Hi everyone! Well...this is MY elective finally! My second day at Gizo hospital over with and thought i'd update you on what a fantastic experience this really is. The hospital itself is very small and compact - just four wards - paediatrics, male, female and maternity. There is an A&E and Outpatients Department (OPD) which is where the med students are expected to work. You can also get involved with theatre (they have one theatre which can do local anaesthetic procedures only) and deliveries. However, for now thought i'd concentrate on the A&E/OPD side of things as i've done quite a bit of the surgery side in Honiara. A&E and OPD is such a brilliant place to work as a medical student. It also has little bit of General Practice all rolled into it as there are no family practitioners in Gizo or the entire Western Province, so people travel from many of the surrounding islands to see Drs here. I'm finally actually getting to use my knowledge and experience to help people! Poor patients(!) And i'm actually helping and making a difference which is what I really wanted my elective to be about. In Honiara it was more about learning, practical procedures and observation. Here you see patients, diagnose, investigate and set management plans including follow-up clinics and prescribing (which is a little scary I have to say!). You really have to use your initiative as resources are minimal. If there aren't any medical students here, the outpatients and A&E is rather limited as they only have about 3 doctors here in total and their time is stretched enough. So i'm feeling needed and valued which is great! Not to say this isn't incredibly daunting! Jackie and Emma (the two students here at the moment) have been kind enough to show me the ropes and without them i'm not sure what I would have done on my first day! The three of us work together in the OPD so plenty of opportunity to shout across to the other one to ask what they think! (Slight lack of patient confidentiality however!). On my first day I got dragged out of the OPD by a paediatric nurse who said she'd like me to see all her sick kids in the paediatric clinic that morning. Bit scary, but managed to pick up a child with TB and admit them which was cool...hope I read the Xray correctly...(!) Today was also busy and saw a domestic violence case which was quite traumatic, but convinced her to see the on-site counsellor which was quite an achievement as she was very scared. Aside from that i've seen lots of boils, fractures, lumps and bumps. Had to do a neurological exam for a lady with back pain...phew, had to get those memory cogs turning in my brain, but made it in the end! My knowledge of Pidgin has come on leaps and bounds! It's amazing how much you can pick up just by having to communicate with people that only speak that language all the time. (Tom, i'm sure Brazil will be fine!). Students tend to work all morning until about 2pm. We then have lunch and can either go back (which noone ever does) or relax for the afternoon on the veranda at Phoebe's or by the pool. The weather has been pretty bad since Monday so not many sunbathing opportunities, but hopefully it will improve. The girls want to take me to Kennedy Island on Thursday afternoon for some snorkelling and then fishing (?!) on Saturday. Apparently we can pay someone to take us out in their boat and any fish we catch we get to keep! Great! The freezer is already stacked high with fish from their catch last week, so it seems like a rather lucrative exercise! If someone told me this time last year i'd be fishing with a spear off a boat in the South Pacific, I honestly wouldn't have believed them! Anyway, will stop rambling and get home to prepare dinner (it's the girl's turn to cook). Thankfully, Emma is an absolutely brilliant cook so Jackie and I get off lightly. We even had apple crumble last night....yummy! Will keep you posted with the week's events... Thanks again for all of your lovely messages x Love Lise xxxx