Long entry - Am actually soon to leave Johannesburg to return home to UK for 4 days, I've been here 4 weeks before reading seeing the email from Laura H. Hve been working in the Chris Hani Baragwanath Hospital in johannesburg. Its catchment area is basically soweto which I am sure you have heard of. Soweto is the same as all suburbs in Jo'burg, housing a mixture of mainly poor and lower class families along side the smaller pockets of middle and upper class. The poor are generally unable to get work and resort to drinking and violence, feeding the very busy trauma unit. The unit only has capacity for 6 P1 patients at one time, meaning that the W/E after pay day, you have to triage patients as to whether they are dying and you cant help them (P1 hold), going to die if you don't help them (P1) can wait but will die if not helped ultimately (P2) and can wait longer (P3). We (the elective sudents) work as part of the trauma team, consisting of the registrar (normally in theatre with the patient you send them for laparotomys and thoracotomys), two interns (PRHOs), 3/4 elective students and 4/5 trauma nurses who you normally have to ask twice for everything. So you can imagine, we play quite a role. The typical patients are in one of four catagories - GSWs, Stabs, Car crashes, Burns. GSWs, burns and Stabs tend to come in at night, wheras crashes come in a steady stream of about 2/3 a day and more at night. After a couple of hours you don't get any shocks, everything is 20x worse than any trauma that you see in the UK but is so much more simple to manage due to the lack of technical equipment and general principles of ATLS that are used on each patient. As an elective student you learn very quickly the proceedures that you are needed to do, including intubation (without any drugs half the time), Needle thoracocentesis, IC drains, and central lines. Nearly every patient that presents on a stretcher gets ABCDE and then two peripheral lines, followed by more if needs be. CT is 1/4 of a mile away along an outside covered walkway making it an interesting round trip with an intubated patient! Anyway, theres a bit of an overview of work. Now play time so far: Have been able to get away twice for some long weekends. The first was to Durban, for 4 days, returning via the drakensburgs (pictured). Durban was fun, nights out were a little more relaxed as less risk of getting mugged etc. Also managed to get some climbing done on an awesome indoor wall. Went surfing in the sea, as usual i was crap at it - still no improvement on 5 years ago! Also went surfing on an artificial wave, which i did master quite well pics to follow. The drakensburg mountains were awesome, we walked up one called sentinal peak that had (supposedly) the worlds 2nd highest waterfall in the waterfall (rather than tallest) which turned out to be the worlds 2nd highest trickle. But still good fun. Also went across the mountain pass into lesoto - interesting people - more to come). I gtg now, talk about the rest in the next entry?!