Award Award - Daisy Dunn

In April 2011, I travelled to Grenada, a small island at the south-eastern tip of the Caribbean, to undertake a five week elective on the Paediatric Ward of Grenada General Hospital, as part of my five year medical degree at the University of Birmingham. This 325 bed hospital undertakes the majority of the healthcare for the island's 98,500 inhabitants, and is state-funded. Although on the surface a popular tourist destination, Grenada was devastated by Hurricane Ivan in 2004, and the economy is still struggling to recover - even now it remains one of the poorest nations in the Caribbean.

Daisy Dunn.jpgFrom a distance, the hospital is in an idyllic position, overlooking a stunning bay. However, the reality was a marked contrast, and it soon became evident that the hospital struggled for funding, and lacked the facilities, equipment and technology that we in the UK take for granted. The ward on which I worked was run down and very basic, with only 25 old wooden cots, meaning that any child over six years was forced to stay on the adult wards. Equipment was usually second-hand, or meant for single use only, and was donated free from the US. Food was not supplied, and parents were expected to provide meals, often resulting in some poorer children going hungry - the staff frequently had to eke out meagre supplies to provide them basic nourishment. Families were also expected to pay for any uncommonly used or expensive drugs, and any scans required, often costing hundreds of US dollars, a sum few could afford.

However, the staff on the ward were incredibly dedicated, and often contributed from their own wages to help those in need, as occurred with one little girl who needed an urgent brain scan following several life-threatening fits. This was just one example of the devotion and commitment of the paediatric staff I worked alongside, who in spite of everything, always provided the highest standard of care possible.

I worked alongside the ward doctors, performing daily examinations of the inpatients, presenting their progress to the consultant, and admitting new children. Their support and encouragement allowed me the freedom to develop my own consulting style and management plans. For instance, one of my patients, J, a six month old Downs Syndrome baby, with complex heart defects, had been in hospital since he was three weeks old. His heart problems had caused lung damage, and because of the basic nature of the hospital, his only chance was to be flown to a neighbouring island with more advanced facilities, or the USA. However, his family could not afford the complex operation, and therefore he was being cared for until his heart gave up. I struggled to reconcile myself with the decision that J was palliative, as in the UK he would undoubtedly have been operated on. Thus I made note of his gradual improvement over the five weeks, and presented my findings to the consultant in charge, eventually securing a referral for expert assessment from a neighbouring island, and possible surgery funded by a US charity.

The experience of working in an entirely different culture and health system was simultaneously challenging and rewarding. I immensely enjoyed the hands-on opportunities my elective provided, and the dedication of the staff was nothing short of inspirational. I would like to thank the LEH alumnae for giving me the opportunity to undertake this valuable and fulfilling experience.

Daisy Dunn, LEH 1997 - 2007