Sierra Leone elections: T-6 weeks...

Yes, on November 17th, Sierra Leone will hold it's presidential elections. Officially the campaigning starts on the 15th of October. Unofficially, it has already begun. Today there was an SLPP rally throughout town. We first spotted then on Fourah Road from our office window just before we were due to leave the hospital to head to the west side of town. Fortunately, although there was rallying in various parts in the city, our trip didn't really take that much longer. In an hour and 15 minutes we were home.

Even this evening a rally came right past my house. It consisted of a couple of vans, huge speakers, many people trailing behind them, loud music, green clothing and lots of dancing. The strange part was when they passed through the street for a second time an hour later playing a soundtrack that ended with gunshots and glass shattering. That was a bit too bizarre for me.

It will be very interesting to see how politics takes over the city during the next 6 weeks. All I can say is that I hope it stays calm. Sweet Salone please remain peaceful!

Back to work, the highs...

Can I just start by saying that despite the many challenges at the hospital, I love my job? Maybe it’s easy to say that since I just returned after being away for 6 weeks! I was basically in the office the entire day but it was good. Even with the very slow Internet I still managed to get a lot done. What I liked most about today is realizing again how diverse my work is and knowing/believing that between now and 6 months we will see a lot of positive change at the hospital. I’m convinced of that! Just to give you a glimpse of my job as it stands now, I’ll throw out some of the activities that I’m involved with. Bear in mind that some of this is leading up to activities that will take place early 2013.

Delivering Emergency Training to nurses

Co-organizing our first Paediatric Symposium

Improving laboratory systems and practice

Setting up a new x-ray department

Chasing auditors for the completion of an audit

Arranging a trip to Guinea with patients

Communicating with our residents in the sub-region

Database queries and hospital data compilation

Representing Welbodi at a conference in Accra

Immigration and medical registration logistics for colleagues

Planning the official hospital accreditation visit

Paying bills for the Welbodi flats

In summary, there is a lot to be excited about. This hospital has a lot of potential and I am determined to help bring some positive changes over the next 6 months. Yes, I know, I am back on the Salone roller coaster and the lows are inevitable but when those lows come I hope to remember that there are many highs as well. I am convinced that we will move things forward. Watch this space!

Life after exams...

My living room table is still covered with exam materials. Now and then I am tempted to look at them and see if some of the questions I answered were right or wrong, but then I tell myself not to, don’t go near the books, no more studying right now. It’s strange to go from pretty much non-stop studying for 2 months to no studying at all! I have to say Friday night I was tempted to pick up my Embryology book (which I didn’t have time to read), but I didn’t. Instead, I picked up a magazine and read about cakes and fashion. Very mindless to say the least!

And so I had a lovely weekend to get settled into normal life! What’s normal? I was trying to think of what I usually did with my time off! I guess I was often out with friends. Ah, friends. I can start socializing again! The weather on Saturday was nice and so I did meet up with some friends for lunch, then attended an Enable the Children Board Meeting and then met up with another friend for dinner. Good times. Today I stayed at home all day and cleaned my room – lots of sorting, re-organizing and cleaning, which was much needed after being away for 6 weeks! Unfortunately some shoes and clothes are moldy due to the humidity and heat but for the most part, everything was fine. This evening we had international church which gave me the opportunity to catch up with more friends.

Tomorrow, it’s back to the hospital and I’ll be going with mixed emotions. It’s a place with so much potential but it is so challenging to work there. I am prepared to go with joy, patience and compassion and hopefully that will see me through tomorrow and the rest of the week. I have to say, I will be spending a lot of time planning the x-ray department startup as well as laboratory improvements and preparing for next weeks’ Emergency Training with the nursing staff. Plenty to keep me busy!

Exam Day: Has come and gone...

The exam is over. What a relief. The 24 hours prior to the exam were the hardest. I was just ready for it to be over. And now it is!

I stopped studying at 7:30 pm the night before the exam and tried to focus on other things. I was the first one at the exam center on Friday morning, with a 7:40 am arrival since my colleagues dropped me off on their way to the hospital. The first person to show up after me came at 8:15! The official start time was 8:00 am. At 8:30 we were allowed to enter the exam room but there was still one person missing – he was stuck in traffic. I think we should have just started – seeing as it was clearly mentioned that we need to be on time. The final hour of waiting was agonizing. At least the invigilators decided to start handing out the answer sheets and exam instructions, which was quite entertaining. You see, there was a suitcase on one of the tables which was opened somewhat dramatically. The invigilator made sure to show us the big sealed DHL style envelopes containing the exam papers per specialty. Then there was a moment of hesitation when one of the invigilators said that a photo should be taken to prove that all of the envelopes were sealed, however, it was quickly decided that this wasn’t necessary. Next there was some discussion around ‘the clock’. There was a clock in the room but it did not have any markings. Then, to my surprise, one of the invigilators pulled another clock (with markings) out of the suitcase! After switching batteries from one clock to another, the exam papers were handed out and at the same time the final candidate arrived.

At 9:00 am the exam started. The first 15 questions were easy. I was surprised. I recognized topics and could answer all of the sub-questions. Then it became more difficult, with questions concerning topics I hadn’t even read up on. Normally, I’d take an educated guess and answer every question, however, this exam has NEGATIVE marking and so guessing is not a smart move. Basically your score is the number right minus the number wrong. One needs to find a balance in answering the right number of questions to get a passing mark. To make a long story short, I am now more concerned that I might not have answered enough questions to get a high enough mark because I was being overly cautious. I guess I will know in a week! The unfair thing is that for pediatrics 1 point is subtracted for every wrong answer, whereas for the other specialties only 1/5th is subtracted.  At 10:00 am there was another moment of panic when one of the invigilators said that pediatrics only had another 30 minutes. I was only on question 40 out of 100 (with 5 sub questions each). We were quick to speak up and say that the exam paper clearly states that we have 2 1/2 hours! Phew. So, at 11:30 we handed in our exam papers and left the room. We had to wait in the waiting room for another 30 minutes while the other specialties (who had 3 hours) finished their exam.

It was tough, but it’s over. Pass or fail, it’s done and I have time to do what I want! At least for a little while.  Of course, I would love to have passed in one go – I’ve never failed a medical exam and would like not to have to do all this studying again. However, if I do need to re-sit, it’s not the end of the world. I’d have 6 months (till April) and know exactly what topics I need to focus on (I think). Plus, the hospital won’t be accredited till March 2013 (that’s our goal!) and so I can’t start residency until that time anyway. If I pass, I probably still won't start clinicals till 2013. Right now, there's an x-ray department to set up!

Exam Day: T-12 hours...

Wow. It's almost time. My bag is packed: HB pencils, eraser and exam number. 12 hours from now I will be at Connaught Hospital waiting for the final instructions before I write my exam. I have stopped studying for now. It is time to eat some dinner, take a break and get a good nights sleep. 

I have no idea how this will go. I feel well prepared, however, I also know they can test anything under the sun and there is the dreaded NEGATIVE marking and the odd ambiguous question here and there. This is one of those exams that I feel like I could study another 6 months for and probably would still not know nearly enough! Oh the world of medicine is so big. I keep having to remind myself that I am doing this with the hopes that it'll ultimately, eventually, in the long-run, improve paediatric health in Sierra Leone. 

This sure has been an interesting journey so far and it is only the beginning. I'm still not sure what I am getting myself into. I'll battle the first hurdle tomorrow and then take it from there. Thanks for prayers, encouragement and support! Fingers crossed.

Exam Day: T-3...

"There comes a time when for every addition of knowledge you forget something that you knew before. It is of the highest importance, therefore, not to have useless facts elbowing out the useful ones." - Sir Arthur Conan Doyle

Three days to go. Eat. Study. Relax. Study. Take a deep breath. Study. Eat. Study. Chocolate. Study. Sleep. And try not to dream about studying. I can do this. Almost there. I picked up my exam number today, so in theory, I am ready to sit the exam. Of course, I feel like I don't know nearly enough but I'll give it a go. I'm still trying to cram in facts that I think will highly likely appear on this exam (who knows really!) and wrap my head around a few difficult concepts that are sure to be tested. Better get back to studying.