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The hospital in which I am working is the largest in Belize and the referral centre for the region. It has approximately 115 beds. There is a medical ward, a surgical ward, maternity ward, medical admissions unit and A and E. On first impressions the hospital is surprisingly western, however, over the past two weeks I have found that they are lacking in funding and therefore in basic supplies and equipment. Patients have to pay for investigations (eg blood tests, x-rays) but these are cheap enough for all people to afford. However, CT scans and MRI have to be done privately and so these are too expensive for some Belizians. A CT is 200 Bz dollars (50 pounds) and MRI is 1500 Bz dollars (375 pounds). The minimum wage is 1 dollar 25 cents Bz an hour - so you can imagine that investigations we take for granted in the UK are thought about a lot more and ordered less often. There is no appointment system, all patients arrive at 8am or 1pm and wait until they are seen, this can take hours as the clinics are busy and doctors are often an hour or so late. I was on the surgical ward yesterday, there are loads of patients with complications of diabetes who have had amputations. Orthopaedic patients are not operated on as often as in the UK, fractures are aligned by manipulation - without analgesia! Fractures are often left to heal in suboptimal positions and patients are left with some deformity. Any complex cases are dealt with in the USA or Guatemala - at the patient's expense.
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