Ronan Flynn

Medical student and Voluntary Services Abroad member,
University College Hospital Galway,
Ireland.
December 2004

I spent June and July of 2004 as a medical student in St Francis. I worked mainly in medicine with Drs. Richard and Jo Newell, who afforded me a greater level of responsibility than I was used to at home, whilst still providing a safety net. I helped out in the clinics and joined in the on-call rota (but always with a more experienced doctor as second on call). This level of responsibility (and the nurses acting as translators) really helped me to hone my history taking and examination skills, as well as build my confidence in making decisions about patients. It is a great opportunity not only to learn, but also to put to use the knowledge that you already have and this is appreciated by all, staff and patients alike.

Although you will see many exotic tropical diseases, other conditions common in the first world such as heart failure and diabetes are also commonplace in St. Francis and, unfortunately for the patients but useful from a learning point of view, the symptoms and signs are obvious. One of the drawbacks with working in the third world is that the modern regimens of treatment and investigative procedures are often unattainable. Because of this when you go home you may not be as aware as your peers are of the most up to date drug or test. My friends and I overcame this by giving each other tutorials prepared from textbooks about the more important conditions. And speaking from experience I can tell you that it does not take long to catch up on this information and the exposure that you will receive in St. Francis will stand you to better stead no matter what level of study you are going back to.

Although I spent only a short time in Surgery, it was time well spent. I was expected to scrub in for every operation as well as help with suturing. By the end it was like tying shoelaces.

HIV is more prevalent than I initially thought. Although it is a priority of the directors to have a ready supply of disposable equipment such as needles and rubber gloves I would advise anyone travelling to bring their own supply of gloves as well as eye protection. I performed a number of blood letting procedures in my time in St. Francis and took great care each time. In the extremely unfortunate event of a needle-stick injury the directors of St. Francis provide a full course of anti-retroviral medications free of charge and immediately available to all staff of St. Francis which greatly reduces the risk of infection.

Outside of the hospital there is a huge amount to do. The South Luangwa wildlife park is close by. This is arguably the best park in Africa and one of the only ones that allows walking tours. There is a special rate for St. Francis employees at one of the local accomodations. The hills behind the hospital provide for a satisfying hike with fantastic views of the surrounding countryside. There is also the opportunity to visit local villages, eat with the villagers and watch performances of tribal dancing.

St. Francis is not just a hospital but a community in itself. All the staff live on campus.There is a school and a church on campus. Students came from Ireland, England, Holland and America when I was there. It was great to be around people with similar interests as myself. We all found it very easy to mix with the extremely welcoming and friendly Zambian people, and I joined in soccer games with the hospital team most evenings.

All in all my elective in St. Francis was an unforgettable experience that I would recommend to anybody interested in working in the 3rd world.