Tips for medical student volunteers

Bringing donations/supplies

  • Have a look at the Wish List on the BPC web site, and/or contact current students who are there and ask what is needed
  • The best way to distribute the donations is to do it yourself during the first couple of weeks you are there – things at the clinic can be very busy and often staff won’t have time to go through a box of new donations themselves for a while
  • If you think of other things needed whilst you’re working at BPC please pass them onto the web site admin, who will put them on the web site
  • Be aware of the laws regarding bringing medicines across international borders
  • Please bring any medical textbooks you no longer need and give them to clinic staff as you feel appropriate – any extra educational materials will be greatly valued

Topics to read up on

  • Infectious diseases: TB, Malaria, Dengue, Typhoid, HIV, skin infections, respiratory tract infections, rheumatic heart disease
  • Antibiotics
  • Emergencies:
    • ABCs
    • Shock
    • Obstetric emergencies
    • Hypoglycaemia
  • Managing malnourished children
  • Wound management, including abscesses
  • Suturing

Things to bring for yourself

  • Books:
    • Lonely Planet Tetun phrasebook
    • A book on tropical medicine
    • Australian Medicines Handbook / Frank Schaun paediatric Drug Doses book (or equivalent from other countries – a book to look up drug doses/information)
    • Antibiotic Therapeutic Guidelines
  • Medical equipment:
    • Stethoscope
    • Torch for looking in people’s eyes/ears
    • Temperature probe

Conduct at the clinic

  • Getting to know the staff at the clinic: This is very important as the clinic always has new people coming and going and it is important to build trust within the working environment to ensure the best outcomes for the patients. Try to:
    • Learn everyone’s name
    • Give your Tetun a go – people really appreciate it and are encouraging
  • Using computers in the office: try to restrict your use to when staff are scarce in the office as they need computers for their own work and often are too polite to tell you if they need a computer. Good times to use them include: before 8am, between 12 and 2pm and after 5pm.
  • Getting drugs from the pharmacy: when you need medications for mobile clinic boxes or patients in the emergency room write it down and then ask the staff in the pharmacy for the medication.
  • When altering patient management – putting in IV lines, putting up fluids etc – involve the nursing staff – discuss the case and changes you are making, often they will want Dr Dan’s input as well.
  • Couples doing placements together:
    • The clinic has had a number of couples come through and are familiar with and accommodating of their needs
    • Public displays of affection are not often tolerated at the clinic as staff and patients can find this offensive

Afternoon ward rounds

Afternoon ward rounds are conducted by the medical students – the aim of the ward round is to ensure all the inpatients are stable and will be ok overnight. Take OBs from all patients, monitor their symptoms/signs and discuss any concerns you have with Dr Dan. Involve a translator if you need to ask lots of detailed questions. The aim of the round is not to make changes to investigations and management. Any changes to management should be discussed with Dr Dan.

The Emergency Room

The Emergency Room is located next to the TB programme office and patients are mainly seen here following an injury or if they need a procedure (eg suturing). There is almost always a Timorese staff member (some nursing trained, some not) whose job it is to look after the emergency room. They will often ask for help from medical students with managing patients. Always make yourself available to help but do not take over the emergency room → involving the staff member and transferring knowledge and skills is very important.

Mobile clinics

  • Involve a medical student, volunteer translator, driver and sometimes a nurse travelling to rural areas surrounding Dili to conduct a ‘GP like clinic’.
  • Double check that everything you want to bring is in the mobile clinic box before you leave. Eg: BP cuff, temp probe, flucloxacillin, wound management materials including sutures and lignocaine, rapid malaria tests etc… often things don’t get replaced when they are used during the previous clinic.
  • Bring back to Dili any patients who you think need management at the clinic or further investigations. Dr Dan is always supportive if you feel a patient needs further attention.

Staff education

Some medical students conduct education sessions for staff at 7:30am each morning. Please become involved in these and try and pass on knowledge and skills to staff members at the clinic in any situation possible (eg, in the emergency room, on mobile clinics).

Driving

  • The clinic employs 3 drivers and the bulk of driving patients to the hospital, mobile clinics etc should be done by them. Their lunch break is from 12 to 2pm and it can be difficult to find a driver at that time. If the need for a driver is not urgent then it is best to wait until 2pm.
  • Medical students are able to drive the vehicles but need to be aware the clinic will only cover them if something happens and there is a patient in the vehicle. If medical students are using the vehicles for other errands (going for lunch, going to immigration etc) where there are no patients in the vehicle the clinic will not cover you if something happens.

Popularity of the placement

The placement is becoming increasingly popular with medical students and there can be times when there are up to seven medical students at the clinic at once. In this situation it can be good for everyone to have a day off each week (with a 6.5 day working week no one should be complaining about this!), send two students rather than one on mobile clinics and to have a go at ‘non-medical’ jobs – eg: sorting out all the supplies that are donated to the clinic, spending time with long term patients (especially children – they are mostly very bored), assisting with personal care of patients who don’t have their family around to help.

Most important of all: Enjoy your time at Bairo Pite Clinic – it’s a very unique place to work!