Tuesday, 22 October 2013

Mental health training in Somaliland - Day 30

Sunday 20th October

This morning was spent meeting with Dr. Jibril. We discuss his upcoming residency, his career plans, the medical student teaching, a paper we will co-write about our recent TOT training and various other areas. We are met by Dr. Abdirahman Gurguurte, the other doctor who works on the mental ward here, and have a good discussion about psychopharmacology and issues surrounding poly-pharmacy. It is very interesting here that, as I found out from nurses, it is often looked down upon if a doctor should check their BNF for a drug dose before prescribing. As such, doctors may often avoid doing the check. I tell stories of the chief pharmacists in the UK always carrying around their Maudsley Guidelines or BNF and often checking them before giving advice, to try and encourage this sort of practice.

The discussion is lively, useful, and I am also taught much by these two. I hear the stories and of the work that went into ensuring the mental ward was built last year. The community initially wanted the ward to be placed a number of kilometres from the main town, though eventually there was an agreement to have it on the hospital site, much more appropriate and useful to the patients, who often need lab tests and medical care. I hear about the experience these doctors have had working in different parts of the country and the varied challenges they faced during their training and work. Most of all I am impressed by the enthusiasm, dedication and love both of these doctors show in their work with mentally ill patients and they I walk with them to teach our 6th year medical students inspired by their commitment. We have a good afternoon practicing OSCE stations and Dr. Jibril chooses the cases this afternoon. We concentrate on documentation as a task, as this is something that can be improved in every area of medicine and having the students practicing it now is useful.