IloiloApril 1, 2018 on the Philippines ⋅ ☀️ 21 °C
First week in Iloilo. Enjoying the weather. Enjoying the placement and meeting very nice people.
First week in Iloilo. Enjoying the weather. Enjoying the placement and meeting very nice people.
Woke up at 6.30am to have some breakfast, nice selection of tasty snacks!
Then met Joy and Richard who showed us to a Jeepney, the main method of public transport in the Philippines (basically a stretched out version of a tuk tuk sort of van with a completely unfathomable route network and payment system).
We made it to the hospital where we were shown into the student’s room. We were then informed that we had to attend the morning ceremony, where songs are sung, mission statements read and awards/intros done outside the front of the hospital. This also included us being announced and introduced to the team, having to stand at the front!
We then did a tour of the hospital where we were shown all of the departments. It’s all very different to the uk (obviously) with lots of cramped beds, relatives helping with care and unbelievable heat!
We then headed out to town for a city tour. First we went to Molo square which has a historical mansion where we tried Blue Ternate (flower) ice cream which tasted like vanilla and flowers. We then went to look at St Anne’s church before getting a jeepney into the city proper.
From here we went to the city hall where we were made to watch some strange videos about various festivals and world record cycling events(?) that happen in Iloilo. After this we were able to try on some local performance costumes full of feathers and beads which was great fun!
Next we went up on to the rooftop to get a view of the city. Not that attractive but there was a nice view of the ocean and the river that joins it.
Then we headed for some lunch at an idilic little restaurant called Buto’t Balat. It was a little haven in amongst the city chaos with a pond and beach hut style straw huts. Had some delicious mango smoothies and a variety of Philippine food.
We then went to a supermarket to get local SIM cards, adapters and crocs ready for placement tomorrow.
Back to the house for my intro meeting and a local language lesson. Trying to learn Hiligaynon is very difficult as it turns out! Another one tomorrow to try and practice what we learnt. Then we had some dinner and a bit of chill time. I was also not so patiently waiting for my email to find out which hospital I was placed at. Off to bed for an early night ready for the first proper day tomorrow. Exciting stuff.Read more
Up early again, back off to placement. Went to the female medical ward this time. Attached myself to the postgrad intern (kinda like an F1) and helped her do a few procedures which was cool. Even learned some tips from her for different things. Went with a patient who had a stroke to have an X-ray, which involved pushing her all the way to a separate building, still being ventilated by her relative, no portable X-rays here!
Went back to the house and had a video call with Roger :) nice to have a catch up!
We then had bbq and karaoke night. Gorgeous bbq food and mango pudding. Had a few drinks and then the karaoke began!
Seemingly it’s tradition for newbies to sing. I was determined that I wasn’t going to do any, but eventually gave up and did a rap - numb/encore with Emma as my singer. It was actually kind of fun!
Had a few more drinks and played some card games on the roof. Really fun evening and good chance to get to know people. Then to bed for an early startRead more
Up at 6.45 for breakfast of hash browns and fried eggs. Headed in, same old stuff. Nothing much was happening at MICU as it was all the same patients as yesterday and they were all now stable. There was a case report presentation on decompensated liver cirrhosis so I went to that which was actually a really useful revision session. I asked a question at the end and so the gastro consultant dragged me over and had a discussion with me which was great. We were also talking about nice places to visit in England.
After this I headed to the gym with Emma and Claudio. It’s right near the hospital which is super handy and only costs 80 pesos for a walk in slot. Taught them how to do clean and press and snatch which was great fun. Also managed to do the WOD from CFL in 31 degree heat with my swollen feet which was pretty painful! Also came out in loads of sweat blisters where I am sunburnt, ouch!
On the way back, we jumped in the wrong jeepney and so ended up the wrong side of the bridge that we’re told not to go past (oops). So then we had to walk back for half an hour in the searing heat. The route took us along the esplanade river which is actually really pretty so it worked out ok in the end. We also called at 7/11 to get mixers for bbq night.
Decided I had to give in and have a nap when I got back as I was so tired! Slept for about 2 hours, hope I can sleep tonight.
Got myself a bit glammed up for bbq night, eyelashes and all which was nice. Everyone was quite tired but still managed a few songs. I did the rap part to Usher’s Yeah which was super fun.
Then headed to bed, absolutely knackered. Have now recruited my flight socks to try and get rid of some of this fluid!Read more
Up at the usual time, omelette today. Had to wait ages for a jeepney this morning as they were all either super full or going to the wrong places. Got to the internal medicine handover and the ICU doctor was nowhere to be seen. Went to ICU after and waited for a while, still no sign. Decided to pop to the loo in the work the world office where I found Joy and Emma. Emma suggested that I come with her to NICU (neonatal intensive care) if nothing much was happening on MICU. Went along with her and it was actually a really great idea. Got to see loads of tiny babies, quite a lot of them really premature and some that had only just been born. Got to cuddle quite a few of them which was lovely! Some of them are really sick which was sad to see, one had an omphalocoele surgically repaired and another had a diaphragmatic hernia. After that we decided to head home. Did a bit of washing and had some lunch.
Emma and I then decided we wanted to go to a pool for the afternoon. Joy told us about the one at the Richmonde hotel which was near SM city so we thought we would give it a go.
It cost 500 pesos to get in which is about £6.80. It’s a very fancy hotel so I didn’t mind at all!
We got up to the 7th floor and were given towels and a drinks menu. Decided to treat ourselves and get some cocktails. Had Mai Thai first and then a Long Island iced tea. The pool was lovely and had jacuzzis in it. The only problem was they wouldn’t let me wear my tshirt (which I wanted to wear to cover my sunburn) in the pool as the cotton is apparently bad for the pool?!
Chilled there til about 5pm and then headed over to SM to get a few bits. Had to walk round to it which was actually about a 20 min walk but we found a few really nice looking cafes and the immigration office on the way which is useful for next week when we need to go. Needed to get some Zovirax from the pharmacy which turned into a bit of a faff as nowhere seemed to have it but I got there in the end.
Came home and had dinner then packed ready for Borocay in the morning. So knackered!Read more
Last day in hospital today! Woke up feeling much better than last night and so decided I would brace it in. Went in for the usual time and headed to delivery. Here I met Catherine who is a midwife. Spent most of the morning just chatting as nothing much was going on. There was also lots of local nursing students milling around wearing weird yellow and green scrubs. They were doing loads of obs and things on the women so we didn’t want to be even more in the way! Eventually we saw an emergency c section for a foetal bradycardia which was interesting. I waited around until about 12.30 to try and see one more delivery but nothing looked imminent and I felt quite light headed again so I decided to head back to the house.
I felt hungry enough to eat and so tried to have a bit of lunch which went down ok. We then headed to SM city to pick up a few bits ready for the weekend/next week. Got a few bits and bobs for the children at the village like notebooks and pencils and crayons. 3 of the girls had been asked to sing in a music shop so we went to see them for a little bit. Then headed back to the house, packed my bag ready for Cebu and then got ready for bbq night.
Had some food and did a song at bbq night but was still feeling a bit ropey so I went to bed quite early. Said my goodbyes to some of the Australian girls as it was the last time we would see them. Then headed for bed.Read more
Up at the usual time. French toast, bacon and syrup for breakfast today, yaaass!
Went to internal medicine handover as usual but this time was introduced by one of the residents who is in charge of work the world things. She showed me where MICU was and introduced me to the staff which was nice.
MICU is air conditioned which is AMAZING! And there are only about 8 beds in there so it isn’t too busy. Most of the patients seem to be stroke patients (still can’t figure out why it’s so common here) who are intubated and have full monitoring. Saw an “emergency” re-intubation in a patient that desaturated to 50% as a blood clot was blocking her ET tube. The resident seemed very relaxed about this and didn’t particularly do it with much urgency! Read through some notes and saw a few patients then headed home.
Once we were all back we headed to SM city mall again to grab a few bits ready for our upcoming weekend away. Got a new bikini, denim shorts and some products. Also treated myself to a frappe! We then headed back to the house to chill.
As this week coming is Easter weekend (Holy Week here), it’s basically a massive national holiday from Thursday to Monday and so me, Emma and Hannah are planning to go to Borocay then. We spent a bit of time looking at hotels and eventually got one booked which has a pool and looks quite nice (decided to treat ourselves). Once we had done that, I chilled in my room for a bit and then video called Momma. Was really nice to catch up with her, even if the video did keep cutting out! After that I went to bed.Read more
Up at 7am to go get breakfast at the hotel. Had to wait for a while for them to check our room so we could get our ridiculous security deposit back. Once we had done that we got a tuk tuk down to the ferry port. This time we only had to buy 2 tickets and there was a guy with a microphone instructing people where to go, much better! Got onto a boat pretty quickly and back over to Caticlan. Here it was chucking it down and so we didn’t want to have to walk far to find the bus. Luckily spotted what seemed like the right one straight opposite. For some reason it was more expensive (only by 20 pesos) but we just went with it anyway. Managed to sleep a lot of the way back and watched a bit of Top Gear on my iPad. We arrived at the bus terminal at around 3pm and then had to try to get a taxi back to our house. The guy didn’t seem to know where it was and wanted to chat to us about everything on the way but we were so tired at this point! Eventually made it back to the house and met my new room mate Chloe. She seems really nice but is only here for 2 weeks so I might go back to an empty room again for a while, we will see! Had dinner and made a plan with everyone wanting to go to Antique at the weekend. Headed to bed to chill and watch some TV to get some rest ready for hospital again tomorrow.Read more
Woke up at the usual time. Headed in with Emma this time as she has been assigned to internal medicine with me so I don’t have to be on my own! We went to handover and then headed to medical ICU for a bit. Lots of the patients were the same as previously although one of the previous ones now had a tracheostomy in rather than being intubated. There was also a young guy on there who had had some sort of brain bleed. He has really interesting eye signs and so we did a brief cranial nerve exam on him to see where the deficits were. We then sat and discussed his case after which actually made for some interesting learning. We then went to a case presentation on bacterial endocarditis which was interesting and informative but once again highlighted serious gaps in the knowledge of the residents as we seemed to know answers to lots of things they couldn’t answer.
After that we headed home for lunch and a nap as we planned to come back in later to do an emergency room shift. Slept for about 2 1/2 hours and felt much better for it, think I was still trying to recover from the weekend!
Spent a bit of time after that getting a bit stressed out as I was trying to plan the weekends trip away for 12 people and it was quite difficult to come to a consensus on what we wanted to do. Eventually got it sorted and everyone seemed happy enough.
Me and Emma then got a jeepney back into hospital for our evening shift at about 7pm. We headed to the emergency room which was noticeably busier than in the day time. There were patients everywhere including in chairs and on the floor and all of them had a bantay (relative/carer) with them so it was hectic. We approached the internal medicine desk but they weren’t particularly forthcoming or talkative (no surprise there). Quite soon after we arrived, we noticed a few of them rush to a patient to do CPR. We were really shocked at how poor their CPR was! We definitely would have done a better job ourselves. They then decided the patient was breathing on their own (although already intubated) and so stopped. We thought that it was probably an inappropriate attempt at CPR rather than a successful revival. We also got to watch an NG tube insertion and talk to a patients relative about their condition. After this not much was happening so we headed home around 9.30pm and went to bed.Read more
Up slightly earlier today ready to go to PYP clinic - pregnancy in young parents. Went to the outpatient department to find that there was 3 of us assigned to the clinic which seemed a bit much. We spoke to Ma’am Eden about it but she assured us that it would be fine. Got to the clinic to find a tiny clinic room and some seating outside. First of all the girls were given a ticket number and had to be weighed, the midwife got to do all of this while we just sat there so I was a bit annoyed. The girls were then given a lecture about family planning and HIV but all in Hilagynon so we couldn’t really understand. We had to introduce ourselves to them and then the clinic started. The girls ranged from 14-19 and some of them had partners with them. One girl was 15 with a 29 year old partner which we were all pretty disgusted about. In the clinic we were told that we would shadow the doctors and that the midwife would shadow the nurse. We quickly realised that this meant we would be ignored and not get to do anything so we asked if we could take it in turns to do the midwife bits - abdominal palpation and listening to the babies heart beats with a sonicaid. The 3 of us took it in turns through the clinic and by the end I felt quite confident in my technique so it was useful.
After this we headed back to the office where I went really light headed and had to lay on the floor. I had some water and then felt ok. Came back to the house and ate lunch but then I started to feel really sick. Went to have a nap but basically ended up staying in bed all evening as I felt so rubbish. Attempted 1 mouthful of dinner but it didn’t go down well so I retreated back to my bed and watched Harry Potter for the rest of the evening.Read more
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