University of East Anglia 2018

Medical, Merida Mexico

Knights, EmmaI always knew that I wanted to go overseas because I hadn’t really travelled that much before. I had tried to organise a trip with some friends, but I got the feeling that they wanted to do different things to me.

Travelling with Work the World gave me the opportunity to go it alone without having to compromise. I also had the benefit of being supported throughout.

When it came to choosing the destination, I knew I wanted to brush up on some Spanish as a bit of a challenge. I also wanted to go somewhere different from home, but not so different that I wouldn’t recognise the local medicine. I ended up choosing Merida.

Knights, EmmaI was nervous when I first stepped off the plane, but as soon as I saw a member of the Work the World team there waiting for me, I was absolutely fine. We jumped in a taxi together to the Work the World house.

We chatted about other students who’d already arrived and what the next couple of days were going to look like for me. By that point, my nervousness had melted away into excitement.

Merida was a pretty city. It was beautifully clean and the houses were in the traditional colonial style.

The Work the World house itself was in a lovely residential area. The rooms were a really nice size and had their own bathrooms with showers. There was a big communal area with sofas, and tables where we ate dinner and had Spanish lessons.

Knights, EmmaThere was a big kitchen where the catering team cooked our breakfasts and dinners,and there was even a pool in the garden!

It was hot in Mexico, so we came home from placement each day and jumped into the pool to cool down.

I really loved the food. The catering team made a lot of traditional Mexican dishes that I’d never heard of before. I really liked the weekly BBQ nights as well where the catering team cooked steaks, barbecued fish, and a made delicious guacamole that I now have the recipe for.

The dynamic in the house was great and all of the housemates clicked quickly. Of course, there were different groups of people arriving at different times, so there were always going to be established friendships. But, everyone was still really friendly and open to welcoming new people to the house. I never once felt disadvantaged having travelled by myself.

Knights, EmmaThere were healthcare students from the UK, Ireland, Hong Kong, Australia, and America, and from all kinds of disciplines.

My hospital introduction was great. The staff showed me around the main areas of the hospital first, and because I was in paediatrics, the staff introduced me to the local paediatrician.

The hospital was so massive that I never even made it to the top floors. One thing I couldn’t get over was the sheer number of staff. Having said that local medical students wore the same thing as the qualified doctors, so it wasn’t always easy to tell.

Everyone was so friendly. There wasn’t anyone who didn’t say either good morning or hello.

It was a very different hospital setting from what I was used to in the UK. They had big, open wards and squeezed in large numbers of paediatric patients. Privacy wasn’t top priority either—I don’t think I ever saw anyone draw a curtain.

Knights, EmmaHygiene and infection control were also secondary concerns. There was one small sink for the entire ward.

They didn’t have a lot of the resources that we had in the UK. For example, there was one child on the ward who had cancer and they had to wait a week to start treatment because the hospital didn’t have the funds to buy the drugs.

The patient was waiting in the isolation room, which again was very different to what I was used to at home. The isolation room in my placement hospital was in the middle of the ward and it was windowed on all four sides. The whole ward could look in.

When things were quieter in paediatrics, I popped down to A&E, which was also very different. They had a practise called ‘observation’, which essentially meant that patients were kept in corridors. I walked along and saw patients with severe injuries just sitting in the hallways. The hospital didn’t have space to offer everyone a bed. That said, the local staff were so used to the situation that it wasn’t seen as the hospital being busy or overcrowded. It’s just that they were using every available space to help patients.

Knights, EmmaOne of the most confronting cases I saw was a girl with Lupus. The illness wasn’t being controlled with immunosuppressants. She had a massive legion on her leg that was obviously out of control, and her leg bones and tendons were all exposed. She’d been there for months.

There were also a lot of children with congenital malformations. I’d seen babies in the UK with diaphragmatic hernias (when the stomach contents come up above the diaphragm into the lung space), but none as old as the paediatric patients I saw in Merida. These cases were fixed immediately in the UK because the condition can cause the lungs to malform. There were children in Mexico who were two or three years old and still suffering from it.

These patients would have had surgery at some point, but the malformation of their lungs would have already happened. They were malnourished as well, so it was quite confronting.

Knights, EmmaIn terms of resources, things were probably similar to what you’d expect the NHS to have looked like a few decades ago.

Local hospital staff used old techniques no longer used in the UK. For example, when feeding patients we sometimes use NG tubes. The way we test it’s in the right place is by testing the Ph using Ph paper. They didn’t have Ph paper in my placement hospital, so they used methods that we’re told never to use.

X-rays were all processed on film in the hospital’s dark room. There were no digital machines to speak of.

I spent two weeks in a maternity hospital and one of the most notable things was there was no pain relief for women in labour—no epidurals, no gas and air, nothing. The only pain relief they received was a local anaesthetic if they needed an episiotomy.

Knights, EmmaThey dealt with the whole labour experience differently in Mexico. To give you some context, this was a public hospital—some of the poorest women in Mexico came to give birth there. When in labour, expectant mothers were put in a room together to wait until things really started moving.

Next, they’d be taken into the ‘labour room’. That’s where they were monitored until the baby was quite literally about to come out. Then, a member of staff would shout ‘expulsion room!’ and the patient would be taken off and put in stirrups. A medical student or doctor would then help the baby out. In most cases, the doctor would perform an episiotomy.

Instead of skin to skin contact and the whole ‘congratulations here’s your baby’ bit we do in the UK, local staff immediately took babies away from their mothers for tests.

I actually delivered a baby myself. The local doctors helped me through the process, telling me exactly what to do and how to do it, they were right there with me. It happened really quickly, but I’m so glad I was involved.

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Knights, EmmaWhen it came to Mexico itself, we fitted so much in that it now seems crazy. On the first weekend, we wanted to sleep in the Work the World house, so we did things that were nearby. We went to Progreso beach for the whole day, which was beautiful and the sea was warm. The next day we travelled by bus an hour or so away to the ancient Mayan city of Uxmal.

The second weekend we travelled out of Merida. We left on the Friday and stayed in a little town called Vallodolid. We explored the town, and the following day we went on a tour that took us to some amazing places. We visited Rio Lagartos (famous for crocodiles), had a Mayan mud bath by a river’s edge, visited the pink lakes of Las Colorados, and saw some more Mayan ruins at Ek Balam. The following day we went to Chichen Itza and to swim in some cenotes, which were unbelievably beautiful.

For our final weekend we went to Playa del Carmen, just to explore a different side of Mexico. There were some great restaurants, nightlife and shopping there, but we also swam with turtles that weekend. We literally just grabbed a snorkels and masks and waded out into the sea to find them. They came and swam right towards us.

Knights, EmmaThe Work the World staff in the house exceeded my expectations. They went above and beyond, and were always around if we needed them. They became our friends, but they were also professional and made sure that all aspects of our placement were up to scratch.

If you’re hesitant about an experience like this, don’t be. Travel overseas, because opportunities like this don’t come around every day. It’s one of the best things I’ve ever done and I wish I could do it all over again!

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