Down river

We were up early today for some tourist activities. We went out into the bush a little bit to see birds and to get some breakfast. I'm not much of a birdwatcher, but it was good to get into some dugout canoes and to see some of the countryside. It's a hell of a contrast with Banjul and the north bank of the Gambia River, which we visited yesterday.

It's damned hot here. I'm going to need a holiday when I get home.

Dirty cash

Filthy, sweaty money. Just like me.

Pool time

After a very long morning meeting, we're finally getting some well deserved pool time. Nobody works on friday afternoon in The Gambia. Well, except us. And probably taxi drivers. But at least we're working beside the pool in shorts and t-shirt.

Taxis held together by rust and dust.

African Atlantic.

Pool side.

Don't forget to keep checking the news page on the sgl.swanih.org website.

Contrasts

It has surely been a day of contrasts today. After spending the morning at the Medical School and the Royal Victoria Teaching Hospital we visited the MRC's base in The Gambia. The RVTH is very poorly funded (for example the pathology labs have only H+E staining only, and manual histological processing - imagine how this extends to the rest of the hospital), newly populated by recent graduates of the Gambian medical school who are working very hard, alongside the nursing staff and senior doctors. Banjul is a busy, poor city, full of friendly hassle but also full of colour and smiles.

The MRC's institute here has been in place for 60 years, and again is populated by dedicated, young, hard working staff. But the MRC is a modern, state of the art facility, filled with impressive kit (real-time cyclers, DNA sequencers, 9 colour flow cytometers) & equally impressive men and women.

The MRC institution is heavily involved in researching & eradicating communicable diseases in the Gambia & abroad. They also treat many of the local population, with people queueing overnight to be seen by a doctor. One man at the MRC that we met begrudgingly admitted that he started work at 3.30am every morning, to care for those patients. He was still there after 5pm when we visited.

Right now, I'm sat in a bar that is itself sat right on the Atlantic, in the sunset. It's quiet, remote and gorgeous. The weather is good, I'm drinking Julbrew and considering forgiving Steve for dragging me away from the pool. My view of West Africa has flipped from desperate dislike to potential and promise. If this was 6 or 7 years ago I'd be thinking about looking for a molecular biology post-doc here.

The man running the MRC institute is a Gambian. A deeply impressive Gambian.

Dragged Away

We had a brief break from work this afternoon & managed to get to the pool between meetings. Its hot & humid. Think white man from the Welsh climate stuck inside a West African hospital & think sweaty. Then imagine a pool, with bar, shady brollies, and a cool breeze. Then the sun came out! A few more hours of this would be nice, we thought.

But no, the evil Steve dragged us away to yet another meeting via deathtrap with wheels. Maybe tomorrow? You're not allowed to work on a Friday afternoon in the Gambia, are you?

Anatomy Teaching

I thought I'd got out of teaching anatomy on Monday, in Swansea at least. Prof. Menendez and the anatomy lecturer here in the Gambian School of Medicine have roped me into teaching the 3rd year students in a 1 and a half hour slot on Monday morning (at about the same time as I would have been teaching the Swansea students). That much teaching would normally take me weeks to prepare for, but I only have the weekend. I'm getting better at winging it these days.

Prof. Menendez (the leading professor in the school) is very enthusiastic about our involvement and it's clear that he and his Cuban team put huge efforts into the training of new doctors here. Much of that training is dependent upon donations of materials and equipment from other countries, including Spain, Holland, Sweden, the UK and many others. Hopefully much of the elearning we've already been developing in Swansea will be directly applicable to the Gambian students (anatomy is anatomy, is anatomy) and we've identified many areas that we can help with.

They've got a better collection of microscopes than we do, but histology plays a more important part of the teaching here and classes are getting larger. There is only one histopathologist in the Gambia.

The histology lab. More microscopes and some decent kit in here. One of the main problems in the Medical School is space, with lecturers sharing offices and some tight space for teaching.

There are no arguments about blackboards vs whiteboards here, and there certainly isn't a digital Blackboard for storing powerpoint lectures. I'll have to practice my chalk skills.

Right, back to work.

P.S. As a side rant, you bastards sending me spam are a real pain in the arse when trying to send and receive email in West Africa! You're slowing down the whole internet!

Arrived

We safely arrived in The Gambia and the hotel after many hours and much tipping of Gambians. The flight was very picturesque, passing south over England, crossing France, the Bay of Biscay, flying over Portugal or Spain, and then north Africa down to Gambia and Banjul.

Today, we met with our Gambian counterparts in a lengthy meeting to introduce each other and get some ideas onto the table, followed by a tour of the Royal Victoria Teaching Hospital to see the facilities and staff (or lack thereof). This further helped our group to form ideas and plans for the rest of the week.

Visiting the teaching hospital.

Puzzling over a burst autoclave.

A wet Banjul.

The front entrance to the Royal Victoria Teaching Hospital, through the mossy meshed windows.

Outside a typical ward.

The neighbouring Gambia Musicians Union has an excellent motto: "Better late than never".

We saw a bit of Banjul, but I nipped back to the hotel to cool off in both the pool and the sea/estuary/river to puzzle out the hotel WiFi. We found the hospital library, which has a number of up-to-date Dell networked computers and a good collection of books, but the internet service provider's bill is currently unpaid so the students cannot access any information on the internet.

Steve has some night maneuvers planned (which is a worry) but these will apparently end in food (which is good). Check the Swansea-Gambia Link website (sgl.swanih.org) for more information about this week's scoping visit to The Gambia.

Banjul

I'm off to Banjul tonight for a week. I'll be switching my mobile phone off to avoid the roaming charges (because I can guarantee that my Mum will ring me and it'll cost me £10 to remind her that I'm in Africa) but should still be able to Skype Out and remain in contact while away. My blog may be very interesting over the next week or very blank, depending on the level of connectivity that I find. I'll take my camera, but it's very wet there at the moment.

See you all soon.

Jack at the range

Jack wanted to come to the driving range with me so I bought him a junior club about the right size for him, gave him a bucket of balls and let him at it. He's pretty good, but he doesn't half get through a bucket of balls quickly!

Clinical Skills Video Podcast

In addition to downloading specially crafted clinical skills training videos from Blackboard (if you're a Swansea University medicine student) you can now access them through iTunes in a format ready for your portable video player. More videos will be released through the teaching year.

Subscribe to the video podcast using iTunes.

Warm Sea Splashing

Just the other week the sea was so warm we were playing in it and hoping for a late summer, but already the weather has turned autumnal. The central heating has gone back on and I'm carrying gloves and a hat in my cycling bag to work, just in case.

iPhone in the UK

The iPhone will be available in the UK from November 9th, at £269 for the 8GB handset and £35/month for the talk plan and unlimited data tariff from O2. It's using outdated technology by European mobile phone standards, as it uses slow EDGE rather than fast 3G for data, and doesn't do MMS photo messaging. I wouldn't use the novel method of accessing voicemail much, but really need to record video and to be able to send multimedia messages. Unlike other smartphones you can't add offline applications without hacking it (meaning I couldn't read digital novels on a plane).

Meh. Not interested.

iPhone (UK)

Clinical skills videos

The embryology podcasts have been well received, and we're working to add to those, to improve them, and to glitz them up a bit. How would you like to see clinical skills demonstration videos in a podcast format on your iPod (or other popular mp4 player)? The videos are already available on Blackboard to Swansea medical students thanks to some awesome work by the Integrated Clinical Method teaching team, but we could make them more widely accessible, both portability-wise and geographically.

How older siblings stunt growth

A study is suggesting that having an older brother can stunt the growth of younger siblings. My younger brother's about a foot taller than me, so it wouldn't seem to apply to my family. Researchers suggest the trends they observe might be due to uterine factors in second pregnancies, or dilution of time, money or love (see DGR learning outcomes any of you medical students reading this) that parents can invest in children when having more than one.

BBC article.

I've got another jab today.

Cravings

Kim is 21 weeks pregnant. Kim has a very interesting craving this time. She has a craving for cakes, and whenever she goes out to buy food she comes back with cakes. Whenever she's left alone in the kitchen for too long on her own, she bakes cakes. The cakes that appear are always more than just for Kim. She doesn't like to cake alone.

Cream cakes...

Doughnuts...

Muffins.

It's OK for Kim. When breast-feeding she'll be burning an extra 500 calories a day. I have to run for an hour or more to burn 500 calories!

Vaccines

I'm visiting Banjul, in The Gambia at the end of this month to aid the development of the link between the medical school there and the school here in Swansea. I'll have my elearning and IT hat on for most of the week, with some anatomy teaching and much meeting and greeting of Gambian colleagues mixed in.

So, with any first trip to the African continent come the vaccinations. Last week I had a hepatitis A vaccination, and this lunchtime I had the yellow fever jab, the most painful part of which was in reading the long list of potential side-effects. People have warned me that I'll feel rough afterwards (guaranteed me in some cases) and I'm starting to feel a little ropey. This could, however be psychosomatic or caused by too much Guatemala Elephant.

Talking of psychosomatic, we were discussing the language of anatomy and the term "hypochondriac" in yesterday's anatomy teaching. Firstly, you can see how the word "psychosomatic" is constructed from Greek words if you look at the parts and the web-link - and you'll remember where "somatic" comes from. Secondly, "hypochondriac" is the correct term for a person who tends to be preoccupied by their own health and continually worried about having a serious illness even when reassured by a clinician that they are healthy (rather than "hyperchondriac"). It does relate to the hypochondriac region of the abdomen inferior to the costal cartilages. The Greeks associated many ailments to the movement of the spleen, which lies in the left hypochondriac region. Some time later the term developed its modern meaning.

There's a Wikipedia entry for this, among many other sources on the web, such as this blog by a very open hypochondriac.

Right, typhoid next.

EPST 2007

Today Cardiff Tri held the second Emily Prosser Sprint Triathlon. I took some snaps for the website during the race. I guess these were my favourite, mostly because they're a little bit different from all the others (I took around 600-700 photos). Click for larger versions.

Baby no.2's first photo

Here's the first photo of Baby No. 2. I expect there will be several thousand more (photos, not babies) after he or she is born in January.

Jack really enjoyed the ultrasound scan, with lots of things he could easily recognise at 20 weeks. He's really looking forward to having a little brother or sister, but keeps insisting that he would like a dog too. Kids are never content, eh?

New students

This week a new batch of 72ish students start the Swansea Graduate Entry Medicine programme. It's a nice easy induction week, followed by 3 weeks of introductory teaching and then 12 weeks of hard, hard work (for both students and staff). Good luck to you all, and I hope you'll enjoy the course and the Swansea/Gower area.

Names

Kim's fussing over possible boy's names for the baby due to be born in January (if it's a boy - we already have a girl's name planned).

Her current favourite is "Ace Max Webster". Hell, at least his CV will stand out.