What started as a mandatory training for the MD5 semester to better prepare them for their challenges as a future part of clinical medical education; health camps, organized by the school, have been successful in ensuring that the students apply the skills of basic sciences and introduction to clinical medicine aptly. The visits were organized under Dr Rambally’s supervision, a practicing physician in St Lucia with great clinical skills.
Home visit, Gros Islet
The students reached the site of the health camp, Gros Islet Methodist church which was a walk of 15 minutes from the school premises in time at 2 pm. Dr Rambally arrived and informed the students about the approach towards the questionnaire, used for collecting patient information, especially the psychiatric history taking. It was a simple approach to a rather complicated concept.
And then he recalled an incident of a psychiatric patient who had auditory hallucinations committing crimes as per what the voices in his head told him. The session went on for several minutes as the students and the supervising faculty stood around Dr Rambally, ensuring they learnt every bit of new information and revising what they mastered over the years. The clinical students added what they knew from their knowledge and experience. Soon, they set out into the lanes of Gros Islet in groups. Each group had a local medical professional, 3 students and a church member. Every physical examination, questionnaire, counselling session was preceded by a Methodist prayer and song and the students displayed professionalism and morale in respecting the patient’s religious and cultural beliefs.
The students then collected the demographic data, counselled the patients about compliance with medication, recalling everything their professors taught. Most of the patients were elderly and the students were introduced to the common diseases and medications in St Lucia.
Hypertension is dangerously common in St Lucia despite the low salt diet they report.
Diabetes follows hypertension very closely.
Some correlation between illnesses of childhood and autism, Down’s syndrome may exist.
Amlodipine is the default calcium channel blocker medication for hypertension.
Compliance is a challenge in St Lucia.
Every student had a chance to visit and examine at least 5 patients and all of them remarked that their patients were very cooperative and the psychiatric patients were sweet (as opposed to what everyone thinks). The students returned to the church, better prepared for the things they would encounter. A note of thanks from Dr Rambally was quickly followed by the students ready to call it a day.
Visit 2, Cacao village, Vieux Fort
Saturday morning, 7th October 2017, despite the fact that it was a rainy day, students of Med 5 along with clinical students gathered at the university gate at 6:45am to start to Vieux Fort for a journey of 2hrs to reach the village of Cacao which was down south. The bus started at 8 am due to the weather conditions and the students reached the site at 10 am. The students awaited the start of medical home visits while the mass was going on in the church, where Dr Rambally was speaking. Dr Rambally started with his famous approach of questioning the students and the students were able to answer all his questions ranging from formication to gustatory hallucinations.
This time too, the patient group would be geriatric and psychiatric or a combination there of, the students were informed. The students were then split up into groups, attached with a church member who, had roses with them to present to the patients they visit as an act of kindness. The groups separated and the students started walking towards the houses of the patients.
The students had to climb uphill in many areas, pass through what seemed like pure shrubbery, saw unkempt houses, but at the end, they reported it was worth it. Every patient they could find, they helped. Diagnosis, counseling, recommending the drug to be taken and letting Dr Rambally know about every patient who needed a new medication or refill. This time too, psychiatric patients were cooperative for the most part. The students after completing half of their assigned houses returned to the church for lunch. It was a true Caribbean lunch. Students had a very quick lunch and set out again to learn more, help further and better themselves. Every patient who was not in the schedule but who requested received help. The students reached the church at 4:30 pm, tired after a long day of work and the adventure of walking through some of the rainforest covered areas of St Lucia. The bus ride back to homes, students reported, was amazing as they had a lot of fun which they obviously deserved. The home visits were a great opportunity to work as a team, learn in the community and understand St Lucia’s health and individuals better.
Report by : Vishnu Byroju, Med 5