President: Professor Christopher Stephens MBA MAEd FRCGP
A meeting of the Southampton Medical Society was held on the 4th December 2024. The President was in the chair. The minutes of the last meeting were approved. This meeting was a hybrid with some of the speakers on Zoom and some in the meeting room.
The President introduced the winners of the Foott Memorial Bursary who spoke about their experiences during their electives.
Dr Harriet Perkins spoke first. She told us that after getting a degree in maths she visited Vietnam and met a medical student doing an elective there. This sparked an interest in medicine and eventually her going to medical school. She wanted to return to Vietnam for her elective.
Vietnam has a population of 100 million and the life expectancy is 73.8 years. The population is reducing due to the increase in living standards causing fewer babies to be born.
Health care is provided through a mixture of publicly funded and private hospitals. Harriet spent her elective at Hanoi University Hospital and did 4 weeks in obstetrics and gynaecology and 4 weeks in ophthalmology. She was initiated quickly into using scanners but in OPD she felt there were long periods of just observing. Her description of the Gynaecology outpatients was surprising to our western ways but they get through large numbers of patients in these clinics. The process is something like a conveyor belt and privacy for individuals is a lot less important in Vietnam than here in the UK; but the patients are seen quicker and do not seem phased by the process. She assisted in theatre and was surprised to find the facilities were as good as ours. However in obstetrics the maternal mortality is 5 times higher than ours. Most of this is due to patients living in remote rural areas, poverty and a lack of access to facilities when needed in an emergency.
In her ophthalmology attachment the staff were welcoming and taught her many skills.
After this attachment she went on a tour of the country and found how difficult it was for the rural people to get to a hospital and there are few resources for medical treatment. Local paramedics were the main deliverers of care.
Harriet found that there was a language barrier with staff and patients that left her struggling at times. Their English was poor particularly with reference to medical conditions. She also felt there was a lack of structure and clear understanding by the clinical teams and hospital about her role.
She ended by thanking the Society for the opportunity the bursary offered to see another health system.
Dr Jack Lushington is now on an anaesthetic rotation in Bristol. He is particularly interested in intensive care and emergency medicine. He went to Stellenbosch University Hospital which is the second largest hospital in South Africa. It provides care for over 3 million people in the Western Cape. In his first month he was attached to the Trauma department. He said that there are millions living in corrugated iron huts and these “townships” were overcrowded. There is a lot of trauma: knife attacks, a high rate of shootings, a lack of regard for traffic rules causing injuries to drivers, passengers and pedestrians being involved in frequent accidents. Paydays result in high alcohol consumption and its consequences, such as violent assaults, particularly at weekends. Suicide attempts are common. The trauma wards were always full. He said that even the passages of the hospital had electronic locks to prevent gangs from getting to the patients. He gained an enormous amount of experience in a short time.
In his second month he did anaesthetics. He attended scheduled teaching sessions and had one to one teaching from the staff and thus had a lot of hands on experience which he found very beneficial.
Jack said that healthcare disparities caused late presentation of disease. Rates of TB and HIV are high; in fact SA has the highest absolute number of HIV cases in the world. TB cases are such that 0.8% of the population develop it annually but the incidence is showing a reduction over the last ten years.
Some reflections: He noted the resilience of patients and staff. There is clear evidence of positive health improvements generally; a National Insurance Bill has just been passed through parliament to try and reduce health inequalities but he considered there was poor access to hospital care for the general population. He thanked the Society for the opportunity the bursary offered. It had solidified his interest in anaesthesia and critical care. The bursary also offered the opportunity to observe a different healthcare system from our own.
Dr Aaron Navaneetharajah went to Sri Lanka. He was born in Colombo. His family moved there from Jaffna because of the civil war. Aaron is interested in emergency and pre-hospital care. He was attached to a private hospital emergency care department. It is well funded and similar to our emergency care facilities in the UK. There is a big difference between the government hospitals and the private ones. He saw tropical diseases and in particular dengue though it is decreasing slowly. He also had “taster days“ in different departments and he spent extra time in neonatal care. They take teaching seriously in Sri Lankan medical schools - very like the teaching here.
He observed how lucky we were to have the NHS here. In Sri Lanka if you don’t have money you have less good health care. He thanked the Society for the bursary which helped him to visit Sri Lanka
Dr Isabel Conibear spent her time in the UK. She spent a month in the Salisbury Hospice as she is most interested in oncology and terminal care, and a further month in a rural general practice in Snowdonia. In Salisbury Isabel did ward rounds, helped with treatments, attended patient activity groups and other sessions, such as reflective groups, and made lots of home visits with the outreach staff.
After this she joined a rural and remote GP practice in Snowdonia. She attended clinics, observed consultations and treated minor injuries. She also went round visiting patients with both the GP and nurses.
The whole elective was a most rewarding experience and an important step in her self development. She learned a lot about herself and has become much more self confident and resilient.
She thanked the Society for the bursary which had been an important help in arranging this elective.
The President thanked all the speakers and congratulated them on their presentations.