Since last writing, I have been working in X-ray and ultrasound. During my first two days, I observed ultrasound guided line insertion into patients' necks and groins, central venous catheter insertion for haemodialysis, and saw some trauma cases (some of which included stab wounds).
Working in the hospital’s only Ultrasound room was busy and often overcrowded—seeing around twenty patients per day, some of whom would bring their families in with them, wasn’t particularly conductive to patient dignity! The doctor on duty would perform the scans and give written details to the secretary, who would then type them up. All the images were printed and kept in a notebook for the doctor to check before writing a final copy.
Another difference I noticed was infection control. Linen was changed less frequently than I am used to, and sterile wipes weren’t always available. However, some patients had brought in sterile gel and toilet paper, which were used to wipe the Ultrasound probes, kits, and table.
On my third week I spent three days in CT and the rest in X-ray. There were only 2 CT scanners (16 slices), and no patient manual handling technique in place. As you might imagine, this was very different to what I was used to back home. I also noticed the contrast pump wasn’t used, instead the contrast (Iopamidol) was injected manually by a doctor when the patient was already on the scanner. Sometimes the doctor was busy and contrast was injected by a Rad Tech. There was also the case of a tumour biopsy being performed by a doctor right on a CT scanner, which I had never seen before.
The differences I encountered weren’t just clinical, either. I also found the work ethic and career expectations of those I was working with in these departments was very different from those in the West. For instance, the doctors and residents were working extremely long hours that included over time, without the possibility payment for the latter. In terms of career progression, I learnt that it is impossible for a Rad Tech to train for advanced practice and subsequently specialise in an individual modality, for example reporting, MRI or Sonography. Instead, Rad Tech students volunteer in the hospital for years in order to get a job, even after qualifying and getting the board exam license to practice. This is because the job market is very tough.
That being said, the working attitude of staff and the adaptation of techniques when working with such limited resources is something I know I’ll be taking home to incorporate in my future practice. I have a lot of admiration for staff working under such conditions, while remaining totally committed to their jobs. You’ll be glad to hear my time in The Philippines hasn’t all been indoors! We spent our weekends island-hopping our way through Guimaras island and others, and visiting Antique. The natural landscapes here are stunning; we worked our way through seven waterfalls, swam in hot springs, and relaxed on beautiful sandy beaches.
I feel very fortunate to have met local students at the hospital to socialise with. Taking our friendships beyond the hospital and learning about Filipino culture—the food in particular—was fantastic. Staying at the Work the World house and being able to form friendships with students from all over the world has been an experience I’ll never forget.
Although the work could be very challenging and different from home, I’ve learnt a lot in a short period of time. It truly is a once in a life time experience, and I would encourage everyone to do an elective in the Philippines! Subscribe to our social channels to get notified of my next and final blog.