Being the patient, what to do...

Even though I don't feel sick, I do have a medical problem which I have to see a GP & specialist for, so I guess in theory that makes me a patient. Thankfully, I am rarely 'the patient'. I have been very blessed to stay healthy over the past 7 years in Sierra Leone, with only 3 sick days in that entire period and a few minor illnesses here and there.

So, I guess the question is, as a doctor what do I do when I become the patient? Do I:

a) self diagnose and treat

b) ask a colleague friend for advice

c) ask your sister (a GP) for advice

d) go and see your GP

e) leave it and risk waiting too long?

I suppose for me it depends on what's wrong and where I am at the time. If in Holland, I think I would go to my GP fairly quickly. In Sierra Leone, I'm more inclined to sort it out myself. Especially if it's something minor, like a skin infection or eye infection: I self diagnose and treat. Pharmacies are scattered throughout Freetown and medication is easy to come by, which is convenient but not always so reliable. I generally stick to the one pharmacy that I believe has good quality drugs. Having said this, when I had an abscess just above my knee I self-treated and even ended up doing some very minor 'surgery' on my leg. At that point I got a bit worried, wondering if my leg would be okay. I had reached the point of considering checking with a colleague but fortunately after 48 hours of antibiotics (doubling the dose to the maximum!), my leg looked better and I could walk normally again and there was no need for a consultation.

Likewise, if I had a fever I would probably head down to one of the few laboratories I trust (because I know the technician) and get tested for malaria. If positive, I would self-treat with the same thing I prescribe for my patients, if negative I'd wait it out. And, after two days, if I was not better (or if I got worse in the meantime) I would go and see a GP in town, possibly after checking with my colleagues or sister.

I think asking for advice from colleagues or family can be quite helpful. However, I also realize it puts them in a difficult situation. I know this because I have been in that situation a number of times. It's hard to be objective when you're treating/advising someone you know well. So, for the most part, I would ask for their opinion but generally not have them treat me.

So, how do I decide what to do? I guess part of the decision making has to do with my own experience in treating patients - if it's a condition I'm familiar with, I would self-treat. However, if it's something bizarre, I'd be more inclined to get it checked out. The same goes for treating colleagues, friends, expat children - I am happy to help/advise, but if it's more complicated and they need to be seen properly, i.e. more tests, full physical, etc, then I would refer them to a GP in town. (Remember: I don't have a clinic of my own and am not doing full-time clinical work.)

Part of the decision-making also has to do with the quality of care available in Freetown, or lack thereof. Sometimes it might be better to try to sort it out yourself or go to a colleague you trust, rather than some random clinic. There are a lot of random clinics in Freetown! You need to know where to go. With my anemia for example, I was happy to check my Hemoglobin myself. I wasn't as convinced to go to local labs, because I wasn't sure if I would even trust the results. Plus, knowing I was going to Holland, I decided to wait and get it done properly. So, on arrival here (after consulting my GP sister, I have to admit), I went to my GP and he got the ball rolling. It did come to the point where I could choose to go back to Freetown and go to a local lab/GP once a month or stay here and get things sorted out first. For reasons mentioned above, it seemed wise to sort things out in Holland. So here I am, 3 1/2 weeks later...

Elections in The Netherlands...

I remember the excitement back in 1998 when I was eligible to vote for the first time in the Dutch general elections. I guess it made me feel grown up and like I was a part of something bigger in my country. Today, approximately 75% of the Dutch went to the polling stations to cast their votes. Unfortunately, I was not among them. Firstly, being out of touch with the world outside of Sierra Leone, I didn't know about the general elections until about 2 weeks ago. Secondly, because I am not a resident and had to 'sign out' of Middelburg, I didn't receive a voters card. By the time I knew about the elections it was too late to sort out the paper work through the Hague (it takes 6 weeks). Next time!

It will be interesting to see what happens. I am by no means a politician and know very little about my government. What I do know is that there are 150 seats in parliament, which will likely be filled by about 10 different parties. This means that the main parties will need to form a coalition. The previous coalition collapsed. Let's see what happens this time. Let's hope that the principles voters based their votes on aren't totally skewed due to coalition-forming and that the parties keep the best interest of the voters in mind.

Just thinking ahead a bit: it's just over 2 months till the elections in Sierra Leone. Let's pray they are as peaceful...

A Sunday in Middelburg...

I had an early start today. I left the house at 6:30 am to meet a group from church: the early birds. The church I am a part of in Middelburg chose today as their special church day - a day with all sorts of activities and a chance to get to know each other.The plan was to begin outdoors and watch the sunrise and thank God for His amazing creation and for the church family He has given us. It was a chance for me to get to know some people (seeing as I am hardly here I don't know a lot of the members). The colors in the sky were absolutely stunning and it was great to spend some time in the cool breeze looking over the water and talking to God. After our outdoor adventure we drove to the church and enjoyed a delicious breakfast with about 100 people.

Breakfast was followed by a service. I missed some of it because my sister and brother-in-law were on stage leading worship and my youngest niece (here that is) was not too happy about that and really really wanted to go to her mom and not sit with me. My niece and I ended up taking a long walk outside. Let's just say we had some quality time together. We saw a windmill, trains, boats, ducks and a lot of people on bikes. My niece was pretty happy.

I spent some time this afternoon studying as well as skyping my parents and a few friends. It's always nice to catch up with people. I then ended the evening with an impromptu BBQ with friends. It's been a good day. And I am again so thankful for the amazing life God has given me. I'm especially thankful today for the the beauty around me and the people in my life.

Bye bye Dutch goodies...

Family and friends were by far the best in Holland but I have to say that there were other pleasantries as well. Guess I'll be saying bye to a very sweet Dutch breakfast, 'western' pears and dairy products for a while. To be honest, there isn't much food-wise that I miss when I'm in Sierra Leone. I forget that half of it exists. Having said that, I am bringing back some chocolate, chocolate covered cookies, chocolate chip cookies, stroopwafels, cheese, pack of tortillas. That's about it. Those will last me for about 2 weeks. : ) And then it's back to groundnuts as a snack. A go manage...