Last week we rotated at a government hospital, one with minimal funding and the most number of infectious diseases this side of the Pacific.

It was horrible.

On the bright side, I finally learned how to do IV insertions & insert foley caths and NGTs with confidence. On the down side, the place was filthy. Worse, I spent three days in the tuberculosis unit, where patients check in to die.

The tuberculosis unit is situated apart from the rest of the hospital. Each room housed ten to twelve patients, in varying degrees of emaciation. Most of them came in ‘vomiting’ blood, although it is probably more correct to say that they were coughing up 3 to 4 cups of blood when they first came in. No one had enough money to treat the disease, never mind that treatment is supposed to be free (hello DOTS!). On average, two people die of respiratory failure every day. I saw a man die because his tank ran out of oxygen, because the hospital ran out of oxygen.

If I sound inured, it’s because I am. I started this rotation a little afraid both for the patients and for myself. This hospital isn’t really the safest place, even for doctors. I also started out concerned for my patients, because I wanted to do my best for them. But that all went downhill after this patient felt up my backside. Asshole.

It’s not all incompetence there. The doctors are all, without exception, excellent. Most nurses are cool too. I love the nurses, except for the one who refused to tell me that this patient in the Isolation room had freaking multidrug-resistant TB. For her, I have unkind words and even more unkind thoughts.


I’m so glad to be back at the university hospital. I can’t believe I’m saying this, but I actually missed the place. It’s not perfect, but it is much better than the other hospitals here. We’re able to make a tangible difference in the patient’s life, and the quality of care that we provide is miles beyond what government hospitals can do.


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