Reflections from a pediatrics elective in South Africa

Frances Morin, a pediatric resident at UBC, spent three months completing a general pediatrics elective at Paarl Hospital in South Africa’s Western Cape.

"I recently had the opportunity to participate in a 3 month general pediatrics elective in Paarl, South Africa. The Paarl hospital is a provincial referral centre in the Western Cape of South Africa. The pediatrics team is responsible for running an inpatient ward and nursery, while also accepting referrals from the emergency department and calls from surrounding district hospitals.

When I reflect on my time spent in Paarl, so many aspects of medicine felt totally different. The names of medications, the types of diseases, the role of a physician – I found myself in many ways feeling as though I was relearning medicine for the first time. And yet, other aspects of work felt familiar – the comforting similarly of the clinical exam, the relief of the first cry when a baby is born, the resilience of families.

There were no shortage of lessons in Paarl, many of them incredibly humbling. The lesson I have spent the most time reflecting on, however, is that of teamwork. When I first arrived, I felt totally thrown ff by the approach of the team. Rounds would be finished in record speed, followed by all the discharges and procedures of the day, at a pace I struggled to keep up with. After all this, the team would be able to have a brief coffee and husk together in the break room before a flurry of admissions took over the afternoon. While in Canada, I am used to each person having their own patients and allocated workload, in Paarl we all worked together off a collective ‘to do list’ to complete the ward work. There were dfferent work areas – a pediatric ward, a neonatal unit, and a clinic – but still nobody left the hospital when there was still work to be done elsewhere. And when the days work was done, we all left together, with a sense of collective responsibility.

It took me months to understand the significance of that breakroom coffee together. Everyday, it felt like there was too much work to possibility get through, why make time for coffee? And yet, every morning, the team returned to face it together. That brief 10 minutes of calm in an otherwise often chaotic day, allowed me to really get to know my colleagues. I learned about their hobbies, their medical training in other parts of South Africa, the names of their partners, their children and their pets.

When I reflect on my colleagues now, I remember the kindness they showed me during times when I felt I needed it the most. After my first call shift when my head was spinning, a colleague taking my pen to write notes for me. My attending insisting that I come to dance class after a challenging day. The many conversations in my consultant’s office going over the details of cases I struggled with.

When I think back to my time in Paarl I think of the team. I learned the importance of kindness under stress, I was reminded of the strength of children and families, and I’ve started to think about the healthcare team in a whole new way. I have huge gratitude for the Paarl pediatrics team, and for the mentorship and friendship they provided me during my 3-month elective."