Bairo Pite Experiences: Bethany Holt #1

Bairo Pite Challenges

Working with the dedicated team at BPC presents many challenges to the fresh faced, foreign medical student: There are endless days, sweltering hot wards and language frustrations. You are faced with uncertain diagnoses, inadequate investigations and limited treatment options. Patients appear unacceptably ill and the ethical dilemmas around resource allocation are painfully obvious. Instead of systems and protocols there is inefficiencies and improvisation. 

But, unlike many elective experiences, as a student you are a crucial part of BPC patient care. And that in itself makes all the challenges surmountable. Whether it's admitting new patients, ordering investigations, waiting hours at the hospital for specialist referrals or researching patients' conditions, your contribution is necessary and relied upon. Although you are supported by the wonderful doctors and staff, as a student have real responsibilities and have to take initiative. 

As a pre-clinical student, my contributions have not all been directly involved with patient care, unlike my colleagues with more hospital experience. But I hope that by initiating the creation of a Volunteer Manual, future students and doctors might be better equipped to meet and overcome the challenges of working at BPC and living in Dili. By spending some time with the HIV program staff, I hope momentum will build for creating a more effective system to track and treat PLHIV. 

Personally, the reward of rising to the challenges at BPC is the awareness that I'm making a difference, in some small way, to outcomes in such a resource poor setting. Whatever limitations the system itself imposes, that means something.

By Bethany Holt