ECU Field Journal: Africa

Marie's Blog from Lambaréné, Gabon<-- back

Beginning to understand my new world
August 15, 2008

I have grown more comfortable in my daily routine here at the hospital, as I have finished my second of 13 weeks in Lambaréné. I am beginning to better understand the Gabonese dialect of French, and I am able to ask the necessary questions to allow me to better compare and contrast medicine here with medicine in the United States.

When I ask any of the doctors why we are managing a patient in a certain way, the reply I get is most often, “It’s African medicine.” So what is African medicine, or at least in my case, Gabonese medicine?

Right now, I understand it to be the mostly symptomatic treatment of acute illness or disease, and the close monitoring of hypertensive, diabetic, and sickle-cell patients. The process of caring for patients is very simple here. We use very basic, but essential, tests. We can perform a complete blood count to see if a patient has anemia, an infection, or worse (few to no white blood cells as in HIV infection). We can measure glucose, creatinine, and urea to check for diabetes and gauge kidney function. Gout is very common here, so we are able to measure uric acid levels. The most important tool we use is the chest X-ray. It is crucial for diagnosing and treating the many tuberculosis and cardiomyopathy cases we see. I have had plenty of practice reading radiographs of patients suffering from what we consider rare medical conditions in the United States. Cavitary lesions, for example, are rarely seen back home, but they are unfortunately a daily occurrence here.

Each day, I am learning so much, and I am grateful for this opportunity. I am beginning to see many advantages to the way the Gabonese practice medicine, which is somewhat of a relief given the disadvantages that seem to overwhelm me at times. With far less technology than we have in the United States, I am learning that I must trust my instincts, and also listen and connect with my patients. This is as much medicine here as any treatment we can offer—especially when nothing more can be done.