With a background in paediatrics, Dr Catarina Olimpio moved to South Africa from the United Kingdom (UK) in September 2018 to work in a rural hospital. What made a young, British doctor working in a well-equipped hospital in the UK move to a rural, under-resourced hospital in South Africa? For Catarina, it essentially came down to ‘right place, right time’. For many years she had had a desire to work in a resource-poor environment so that she could learn different ways of practicing medicine, and be exposed to different issues that patients presented with. Catarina wanted to grow as a doctor and as a person. When she heard about AHP and what we offer, she realised this was the perfect opportunity for her, and the perfect time. It was also Catarina’s curiosity that helped her pack her bags, say farewell to the comfort of her home and move continents.
Working at a hospital near Port St. John’s in the Eastern Cape, Catarina has made a positive impact on the nurses’ knowledge and treatment of infants.
With limited resources at her facility, Catarina realised that the best way she could make a difference would be to find simple ways of improving the way infants were being treated. Catarina observed that the nurses seemed almost reluctant to call for a doctor when it seemed to her this would be the obvious course of action. But as she continued to observe and speak to the nurses, she realised that the problem seemed to be the nurses’ confidence about the observations they made of the infants. The nurses were sometimes unsure what to look out for, making them hesitant to call a doctor when it was required. What Catarina first identified as a lack of interest to treat the infants soon showed itself to be more about them not knowing what to look out for than an actual lack of interest.
With an understanding that the issue was around awareness, Catarina wondered what simple measures she could take to help the nurses become more aware. Her solution was to create some straightforward posters to make nurses aware of normal baby values, such as respiratory rate, heart rate, and blood pressure. Catarina believed that making the nurses aware of these vitals and what to look out for when treating infants would give them the knowledge and confidence they needed to know when to call a doctor for assistance.
‘We don’t have all the necessary resources, and that I can’t change, but I can affect their knowledge and raise awareness around what to look out for.’
Catarina used the South African guidelines for babies to guide her in the treatment of infants, and adapted it to what she and her staff were realistically able to do in their facility. ‘If we do the basic things right, we might still lose babies, but at least we’ve done the best we can do.’
Catarina’s impact goes beyond her posters. She recently gave the nurses a survey to ask them what things they would like to receive more formal learning on. Once she has reviewed their feedback, she will start learning sessions with the nursing staff on a more regular basis.
‘When people know what they’re doing and why they’re doing it, they’ll do it.’
AHP’s aim is not only to place doctors where they’re needed the most, but to support and equip those doctors and their colleagues to make people and hospitals better. To that end, AHP held an HIV/TB Management course earlier this year which Catarina attended. She feels the training totally changed the way she looks after her patients now. ‘I feel much more confident treating HIV positive patients now. I know what I’m talking about, I know the guidelines better, and I know how to explain HIV treatment to patients and why they must take their medication.’
It hasn’t all been plain sailing of course. After about six months into her job in South Africa, Catarina hit a real low patch. There is a lot that one has to adjust to when moving to somewhere like rural South Africa, but focusing on her aims, her reasons for making the decision to move to South Africa in the first place, and keeping a positive mind set all helped her to persist and thrive in this new challenging environment.
When asked about the benefits of working at the hospital in the Eastern Cape, this is what Catarina had to say: ‘My ability to make decisions, to work independently, and to prioritise has improved significantly. Here, you have to make your own decisions because there isn’t always someone there to back you up and to ask. This has made me a more confident doctor. I can now rely on my assessments and I can make decisions based on that.’ Catarina has also made time to explore the country. ‘Outside of work it’s just amazing. I try and get out on weekends and explore this amazing country. The Transkei is just beautiful!’
To ensure that Catarina’s efforts don’t go to waste when she returns to the UK in July 2019, she believes the best way to ensure the sustainability of her efforts would be to recruit more AHP doctors. There are simply not enough doctors in rural hospitals across South Africa. And this is exactly why AHP exists. We get doctors to where they’re needed the most. Since our inception in 2005, we’ve placed almost 4 500 doctors, which has resulted in close to 35 million patient consultations.
Dr Catarina Olimpio and fellow AHP placed doctor outside their hospital
Dr Catarina Olimpio
The posters Catarina put up in the paediatric ward
Exploring the Eastern Cape