I’ve been on my radiography placement for about a week.
My role in the hospital in the Philippines differed from working in the UK. For the first week, I spent time in the X-ray Department, which has two X-ray rooms — one fluoroscopy and one CR/DR room — located in the Emergency Department. While I’ve been here, we’ve seen an average of 200 patients per day.
The Fluoroscopy room is used for special procedures like barium swallows, colonograms, cystourethrograms, and IVPs, to name but a few! The X-ray department provides 24/7 services to local people, mostly from low-income backgrounds. Most diagnostic services like X-ray and CT scans weren’t free, but they still cost half the price you might pay in a private hospital here.
I’ve also been shown how to use an automatic processor in the dark room, which is now officially a piece of X-ray history. The automatic processor was used to reduce film processing time compared to manual development. It’s fantastic to know that it was still used as recently as a year ago. It shows the difference in the speed of progress compared to the developed world.
New technologies were introduced to the hospital last year. Now, both rooms are equipped with CR/DR Shimadzu Carestream machines.
The condition and functionality of the machines in the hospital vary. There’s one operational CT machine in the department, yet the MRI machine has been broken for a while due to problems with its power supply.
The Radiotherapy Cobalt suite hasn’t worked for over two years, and local people must travel as far as Manila to get the required radiotherapy treatment. It’s a real learning experience to see how skilled the local professionals are at performing their jobs with whatever limited resources they have.
There is, however, good news on the horizon. A mammography machine is just being brought in from China and will be installed within the next few months.
During my working X-ray week, I noticed significant differences from my placement back at home. Apart from justifications and protocols being different from what I am used to, there were differences in how things were done — for example, manual handling, patient privacy, infection control, and radiation protection.
What’s more, families were bringing patients into the room and assisting in patient positioning, manual handling - and, on some occasions, holding the patient during the exposure.
Only a few of the patients spoke English, which made communication challenging. Learning basic Hiligaynon — the most commonly spoken local language in Iloilo — helped, but understanding patients’ detailed responses to my questions was difficult. However, all the staff were supportive and spoke excellent English when translating on behalf of the patients.
I have also noticed that radiographers here don’t communicate much with the patient during the positioning, and very few instructions are given to the patient before the exposure.
As I said before, the radiographer would position the patient with the assistance of a patient's relative. Various trauma patients arrived by trolleys pushed by their relatives, as there was a shortage of porters.
Trauma patients were positioned and moved by the Rad Techs. The reporting radiologists were based in the department next door and worked long, sometimes 24-hour shifts and up to 60 hours per week.
The radiologist on duty handled reports for CT and X-rays, special procedures (interventional radiology) and ultrasound, plus answered patient questions and other staff queries during the reporting sessions.
At first, I was surprised by how things were done. But I soon realised that all staff knew safer procedures — they just lacked the resources necessary to carry them out. I felt very fortunate to have such a comprehensive nationalised health service at home. I admire the staff for working so hard, such long hours compared to what we’re used to.
In my first week, I saw a lot of trauma patients (the majority due to an RTA) and many patients with pulmonary tuberculosis (TB). I have noticed that most patients had conditions not typically seen in the UK. Also, due to the cost of healthcare, patients often can’t afford to come to the hospital in the first instance and see it as the last resort.
It was an emotional experience, and I felt grateful to all the staff who worked so very hard with such limited resources to provide the best care they could for the patients. All the staff are very experienced, and I've learned many new positioning techniques. I’m also grateful to all the staff and local students for working with me and helping me along the way — I felt immediately immersed in the Filipino culture.
I’m excited that I still have a week left in The Philippines, so I’ll report back when the week is out to let you know how the last days went!
Are you interested in taking your healthcare placement in The Philippines? Read more about our destinations there here. What's more, our friendly team of elective experts are always on hand for a chat. Call them on +44 (0)1273 974634, or email us at info@worktheworld.co.uk.
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