“Hello Global Nomadic!
I figure it is time that I send in my month two report and talk a little bit about where I am working!
My day starts at the very respectable hour of 8am. After the typical morning routine (get presentable, make breakfast, pack a lunch) I leave my apartment at 8:50. Ulaanbaatar, despite all its curving semi roads, is actually pretty easy to navigate. I wander past multiple apartments until I get to a main North/South road and work my way up to Peace Avenue which is the main road traveling through the city. The walk is generally 15 minutes (12 if I’m running late and in a hurry!).
When I make it to my bus stop I wait for Bus 2 headed to Sharhad. There I get off and walk for approximately 5 more minutes before I get to my clinic!
This one clinic serves the entirety of its district, meaning that 1 clinic serves 12,000 people. Its a very busy place.
For the first few days I mainly observed one physician as she went about her daily routine. Most of the people who come in are simply there for check-ups. However, one major difference I noticed between the US and Mongolian practice is that if a patient has a more serious condition, they have to go to the family clinic first, then they are referred to a larger regional clinic, and then from there they have to be referred to a specialist. Therefore, with a system like that in place, efficiency at each level is key. Patients are in and out of the clinic very quickly. There really is no such thing as a 45 minute wait (which I feel like we have come to expect at US clinics). Patients will simply wait outside the physicians door, and as soon as one leaves the next will simply walk in.
After a few days however, it was time for me to get busy! For much of the morning I was assigned with my fellow volunteer to conduct breast exams. Yes, that’s right. Had I ever conducted one before this trip? No, no I had not. Am I very familiar with the process now? Yes, yes I am. But I figure that’s bound to happen if you examine 15+ women every morning for two weeks…
It has been a learning experience! But by the second week I was ready to try something new. And I definitely found it. One day I was wandering the clinic in during the afternoon shift and I came to the IV room. Essentially in Mongolia much of the administrations of medications are done in the clinic. While it does create a bit more foot traffic, its very helpful for making sure patients take their medications faithfully.
After reviewing a few IV administrations, the nurse I was shadowing was ready for me to try it myself. I wasn’t quite ready to make that commitment so I just told her I would watch for now, but now my recent job has been to remove them (a much simpler task, but a stepping stone none the less). Maybe I’ll try administering IVs next week.
Overall I love the clinic that I work.. Much of it is the same routine everyday (breast exams in the morning, help measure and record blood pressures, IVs in the afternoon). But I love it. I am learning so much. I think the language barrier in this instance serves as a benefit, because it forces me to focus on observing patient body language. Are they pointing to their stomach? Is the doctor responding by tapping the areas where their kidneys are located? Or is she pressing on their appendix or under their rib cage? Many of those kinds of observations are done in a day.
This clinic also is different from what I am used to because every Monday/Wednesday/Friday, the head physician brings families in to teach them about various topics related to health. Sometimes it is teaching exercises, and other times it is showing new parents what their child should/shouldn’t eat, the other day we even had a seminar on hand washing. I personally think these kinds of seminars are so cool to observe, and they really help to develop a community among the patients. You begin to recognize the families that come in, and they all regularly engage in conversations with each other. The sense of “small community” here is really impressive when considering how many patients this one clinic actually serves.
But that’s all I have time for for now! But hopefully I can update soon with more details about what I am observing. In the meantime thank you for sticking with me!
Until next time!”