CPM Summer 2018 - 20

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Features

Medicine
in
Macha:

A Medical Student's Story of
Her Time in Macha, Zambia
By EMMA DAHMUS

20 Summer 2018 Central PA Medicine

D

uring my month at the Macha Mission Hospital in Zambia, I
saw multiple diabetic foot infections leading to amputations,
HIV leaving its patients cachectic and without immunity, and
children with extensive burns that would challenge the best
burn centers in America. While every patient taught me lessons in
clinical care, there were two patients who will continue to remind me
the reasons why I chose a career in medicine.

When I first entered Macha's surgical ward, I noticed there were distinct
wards for men and women. In the female ward, I saw a long line of beds
without walls or curtains separating one bed from the next, and it was
where I found my patient. Barely conscious, she was hospitalized for a
necrotizing soft tissue infection from what was believed to have started
from an infected diabetic foot ulcer. The physician's gloved hands were
cleaning out her right lower extremity. His hands pierced through her
calf muscles as if they were butter, and the soft tissue was dusky and
grey in color. From what I learned in medical school, I knew this patient
needed immediate help from her infection. In the U.S., this patient
would be taken to the operating room immediately, without hesitation.
Unfortunately, in rural Zambia, access to a physician willing to perform
an above-the-knee amputation on short notice is not easy to come by.
The rounding physician had already taken the previous three hours to
round on the male and pediatric wards and was wanted at the acute
outpatient clinic as soon as he completed his rounds for the female and
male surgical wards. He was exhausted, and he needed to weigh the
risks and benefits of taking this incredibly sick patient to the operating
theatre. He could operate by himself and neglect the 30+ patients waiting
to be seen, or he could wait for more colleagues to arrive the next day
and risk the patient deteriorating further.
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Table of Contents for the Digital Edition of CPM Summer 2018
