Cape Town paediatrics placement
Old Members’ Trust Graduate Travel Fund Report –Mark Brookes
There are six specialty rotations in the 5th year of medical school at Oxford and for my paediatrics rotation I was fortunate enough to secure an overseas placement. In January, I flew to Cape Town to spend four weeks on the Children’s ward at Victoria Hospital.
The hospital building (see picture) was old-fashioned, but the staff and medical practice were not. I was taken under the wing of an excellent team of paediatricians, interns (the equivalent of junior doctors) and University of Cape Town medical students. From the first day we were asked to see patients before the ward round. As a student in the UK I have spent plenty of time taking histories from and examining patients, but at Victoria we were given much more trust and responsibility. Seeing a patient included the routine discussion and clinical exam but we were also expected to chase up outstanding test results, perform any further appropriate investigations and suggest a management plan. The line between student and doctor was blurred, making it easy to immerse myself in the paediatric specialty.
While many conditions seen in children are ubiquitous, it quickly became apparent that two diseases were on the forefront of each doctor’s mind: HIV and TB. Although South Africa is relatively well equipped in terms of anti-HIV treatment when compared to other African nations, around 20% of adults under the age of 50 are positive for HIV. This affects children both in terms of mother-to-child transmission and through loss of family members. TB is the leading cause of death in South Africa and the Western Cape, containing Cape Town, is the worst-affected region. The huge inequality seen across the country and within its cities, and in turn the variation in access to healthcare further complicates the successful provision of long, multi-drug regimens that patients require. It is not surprising then that any discussion of a patient would begin with their HIV and TB status – a constant reminder of the different public health issues faced around the world.
Away from the hospital, there was also plenty to do. When there was a quiet afternoon, the registrars would suggest nearby attractions not to be missed during our short stay. This allowed us to sample some excellent golf courses, wine tours and picturesque coastal towns. There is a wealth of beaches, national parks and vineyards in and around Cape Town that we were also lucky enough to explore. Our day spent on Robben Island, a site of internment for many political prisoners during apartheid, was a particularly powerful one. Other highlights include the hike up (and cable car down) Table Mountain, the outdoor cinema at Kirstenbosch gardens and a weekend at Inverdoorn game park and animal rehabilitation centre.
I had been somewhat nervous about the paediatrics block as it is something we have little clinical experience with before 5th year but my placement fully remedied this. Paediatrics is a wonderful specialty and I was very fortunate to experience it in such a wonderful place. The trip was entirely made possible by the Old Member’s Trust graduate travel grant which helped cover the considerable hospital fees and transport costs.