The first few days after leaving Croatia didn't quite go to plan. Firstly my flight out of Croatia to Budapest was delayed by 4 hours, causing me to miss my connection to Bucharest and wait another 8 hours in the airport. This meant I arrived in Bucharest at about 2am and had some fun directing the taxi driver to my backpackers before finally getting there. The next morning I set off in search of the Moldovan embassy to get my Visa, the main purpose of my being in Bucharest. I arrived at the embassy only to learn that that is apparently just where the ambassador lives (of course!) and I needed the consulate for Visa applications. An hour later I had located it. I walked up to the guard standing at the entrance only to be told the consulate would be closed for the next two days due to Moldovan National holidays. Perfect. The two days of the year I need to get a visa, what are the chances? Anyway, without much I could do I was stuck in Bucharest for an extra day, losing the money for my flight to Chisinau.
I made the most of it, exploring the city and meeting people. The first night I ate at a café near the backpackers and met some Romanian guys who were sitting at the table next to me. We ended up going out together as they called up some of their friends and family to meet 'this Australian guy' they had found. The next day I did a bit of shopping for essentials and explored the city. Literally the biggest attraction in Bucharest is the gigantic Palata Parlimentarium, built by the former communist leader Ceascescu basically as his residence. It is the second largest building in terms of floor space in the world behind the pentagon.That afternoon I met three Finnish guys at the backpackers on their way to Moldova to watch the Finland v Moldova qualifier for Euro 2012. We played some cards, I swindled them out of a bit of money at poker and we headed out on the town.
The next morning I set off again to get my visa. This time things went relatively smoothly and I got the visa after a few hours. I then headed to the train station to book a ticket on the overnight train to Chisinau which the Finnish guys were also taking. It was a pretty good trip and I had a whole sleeper booth to myself. The border crossing was interesting with Romanian and Moldovan guards both talking at me in Russian and Romanian as if they thought I would suddenly understand them the third time around. They generally gave up with a frustrated snort after a few minutes of this failed questioning.
When I first looked into volunteering with projects abroad I have to admit I knew next to nothing about The Republic of Moldova. I therefore arrived excited to learn more about this country and its people as well as gaining experience in hospitals as a medical volunteer. As I stepped off the train I was greeted with a smile by the projects abroad desk officer, Elena before we caught a taxi to my host family's apartment. There, we were welcomed by my host Victoria who gave us a tour and showed me the room that would be my home for the next month, complete with a city view!
Once the formalities were over I had a short time to relax and unpack before meeting Elena again to visit my project supervisor Dr Boris Topor. He was also very welcoming and encouraged us to make our first stop at the anatomical museum housed at the university which we did. The collection contains a lot of interesting specimens of Siamese twins and other prenatal disorders as well as displays of all the bodies systems.
After shopping for hospital clothes I headed back to my hosts where I met the other half of my host family, Vova, and enjoyed my first Moldovan dinner. I think one of the best things about staying with a host family is that you get to experience the real local cuisine and that has definitely been the case here. With most meals consisting of at least two courses, soup and a main, I am definitely not going hungry!
The next day I headed out with Tatiana, another of the projects abroad staff, for a tour of the city and to pick up some shoes for the hospital from the central market. And what a market! Definitely the largest I have ever seen selling everything from electronics parts to fish, clothes to bananas and toilet paper to an actual toilet. You can really spend hours in there just wandering around. That night I went to Chisinau's largest stadium (still only holds about 14000) with my hosts to watch Moldova take on Finland. It was an exciting affair with Finland going down to 10 men and also going down on the scoreboard 2 - 0 much to the raptures of the home crowd. I also met up with the Finnish guys again however their intentions to go out after the game were slightly dampened by the result.
The next day I met with Elena and some of the other volunteers for a trip to the Museum of Nature and Ethnography. It was good to meet some of the other volunteers, many of whom were also recently arrived and the museum provided some interesting insight into Moldova's history. That night we met with more volunteers from another program and got to know each other over a few drinks in a cosy Russian style bar.
So, all this and the volunteering hadn't even begun! Monday morning I met with Elena and my translator Veronica, who would be my shadow for the next few weeks, before heading to the Children's hospital. There, we met the director who asked me what I would like to see and do while I was there and if I wanted to see surgeries etc. I basically said I wanted to experience as much as possible and see some surgeries if I could. Two minutes later we were walking into the operating theatre. This was a definite first for me and I was a little nervous about how I would react to begin with. However, once they got underway it was amazing to watch. The first surgery was on a 3 year old male with a cleft palate (we were in the maxilla/facial department). I watched as they performed the first stage of repairing the defect, the soft tissue repair. As soon as this was done, the next patient was wheeled in before the first had even left the room.
The next day we arrived and met Sylvia (one of the doctors who speaks very good English) who advised us to go to the burns unit to observe some surgeries there. The first patient was a young male with some deep burns on both legs and lighter burns on the torso. The doctors took grafts from his arms and upper legs to graft onto the burned areas. It was interesting to see how the grafting process works by perforating the skin to allow more area to be covered etc. The second patient was a 16 year old male with burns on the right leg after an accident with a car battery. Again a grafting procedure was performed. The final patient was the worst case, an 11 year old girl with burns to 75% of her body. The surgeons worked mainly on her lower legs which were completely charred and the skin had to be removed often down to the fat layer. They then took what skin they could to graft with before packing the remaining exposed areas with some "artificial skin dressing" and rewrapping the wounds.
We returned to the burns ward again the next day and saw the follow up with two of the surgery patients as well as several others. This mainly involved changing the dressings and cleaning the wounds which is extremely painful for the patients. One boy had to be sedated to stop him screaming. After this we headed to Moldexpo to check out the MoldMedizine exhibition of medical equipment and medicines. Was quite interesting and we watched a presentation by Andrei, a Moldovan guy who I had met in Australia whose family owns a medical equipment manufacturing business.
On Thursday we returned to the maxilla/facial department where they had a few of surgeries. The first was, as described to me by an American resident, Brian, a textbook case involving a fistula running from the neck to the inside of the mouth. This could be demonstrated by injecting a blue dye at one end and observing it entering the mouth. The surgeons carefully removed it, taking care to avoid the branches of the carotid artery. The second was a solid cleft palate repair, and the third another, smaller fistula located just in front of the ear.
The next day we started in the opthamology department, where we watched a couple of patient examinations as the doctor explained the cases to us. They were very busy and crowded due to some renovations taking place so we decided to head over to the Malnutrition department. There, we talked with a number of the mothers who were there with their babies. They appeared quite happy to have someone to talk to as they spend most of the time alone there with the kids. This department deals with infants that are failing to gain weight or eat enough food due to allergies etc.
Over the weekend, Olga came to Moldova for a visit! It was really great to see her again and we spent the weekend catching up and exploring some more of Chisinau. We visited the botanic gardens which have a certain character to them owing to their slightly overgrown nature. We also met up with Andrei again, who I had actually met through Olga, and his brother for dinner and drinks on Saturday night before it was time to say goodbye again for a couple of weeks.
On Monday I arrived at the Emergency hospital and met the director of the microsurgery department. Unfortunately there were no surgeries today so we waited for quite a while before observing the nurses changing patient's wound dressings. I did get to perform one of these procedures with the nurse's supervision. On Tuesday I observed two surgeries, the first was on a middle aged male to release a nerve in the leg that had been trapped between the muscle and bone following a previous surgery. The nerve also had an abscess which had to be removed. The second operation was to shorten a finger ligament which was too long after healing from a wound. The operation basically involved removing a section then suturing the two ends back together.
On Wednesday we watched 2 surgeries. The first was on a middle aged male who had sliced the tendons in 3 of the fingers of his right hand. The surgeons made incisions to find the ends of the tendons which had recoiled a significant way into the hand before threading one end through to suture to the other. For the second surgery, I was allowed to scrub in and stand next to the surgeon. It was a more complicated surgery, looking for damage to 3 of the nerves running through the shoulder. The patient had been carrying a sheet of glass under his arm when he slipped and fell on it, slicing through his underarm. After locating two of the nerves it was seen that they hadn't actually been cut. While trying to locate the third, one of the arteries was cut and started spurting blood. Attempts to clamp it there failed and they were forced to cut through the Infraspinatus to clamp it further back. After it had been sutured they closed up. The last two days of the week were spent observing several more surgeries and talking to some of the patients about their injuries and progress.
On Thursday I headed with the rest of the volunteers to the National Theatre for the ballet production of Swan Lake. It was very entertaining with some amazing dancers. Also educational; I learnt that it's apparently physically possibly to do the vertical splits while standing on one toe! who would have thought!? On Friday night I went out with another volunteer, Nicolai from Denmark. We ended up at a fairly exclusive club called Dance Planet. At first the bouncers were not going to let us in because of our shoes, but as soon as they heard us speaking English they asked where we were from, apologised and ushered us in! Benefits!
In the third week I have been at the Mother and Child hospital near where I am living. The first day we headed to the Cardiology department where we talked to a lot of the patients and took some of them to different procedures such as Electroencephalographies and Electrocardiograms. I also had the opportunity to talk to a few local medical students about the medical program and conditions in Moldova. After 6 years of university they have a 5 year internship/residency during which they are paid about $100 a month. I felt bad telling them how much I might be getting at the same stage.
On the second day I joined a group of Israeli medical students studying in English in the paediatric surgery department with their teacher, Natalia. We discussed intestinal intussusception before heading to the operating theatre where we observed a surgery on a 16 year old male with advanced peritonitis following a previous operation for acute appendicitis. The aim of the operation was to clean the abdominal cavity and resect a small section of the intestine. The next day we observed another intestinal resection, this time on a 3 year old male. Torsion of the bowel had caused occlusion of a section of the intestine which had subsequently become necrotic. Thursday and Friday were spent mostly discussing and learning about various bowel disorders including Hernia, Peritonitis and Haemorrhage. We also visited some of the patients and observed the redressing of wounds.
Over this last weekend our volunteer group went on an excursion to Old Orhei and the nearby Orheil Vech. The latter is a monastery carved into the side of a cliff by some orthodox monks in the 15th century. We were also shown a traditional Moldovan home where the whole family basically lives and sleeps in one room with the stove providing the central heating. It's definitely a different world in the Moldovan countryside compared to the capital, there are almost as many horse drawn carts on the roads as cars.
Overall my 'volunteering' experience has been great. The doctors and Nurses have all been extremely tolerant, welcoming and informative. Although I haven't been able to do a great deal due to my obvious lack of qualification, the experience I have gained has been amazing. I have been able to observe a variety of surgeries as well as talking to patients, doctors and other medical students. It has really confirmed my decision to start med next year which I am now pretty excited about!
Well, that's about all for now. A few days left in Moldova and then onto Russia and beyond! I am also really starting to look forward to getting home and seeing everyone. See you soon!