aware of the cultural context is important, and good communication is essential. To get a history from patients, you need a good translator who can help you interpret patients’ symptoms. It may…

Poisoned

“Quick doctor, there’s an emergency. A girl has been poisoned,” shouted Andrew, one of the nurses at Kakumbi Rural Health Centre. Heath care assistant Helen pushed past him, saying, “I will put up an intravenous line.” “But we don’t have any intravenous fluids, Helen,” I said. “There’s no point. What has she been given?” “Poison,…