This Week Brought the Strike

Written by Sarah King, M.D. '17

This week brought the strike of the junior and senior resident medical officers (JRMO and SRMO).  They have gone on strike for a number of reasons, including salary, but also because there is no guaranteed job once they finish the first two years of post-graduate training.  Typically, after these two years doctors will work in a rural area for at least a year, a way of “giving back” to the government.  Unfortunately, although there are not enough open posts for the graduating SRMOs, the government will not issue permits to work in  private practice leave the country. As a result,  after seven years of training, a large proportion of them will not be able to find work.

Outrage As Impact

Written by Sarah King, '17

I’ve been home now for just over a week. I was so excited to come home to see my friends and family and perhaps most of all my two dogs, that the realization that I am home didn’t sink until I had been home for a couple of days. I feel sad that I was not able to help more, that I am able to fly across the world back home to my comfy bed, my healthy family and friends, my car. I feel guilty realizing just how very privileged and lucky I am. We give my one of my 14 year old dogs a medication for her painful arthritis that many patients in Zimbabwe could not even afford. I’ve been struggling with feeling despair about the lives and suffering of so many people, of such profound poverty.

Closed Doors Have Opened Others: Part II

Written by Katrin Sadigh, MD, WCHN assigned faculty for program development at Zimbabwe University

On Thursday morning, we attended the weekly Kaposi Sarcoma (KS) Clinic. This clinic specializes in the care of patients with this vascular tumor, with epidemic (HIV-related) and endemic (non HIV-related) the most common types seen in this patient population. We worked first with the senior housestaff member and then with the attending. Roughly forty patients are seen in this clinic weekly, though previously, the numbers averaged between sixty and eighty. Many patients are followed over several years, and return for follow up of quiescent disease. Others are referred from outside clinics and hospitals for initial evaluation and subsequent management of KS. Others are simply sick and complex, sent by their physicians with accompanying letters, asking for assistance.

Closed Doors Have Opened Others: Part I

Written by Katrin Sadigh, MD, WCHN assigned faculty for program development at Zimbabwe University

Rain, and plenty of it, has been cast as the main character of our first week in Harare. Not the kind of rain that even the local people expect during the rainy season, its brief, sudden arrival muddying the streets though with hints of blue skies in the distance. Now, the cloud cover does not dissipate, issuing any manner of rain, torrential or mist, overnight and throughout the day. It seems fitting somehow, as I awake each morning twisted in stiff white linens, stenciled with “University of Zimbabwe” in black letters, my dreams heavy with what I fall asleep reading.

Woody Hard Leg

Written by Katrin Sadigh, MD, WCHN assigned faculty for program development at Zimbabwe University

Color ascends her plump form in layers—from the wide double skirt up to the chemise beneath the long sleeve blouse beneath the heavy rain jacket, up to the hat which she took off before sitting down in the chair. Despite the layers, she cannot hide her legs, the swollen, thickened skin, what we soon learn to be described clinically as “woody hard.” The shape of her sandals is imprinted on the tops of her feet. She tries to tuck her feet under the hem of the billowing skirts, but my eyes have already spotted the growth on her left lower leg. From the boggy epidermis, it rises first as skin-colored specks with sheen, resembling dewdrops.

The Art of the Physical Exam is Alive in Zimbabwe

Written by Herman Sequeira, M.D., Pulmonary/Critical Care Medicine Fellow at 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.

Everlasting Hope

Written by Aparna Oltikar, M.D., Chairwoman of the Department of Medicine, Danbury and New Milford Hospitals, Western Connecticut Health Network

Zimbabweans have the unusual custom of naming their children after important events or emotions they experienced at the time of the child’s birth. In 2004, for example, when the swimmer Kirsty Leigh Coventry represented Zimbabwe in the Athens Olympic Games, a great many newborns were named “Backstroke,” denoting the event which won her a gold medal. A young waitress I met at the Victoria Falls Hotel explained that her name was “Happiness” because this is what her parents had felt when, after many years of trying to have children, she was born. Things were decidedly different when her youngest brother – the last of seven children – was born unexpectedly many years later. His name was Hardship.

The Difference Between Knowledge and Comprehension

Written by Morgan Hadley, '19

Before coming to Zimbabwe I had been warned that many of the patients I was going to see would die. These words intimidated me, but after five weeks I have yet to be stared in the face by death. Instead, patients disappear from their beds. The man from Ward C8 that spoke no English and only wanted to lay on his right side was simply not there one morning. The woman with labored breathing and severely decompensated heart failure; her bed was empty the next day. So was the bed of the woman with Kaposi Sarcoma on her vocal cords and that of the very skinny man with a history of strokes and HIV. One morning, they were just gone and new patients shortly took their places. For the number of patients that have died in the wards, I feel like we have seen just as many discharged. In the ICU, however, the ratio does not seem to be quite as even. The man with tetanus, the woman with goiter, and the girl with the necrotic uterus…all three disappeared, leaving behind empty beds.

Necessity is the Mother of Invention

Written by Omkar Betageri, '19 Zimbabwe This week marks the third week of our stay in Zimbabwe, and as such, this amount of time has allowed sufficient introspection regarding the culture of medical practice in Zimbabwe and the people themselves. As we spend more time with the medical system here, I find myself becoming more in awe of the students and medical faculty.

Immersion in the Unfamiliar

Written by Amber Meservey '19 Zimbabwe I write this on my way down to New York — finally the time has come to depart for Zimbabwe! Despite having had many months to contemplate my summer in global health, I don’t feel I even know what exactly to mentally prepare for. I have only a limited foundation of logistics from which to draw from in determining what to expect in Harare. Obviously that is also part of the appeal. I do know that I’m ready to throw myself into whatever I discover there, to stay open-minded, and to learn as much as I can. I’m looking forward to that inevitable and rather indescribable feeling of being immersed in the unfamiliar. As the trip gets closer, I am more and more appreciative of the structure of the program.