My Routine

It's probably time to break my silence, as several have asked about my typical routine.

Monday- Surgery either in Siteki (where we are living), or Manzini (largest city in Swaziland, 45 minute drive from Siteki).

Tuesday- Clinic in Manzini

Wednesday- Clinic in Siteki

Thursday- Surgery in Siteki

Friday- Post-ops, short clinic, and administrative details in Siteki

Clinics can be quite busy and full of pathology. Efficiency is paramount. Patients line up on a bench, and at the end of the bench sits me and a slit lamp on wheels. Once the patient on the end of the bench is seen, he stands to leave and all the other patients slide down one slot on the nicely oiled bench (sort of like the reload of a revolver). The list of medicines has been pared down to only the necessities, and glaucoma is a surgical disease, as people cannot afford the many trips for follow-ups and medicine re-fills. The clinic sees about 75 patients on a typical day, but most of these are "doctor" cases, as the nurses have already pre-screened and treated the easy problems (red eye, corneal foreign body, chalazion, etc).

If surgery is indicated, the patient is admitted to the hospital for surgery the following day. Many patients cannot afford to go home and come back again, so the hospital is essentially used as lodging to ensure the patient gets the surgery they need. No patient is turned away for lack of resources, but all are asked to pay what they are able. A typical surgery day might include 2 cataract phacoemulsifications, 22 Non-phaco cataract surgeries, 2 trabeculectomies (glaucoma surgery), and 3 conjunctival cancer removals.

The clinic also has the capabilities for YAG and argon laser (to treat diabetic patients).

Overall, I feel the clinic provides excellent eye care. My mentor is fully capable, and a wonderful instructor. This experience has already greatly augmented my ophthalmic knowledge, and I will undoubtedly gain more confidence as my time here progresses.

-Eric