White Knuckle Rides

The transport around Sri Lanka is also worth noting. Here are a few of the memories from cars, buses and trains that will stick with us the most.

We got stuck on a 2 lane road (the only one from Kandy in the South to the North) trying to travel back to placement on a Sunday after a weekend in the hill country. The 2 lane road was made into a 6 lane road by inventive and bonkers drivers. There was a pedestrian, moped and tuk tuk lane, 2 inside lanes with also buses, lorries and tuk tuks undertaking and overtaking eachother all at the same time, a middle lane with cars who maybe weren’t sure what direction they were going in, and the exact same on the other side of the road for people heading the other way.

At one point, after a toilet break, the driver turned the key in the ignition, looked at me, and when we heard only silence, we both burst into hysterics with eachother. If our nerves survived about 4 near front-on collisions a minute when driving, they definitely did not survive a broken down minibus in the middle of nowhere during Poya. Picture 6 girls pushing a minibus trying to jumpstart it in the middle of a crowded Buddhist festival. Not OK. Another brilliant moment was a driver attempting a dirt track up a hill to show us the white Buddah statue – Bahiravokanda – that overlooks Kandy, and the boot swinging open for suitcases to fall out, with the driver not noticing at all (though I’m still certain screaming ‘stop’ in English surely crosses language barriers?!). 

Public trains and buses have their ups and downs. We were lucky to be travelling in a big group of sassy girls, but it is hard to see how single women would travel here on public buses without being harassed by men a bit, some of us did and ‘Ehatiyana’ (meaning ‘go away’) was used more than we’d have hoped. Getting from the north to the south cost us around £1.75 for a five hour train. We thought this was a boss price compared to home, however maybe we should have pushed to 1st class. During those five hours we both went through every emotion possible. At first, the novelty of not having a seat and having to stand up next to a door that does not close with a 18Kg rucksack on was quite fun. Then the train started moving. Maybe we should have been scared when all of the Sri Lankans sat down sharpish and didn’t show their typical hospitality by offering us a seat, but we were oblivious. The second hour, and meltdowns came. It was like being on a runaway trainride in a themepark. Except with no handlebars. Or carriages in fact. Or any security at all. We could both honestly say it was the closest we’ve ever been to actually vomiting due to fear. Sitting down was OK, if you clung to your rucksack, and made sure you were bracing yourself to stay in one place. Let’s just say we got off that train and Sri Lankans looked at us as if they were congratulating us for surviving. Glad we did it, but never again.

Love,

Hannah and Erin x

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Elephants, big rocks and £1 beer.

As amazing as working in the hospital has been in Anuradhapura, adventuring at weekends has been just as good. We traveled around the south of the country for our last week without the other work the world girls, who are enviously here for another 3 weeks. If this was a travel blog we might detail which bits were better than others, where to stay and what to do, but I reckon if you just pay for flights to Sri Lanka (STA travel do them for cheap if you look at the right time) and have 2 weeks to spare, you’d have a boss time whatever you choose to do. This country is paradise, and the people living here fully know that and will suggest things to do, guide books or no guide books.

Here are some of our pictures of sunrises, elephants, sweaty backs, near death train rides, Stupas and dodgy food.

Love, Erin and Hannah.

 

 

X-rayted

We’ve finished our placement at Anuradhapura Teaching Hospital! We write this blog at the end of our last week before travelling, just after filming a dead, dead keeno video for work the world. (It includes us being meffs on live actual camera before you begin to think we may be sophisticated). Mind you, we did get a bit emotional towards the end, it’s just all a bit mind blowing that we’ve been able to get so involved in every part of our department and maximise every bit of learning possible.

Here are some pictures of the department and the wonderful staff, with some explanations below them, if you’re into that sort of thing…

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One of the 2 working X-ray rooms in the department, which uses plain film and occasionaly CR cassettes for KUBs. 

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Us and some of the CT staff as well as the 16 slice CT scanner that was donated by the Japanese government. 

The level of knowledge the radiographers have about their equipment is a lot more than we’ll ever learn, they were asking us questions about the brand and types of our lead aprons, to which we had no explanation other than interventional radiologists wear fancy light ones. Note to self, learn this on placement and never take a lightweight one for granted again, especially after watching a 4hr bladder tumour excision in a dead heavy one.

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Tea break in the canteen was a dahl with fish in it and spicy bread, Wathi, one day, and sweet doughnut type rings the next day. 

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Erin posing for a dead awkward photo doing a CT head…

The CT scanner software is thankfully similar to those at home, the only problem being our incapacity to spell second names like Rathnayake or Wanwajareene with a whole room of Sinhalese students watching us and laughing.

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Us and some of the attendants in the department who never failed to laugh at our attempts at Sinhala! 

The attendants in the department keep it running at such a fast pace, and the radiographers couldn’t work without them much like at home. They even drive the mobile machines to the wards for them!

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A mobile chest x-ray taken in MICU – photograph with patients permission. 

The image quality of film chest x-rays is significantly poorer than with DR and we are incredibly lucky to have the equipment that makes X-rays significantly more diagnostic back home. This is a CXR taken on an MICU patient and you can’t see lung markings half as well, it would take a lot of skill to diagnose small abnormalities from these films every day.

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Our first day and introduction – realising outdoor wards with no walls existed was a bit of a shock to us all. The white coats were also very strange to us. 

On our last day, we decided to give the department a present that would mean they’ll never forget them mad westerners who visited in 2016 and didn’t have a clue about facial bone projections or basic exposure factors. They then took us out for a gorgeous Chinese meal in town, and through broken English we got to discuss the difference in how healthcare is governed in the UK. Unsurprisingly, they are also not a fan of their health minister, who doesn’t distribute minimal health resources equally and is quite a fan of private practice. Healthcare lefties exist everywhere, then.

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We’re currently writing posts about everything else we’ve been up to here when not in work so that will be up shortly once we have a nice long sleep!

Love,

Hannah & Erin x

“Yeah, why not?”

When we first decided to come to Sri Lanka for a placement it wasn’t something we spent ages thinking about and booking. Erin literally just text me saying ‘fancy doing a placement in Sri Lanka?’ and I replied saying ‘yeah, why not?’. The next thing we knew we had paid a deposit and committed ourselves to going to Sri Lanka which was very exciting but it didn’t feel real until we were actually at the airport, about to board the plane. The lack of planning we did means we never had a specific reason why we wanted to do this; we knew we wanted to experience a new culture and learn to be more skilled radiographers but there was no one reason we made this decision.

Being here and the experiences we have had, however, has made me think about the experience in a whole new way. I have proven to myself more than ever why it is I want to be a radiographer. Being in Sri Lanka there is, of course, quite a language barrier, although we have built up a relationship with radiographers and found ways to communicate with them, communicating with patients is still a challenge. This is such a good experience for us as improving our communication skills is something we can take home with us, but it is difficult when you really want to comfort a patient and you just don’t know if they understand you or that you just want to help. There have been a couple of times where we have seen patients who are in unbearable pain and there is no one else there trying to comfort them (that we are aware of). Personally this breaks my heart and I just want to take them home with me and look after them – if only this was possible. When all you can offer a patient is what you hope to be a soothing voice and a hand to hold, you really appreciate the ability that we have at home to comfort a patient and know that you are actually making their experience a little better.

The patient should always be at the heart of every health care system and are always the most important. Here, they show how much they care for patients and want them to get the diagnosis and treatments they need by the way they work so hard, all day every day. In order to get every patient examined on the day they come in, otherwise they may not get the treatment they need. To some people it may look as though patients are rushed but we know that they are doing it for all the right reasons. The radiographers here are just the cutest (I want to take them home with me too) and a lot of them work seven day weeks just to ensure all their patients are seen to, which is so admirable – especially as its way over 30 degrees and we are usually drowning in sweat with half an hour of entering the hospital.

We are so privileged in the UK to not have the ridiculously high workload that Sri Lankan radiographers have, and I don’t want to take this for granted. I think that as we are lucky enough to have the extra time to spend with patients I always want to ensure that I give them the best patient care possible, and this is something I can’t wait to do when I get home.

Love,

Hannah and Erin

ps, maybe it’s all this Sri Lankan food going to my head – today we were kindly invited to a buffet to celebrate a marriage in the department. As you can see, the food was quite something…

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M.R.I-opener

Not all of our blog posts will be lists (or titled with ridiculous puns courtesy of Hannah), however it seemed fitting today. We’ve been in the MRI (magnetic resonance imaging) department this week and saw loads of pathologies you’d never see at such advanced stages in the U.K. We also learnt lots of other things, some were even professional…

  • Sun burn, aftersun, sweat and itchy scrubs do not go well together.
  • MRI scanners that require air con in the room are brilliant for sunburnt British girls, and staff here will point and laugh at reddened painful skin for a good hour.
  • Functional MRI is really pretty when watching studies about motor function.
  • Our hospital has amazing equipment, a 3Tesla 5th generation Philips scanner with easy to use software that is not to be taken for granted. It is one of 7 in the government healthcare sector in Sri Lanka.
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Hannah, Erin and the lovely MRI radiographer in our hospital.

  • However, there is only one trained MRI radiographer in the hospital, and the scanner supplies the whole of the northern part of Sri Lanka. There are not enough radiologists to report on many images (the radiology department has 2 consultant radiologists and one senior registrar).
  • Because of the long nature of MRI scans and the importance of tea in healthcare everywhere, we tried a lovely Sri Lankan black tea and a radiographer’s mum made us some Askme which we tried with it. It’s a traditional Sri Lankan snack made of fried stringhoppers and honey and it’s lush.

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    Askme, a traditional Sri Lankan snack

  • We understand a little bit more about the Sri Lankan attitude towards healthcare now, after the consultant radiologist explained to us that litigation isn’t an issue at all here due to the strong Buddhist beliefs of a large proportion of the patients. This means they put their trust in doctors, and also a belief in karma. Patients grin and bear painful examinations rarely wincing, including claustrophobia in MRI.
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Milk rice, another delish Sri Lankan dish.

  • A lot of the girls in the house have signed up to the EU referendum and are postal voting, and we all have strong and (thankfully) united opinions against certain politicians, but are divided over what a wenis is, and whether elephants have one.
  • Australians, like our new roommate Ashley, call flip flops thongs and lolly ice is 100% the correct name for lollipops that you find in the freezer.
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We’ve grown close as a group, and when a mozzy bites…

  • Hannah doesn’t believe in physics, like how can we trust the people who made up physics and how do we know they are clever. Who are these so-called physicists, where do they come from and where did we find them?
  • Size 7 flip flops aren’t widely available here, but Sri Lankan shopkeepers will try, and try, to get a size 5 to fit on your man sized feet.
  • Sri Lankan shopkeepers will also walk out of their shop with 5000LRK to get you exact change, and you don’t even have to peg it down the street after them.
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A typical scene from the market which doesn’t sell size 7 flip flops. 

  • PACS systems are not to be taken for granted. Here, MRI, CT and CR films are printed on films for radiologists and doctors to report on because the country does not have a network set up yet.
  • We do not have the back strength or stamina for the washerwoman life, and our clothes will forever be covered in soap suds and sweat we can’t get out.

Love,

Erin and Hannah x

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Wayasa Keeyada?

At the end of our first week, my thoughts have completely changed from what I thought it was going to be like here. Some radiographers at home said we’d be close to the level of their newly qualified staff here (ha ha ha) it’s not true at all. All of the staff in the department have the such experienced, developed skills any UK radiographer would be jealous of. They work so tirelessly for patients, putting themselves at risk because of a lack of resources. We are so very lucky to be able to even worry about radiation protection and infection control as we have the resources and education to do so.

The radiographers are lovely, and have brought in food their wives or mums have cooked for us every day, like ‘Kiri Bat’ and ‘munkown’, which have been delicious! The skills we will learn here will be nothing compared to the values about patient care (not in the manual handling way!) we will learn, and we are so grateful for this experience.

In the evenings (our shifts are 8am-12pm and 2-4/8pm) we have been using the local hotel pool, eaten amazing Sri Lankan food cooked by the loveliest caterers Uncle and Chucka, and been welcomed into the Sri Lankan culture via using banks, supermarkets & wandering round the busy town hub of Anuradhapura. We’re currently on a beach, staying in a beach hut surrounded by fishing boats in the remote East Coast town of Trincomalee. It’s the most heavenly work/life balance!

Th work the world house is fabulous, we share it with 5 student nurses from Manchester uni – Anna, Annabel, Lauren, Beth and Olivia – and a qualified OT Katie, who are all enviously staying here for 6 weeks!

As part of RADSOC we always wanted to fundraise for the largely unheard of world radiography education trust fund, and we will be also organising fundraising for this incredible department in the future as let’s be honest, we’re in the best position to donate when they work so well with little resources in a developing country to do the best for their patients.

Love,

Erin and Hannah x