The Art of the Physical Exam is Alive in Zimbabwe

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Dr. Herman Sequeira, second from left, with a group of UVM medical students and a resident from Norwalk Hospital

I was thrilled to participate in the global health elective in Zimbabwe this past July. Having grown up in Kenya, my prior global health experience had primarily been in that region. In some respects, Zimbabwe is not different from other African countries. Its people have tolerated rigged elections, hyperinflation, corruption, collapse in tourism, exploitation from the West and, as a result, lack resources in their medical system.

On arrival to Parirenyatwa Hospital, I was impressed by the organization, efficiency, and care provided by the medical house staff and attending doctors. As an educational hub, the hospital accommodates a multitude of local medical students and nurses. Academic activities included multidisciplinary rounds, morbidity and mortality conferences, cardiac didactic rounds and obstructive structured clinical examinations. The Zimbabwean doctors had a wealth of knowledge regarding epidemiology and pathology of local diseases but were also versatile in the latest clinical trials. They provided evidence based care despite the challenges surrounding them. Infectious disease made up the largest burden of disease due to a high prevalence of HIV in the country. The opportunistic infection and Kaposi Sarcoma clinic was eye-opening both in terms of the multitude of different presentations of disease and the large number of patients on anti-retroviral therapy despite social stigma and discrimination that still exists.

I had the privilege of giving critical care lectures to the anesthesia residents, conducting attending rounds in the Intensive Care Unit, and teaching a point of care ultrasound course to eager intensivists. My most import role, however, was providing an environment that facilitates learning for our three UVM students and internal medicine resident. We held daily discussions on ethical dilemmas, clinical cases, and medical and research topics. I tried to provide insight on life as a resident and fellow and what the future of medicine may look like.

I had the opportunity to travel with our group to the Northwest of Zimbabwe where we saw the mighty Victoria Falls, went on a river Zambezi dinner cruise, adventured on safari to Chobe National Park in Botswana and finally, on our return to Harare, saw the Zimbabwe national cricket team play against New Zealand. We became wonderful friends and continue to keep in touch.

Despite its ongoing difficulties, Zimbabwe is a beautiful country with an abundance of natural resources. Its people remain gentle, generous, and hardworking. The healthcare standards impressed me immensely. Healthcare is in good hands thanks to the physicians who continue to strive for perfection despite the hardships of a failing government.  These doctors taught me that the art of the “physical exam” is very alive in Zimbabwe.

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