I don’t know what I’d expected from rural Zambia, but the medicine here is really not too different from home. There is a lot of malaria and tuberculosis of course, and about 80% of the patients are HIV positive, but apart from that the common conditions are the same as home.
My friend and I are currently on the female medical ward “St Monica”. We have patients in with pneumonia, stroke patients, a woman with ascites from liver cirrhosis, a young woman with pericardial effusion, and a few with diarrhoea. I think the threshold for admission might be a little lower than home, because most patients live remotely and don’t have transport.
The ward setup is a lot different – you don’t get a private room unless you happen to be the only measles patient in the isolation ward. For most patients, the beds are lined up next to each other along the walls of the ward. There are screens for privacy during procedures such as lumbar puncture, catheterisation and pericardiocentesis (there have been two since we’ve arrived). Normal examinations are just done in front of everyone.
Apparently it is quite acceptable to discuss medical conditions in front of a large group, because traditional healers would have everybody in the same room in a circle, and they would go around discussing their ailments.
Similarly, the outpatients clinic is conducted in a small room with three or four doctors all working at once with different patients. There is a single examination bed behind a curtain, and two doctors will usually share a desk – one on each end. Privacy is not even optional, but nobody seems to mind.