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Working in Tonga
I have completed the first week of my placement at Vaiola General Hospital in Tonga Tapu. As the hospital is fairly small and there is quite an abundance of elective students already me, Rynn and Matt decided to separate out and rotate through the different specialities during our four week placement. I started with O & G which was quite nice seeing as I had just spent time doing O&G in Trinidad. We also decided to spend two weeks in Vaiola Hospital then get a plane to Va'vau (another on of the 3 island groups that makes up Tonga ) to work in the hospial there for the last two weeks. This is really good as we are able to combine travelling around the islands with working!! Va'vau is also meant to be beautiful and slightly wamer than Tonga Tapu as it is a bit further north.
The O & G department have just moved to the newly bulit wing of Vaiola hospital so everything is clean and fairly modern. The money to bulid the new wing was provided by the Japanese Government (Japan seems to have a lot of influence in Tonga). The )&G department is quite small with only two main Drs and no interns, which is good for me as no one to compete with to do jobs. I was assinged to shadow Macca, a rather large but friendlyTongan man, dressed in a black skirt and shirt with mobile phone head set permenantly in his ear. I was introduced to the O&G nurses who are all also really freindly and willing to help me out and they actually remember my name which although doesn't sound like much is really nice, makes you feel like part of the team. My first week has been very productive, despite the fact I start at 9am and finsh at lunch time most days. Within the first hour of starting my placement I had watched a normal delivery, episiotomy repair and shadowed Dr Macca's ward round. I think this must have been all a bit too quick however as during the delivery I almost fainted!!! As soon as the nurses made the episiotomy cut I started feeling lightheaded and sweaty and had to sit down. I am a nightmare, I have whated lots of deliveries before, I really need to get over this fainting malarky!!!!!
My time on the obs ward has given me a real insight into Tongan women. They are all so gentle and very passive. They are very trusting of the medical profession and never seem to ask questions, just follow instructions. For example, there is no gas and air or epidurals here, just a few encourageing words from the midwives or stern words if mums making too much of a fuss about the pain, pushing, pusing then out pops the baby. Yes thats right alot of women here have large families so by the 3rd or fourth baby it is just routine for them. There are also far less teenage pregnancies in Tonga, than Trinidad or the UK, probably due to the strict religious beliefs, the average age of mum in the antenatal clinic was 20-30 yrs. Antenatal clinic was really fun, it runs twice a week and Macca is the only Dr seeing 20-30 patients in one morning, plus covering the ward. After the first morning with him he was allowing me to review the patients myself, take histories, examine and said I only needed to refer them on to him if I had any queries. It felt really good that a doctors actually trusted and repsected my judgement for once, after all these years of med school. He even allowed me to independantly referr a patient to the cardiac clinic, for query ectopic heart beat in mum. The gynae clinic was also really good experience, instead of observing as I have done numerous times in the past, I was given patients to see, with the aid of the nurses interpreting, I was asked what I thought the management optoins should be and I was even asked to do two cervical smears and remove an IUD with only a nurses assisting. I am starting to feel like a proper junior Dr at last!!!!
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