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 Read in-depth articles about elective placements around the world - get a taste of elective life and the enormous number of options available. From the UK to Australia or Canada to Zambia, from rural clinics to state-of-the-art teaching hospitals, we try to feature a broad spectrum of elective experiences. We add a new article monthly.
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| | | | | |  A condensed version of one of our feature articles ... | | | | Alex Tulikkan claims he planned his elective under the same conditions that he did most of his academic work – late at night. Here he tells of the first six weeks of his trip, which he spent at Georgetown Hospital in Guyana.
It seemed to me I had made a sensible two-part elective plan. Guyana, I felt, would afford me all the fascination of developing-world medicine, in an English speaking country. Then on to New York, where the sweet rhythms of Julie Mango and I'm Feeling Uneasy In My Pants and other contemporary calypso classics would be replaced by the quiet hum of hardworking doctors on the 23rd floor of a rich Manhattan hospital.
It turned out that very few of the people I met in Guyana, from diplomats to airhostesses, had anything good to say about the place. But I didn’t know this when I left – in fact, I didn’t know anything about Guyana when I left. I had left buying a guidebook until Heathrow; its pages seemed to indicate that it was ugly, boring, expensive ... and violent.
Having nowhere arranged to stay, I took the recommendation of a man on the plane and headed for the Sheriff Street Nightclub on the outskirts of town. It was only a short bus ride from the hospital and was the cheapest room in Georgetown – and must have been one of the worst. I decided I could suffer it for one night. It was to be my home for the first three weeks of my stay.
My mentor
Following my first night kept awake by the pounding music from the nightclub below, sweating copiously, and covered only by a thin blanket of mosquitoes, I set off the next morning in search of the hospital.
The public hospital in Georgetown serves a population of about 400,000. With some 200 medical patients on the wards and essentially only one medical consultant, attempting a thorough ward round would have been superhuman. But superhuman is a good description of my mentor there. The people of Georgetown rely heavily on this one-man multidisciplinary team – everything from Regius professor to radiologist – who sweated from one patient to the next. His reading would have impressed in any teaching hospital in the world, and in Guyana, by necessity, he replaced Medline. There was seemingly nothing he didn’t know and nothing he didn’t know how to treat. But with so little in the way of funds, there was often little he could do except teach.
So for six weeks I learned everything I would need to know for finals, provided I could remember that, in Oxfordshire, the number one cause of pancreatitis is not scorpion sting and the first differential for a hot leg should not be snakebite.
A puzzling place
The hospital alone, with the teaching and the patients, would have made my elective enviable to anyone approaching finals, but I also had a good time. All the reasons my guidebook gave me for not going to Guyana are true but they are not good enough reasons not to go. Although Georgetown is quiet in the evenings, the weather is good, the drinks are cheap and the calypso never stops.
Guyana is a puzzling place for the visitor. Since the British left in the 1950s, its economy has steadily worsened and it has very little foreign investment. There is much social and political unrest running through Guyana, and Georgetown especially has been a center of sporadic demonstrations and disturbances. The population is roughly half Afro-Guyanese and half Indo-Guyanese. The country also has huge natural resources: diamonds, timber, aluminium and oil, not to mention three rice harvests a year and numerous unspoiled rainforests*. And its geography is peculiar as well; although indisputably part of continental South America, I found it defiantly Caribbean rather than Latin American in character.
There is much more to Guyana than Georgetown. I was taken on a fishing trip into the western jungles and savannah swamps of the Pomeroon River to catch the mighty Arapiama fish. It was a hard place to get to and, once there, we had little success until we resorted to the Arawak tribe’s method of fishing. They simply submerge poisonous bark from a tree into the river, set a net downstream and – await the satisfactory results.
Mugging up for finals
My return to Georgetown was to vastly better circumstances than those that I had left. I spent a weekend at the Bartica Easter Regatta, the highlight of the Guyanese sporting calendar. But my expectations of some Henley equivalent were somewhat dashed when I discovered that it consisted of 50 ten-foot boats with 200hp engines racing in a half-mile triangle around buoys until podium places seemed to be arbitrarily awarded to the three survivors.
A fellow regatta guest, an American embassy official, took pity on me when I explained about the Sheriff Street Nightclub and offered me his spare room at a nominal rent. So, for the next three weeks I lived in colonial luxury just two miles from the hospital in an enormous white-walled, green-roofed house.
Though more conducive to revision than Sheriff Street, my new environment lacked none of its excitement. Just two nights before I left I was mugged with my housemate during a night out at the Astor Theatre, where I was given a good beating from six of my fellow cinema-goers. It wasn’t until I’d been dusted down and given a stiff drink by some locals that I summoned up the nerve to walk home.
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I don’t know if I’d recommend anyone else to go visit Guyana. I found it dirty, chaotic and expensive and it can be violent and at times quite threatening. But it is also exciting, friendly and beautiful in places. Go expecting a tough time… and, if you do go, I can be pretty sure that you will have an amazing time and a most memorable elective.
* Source: Lonelyplanet.com
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