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A World of Opportunity - a South African elective

Hymn singing during operations was just one highlight of Daren Teoh's South African elective
Five hundred miles away from the skyscrapers of Johannesburg is the town of Mangusi. This is the real South Africa - a dozen shops and the local market at the town's only crossroad. Scattered around this lie individual Zulu houses and huts and a population of approximately 1 00,000. Mangusi hospital served this population and six other primary care clinics around the region.

Mangusi was started by the Methodist church and has up to eight resident doctors serving a maximum of 560 patients at any one time. I spent my time there moving between paediatric, medical and surgical wards, primary care clinics and outpatients, and ophthalmology was a special part of my elective.

As in most of subSaharan Africa, HIV and AIDS are taking their toll in Mangusi. 33% of antenatal patients and 70% of hospital patients are infected. Children are not - spared. Florid opportunistic infections and failure-to-thrive were beyond anything I'd come across in the West. On top of that, doctors had to cope with restraints in basic blood tests and malarial screens, not because of technical limitations, but rather because of shortage of funds.

One thing I always looked forward to was theatre days. If regional anaesthesia was used, patients and staff alike would sing Zulu hymns right through the procedure. And when Zulus sing, an international choir is born. Newcomers to the hospital might even mistake the theatre staff for the hospital choir!

A good proportion of the work in the hospital is done out of the goodwill of the staff. My tutor should probably deserve special mention. He hails from Rwanda where he was a consultant surgeon. During the genocide he lost everything except his family and fled to Zambia and finally to South Africa. He has had to learn English from scratch and now only works as a medical officer. However he still testifies to God's faithfulness and sovereignty and harbours no hatred against the perpetrators of his suffering. He is also certainly the most pleasant person in the hospital. I will always remember his example and I was pleased to help him with his English.

I spent my final days at an outlying primary care clinic. Resources here were scarce. The clinic was even out of stock of paracetamol and penicillin.

Around Mangusi is a beautiful lagoon system known as Kosi Bay. I also managed two safaris (one even on horseback) and some scuba diving on my way back to the UK. Looking back on my time at Mangusi, I know I can trust God More with my future And would certainly Like to return to the developing world some day. And for now, at least there will be less of a chance for me to miss crackles when I listen to a patient's lungs.

In his penultimate year at Nottingham Medical School, Daren Teoh did his elective at Mangusi Hospital, South Africa this summer. He received a Joe Taylor Scholarship award for the ophthalmology part of it.
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