Monday, January 29, 2007

Sunday, January 28, 2007

Misunderstanding around HIV testing in SA

A comment appearing on Champagne Heathen deserves a quick post. Ties quite nicely into the aritcles we've been writing about HIV ignorance - some malicious, some not.

At least, with this reader, she's bothering to ask, and not just assume. Cough.

I really do start off every year having an HIV test as well as a full STI test. I don't know why, it's just a thing I do. I have to tell you it really peeved me off this year that I couldnt just walk into the lab, ask for the test, have it, go home and wait for the results.

I had to get a consultation, so that the doctor could write up the bloodwork request. He of course wanted to know when this happened - that was his actual question to me. Firstly "it" didnt ever happen and secondly if "it" did why would "it" be any of his business?

What "it" was we can only assume... a rape incident I dunno... The point is it shouldn't be such a hassle for something like this, especially in this country. Sorry god I really did have a rant there. Seems I'm still quite mad about this.

Dear Anonymous Commentor. Thank you for asking - people often get confused about a Doctor's intention. More so when it comes to something as private as HIV testing.

The simple answer, is that whoever you are, we have to consider the potential of pre and post test counselling. A Doctor, first and foremost MUST determine the reason for a patient wanting test

For instance, if there was a little drunken hubba hubba unprotected mistake. Well, we've got window periods, contraception patterns etc. to worry about. If it is rape, as you probably wrongly assumed... there's both window period and proper rape counselling. Even if a patient is just paranoid - there could be other reasons. We wouldn't be doing our job if we didn't ask. The question is never intended to offend.

Now, let's consider the horrible side. WHAT if it's positive? That's the reason Doctor's make you come in for an appointment instead of telling you over the phone. This virus, she's a seeeriiuss thing. No-one wants to receive a life-changing diagnosis over the phone.

"It " simply means unprotected sex or the reason for the test, not necessarily "rape" . And "it" IS his business - we can't practice blind. And remember, as clinical as doctor's seem to be getting - we still care about the whole patient... Emotional wellbeing is as important as your health when confronting the medical decisions / risks of everyday life.

Saturday, January 27, 2007

A shout out to the 27 Dinner Scrubbed fans...

Just returned from a highly successful 27 Dinner - a local gathering of techies, geeks, bloggers, media folk and business people alike. It was truly mind-blowing to actually meet All Scrubbed fans - and we thought all our traffic came from LinuxToday!

More of the same coming ladies and gentlemen. Keep reading and we'll keep entertaining you with the "other" side of medecine. Seee. Ree. Ass. In the mean time, why not Del.ic.ious this site? Quite keen to ride this wave of new medicinal confidence :)

New Blogger has surgically removed our header...

I knew the "templates" would change slightly, but was hoping to be able to restore our header. Can anyone help out here? Or point me in the right direction? The header is stored here.

Tuesday, January 23, 2007

Medical T-Shirts...

Found these on Cafe Press - and they're hilarious. So we're posting them.

Go buy yours now! Please note: All Scrubbed gets absolutely no commission from this deal, even though we should :)

Monday, January 22, 2007

Medical Joke #1

An Israeli doctor says "Medicine in my country is so advanced that we can take a kidney out of one man, put it in another, and have him looking for work in six weeks."

A German doctor says "That is nothing, we can take a lung out of one person, put it in another, and have him looking for work in four weeks.

A Russian doctor says "In my country, medicine is so advanced that we can take half a heart out of one person, put it in another, and have them both looking for work in two weeks."

The Texas doctor, not to be outdone, says "You guys are way behind, we recently took a man with no brain out of Texas, put him in the White House for four years, and now half the country is looking for work."

Wednesday, January 17, 2007

White people don't get HIV. Apparently.

Having moved from government (where the predominant culture is African) to a Northern Suburb private practice (predominantly white population), it has been absolutely mind-blowing to witness the the difference in cultural beliefs surrounding HIV.

Forget what LoveLife tells you. Forget what you've talked about with your friends. The truth is far scarier.

Don't get me wrong - I don't think white people ACTUALLY believe that they are immune to the virus - but they have this unbelievable disregard to the rules of "engagement", so to speak. It's baffling.

Why do white people think they can SEE a person who is infected? If a person "looks clean" – it's ok to bang them without using a condom? Argh.

And it is not about education... I have medical friends (who know the most about the disease and its implications) – yet STILL sleep around (one night stands or new relationships) without a condom or a recent negative HIV test.

It's irresponsible. And more frustrating than you could guess.

And then… there are those who are oblivious to the basic facets of human nature. Never underestimate a human's ability to be STUPID. I see a couple who "swings" - and still don't always use condoms. The rationale? They say that they are in a circle of swingers (5-6 couples) that only swing with each other... it's safe! Rule one: NEVER underestimate human nature. Do people not realize that all it takes is ONE to sleep outside the circle and the risk is introduced to ALL of them? What is the matter with people in this country?

HIV can wreck lives.

Case in point - a single episode of infidelity (genders, names and unimportant particulars have been changed to protect the identity of this person). One of my patients came to see me for an unrelated problem - I see him and his children regularly for typical GP stuff. They are the "perfect family" – and he, the near perfect father and husband.

During the consultation he nonchalantly asks whether he should be worried about HIV. Nonchalantly. After much probing it turns out Mr White Right had an extra-marital incident with a work colleague - who is, get this, "perfectly healthy and doesn't look ill".

I did the pre-counseling thing and pulled the bloods. HIV Positive.

It was the worst thing I've ever had to do. Perhaps I saw some of me in his situation? Perhaps I worried some of me would end up in this situation? Perhaps I culturally empathized – I don't know… What I do know – is that this man's whole world was destroyed with a single result.

It gets worse. He had been sleeping with his wife post-incident. Now, not only does he have to tell her about the cheating but also get her tested. If anyone has been in a relationship where they've had to deal with infidelity - they can empathise how truly awful it is... now you add an HIV test to the equation?

HIV can infect ANYONE! For crying in a bucket! You cannot tell who has it and who doesn't, especially in the early stages. In fact, if patients look after themselves – you'll barely know the difference until the last quarter of the disease starts running its course.

White people need to catch a serious wake up. This is NOT a black disease. It's NOT an African disease and it does not only occur in townships. Wear a freakin' condom and have yourself tested.
It makes me sick sometimes.

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Tuesday, January 16, 2007

Back to Ubuntu Medical, for a short while…

First off, let me say that we were blown away with the response to what was initially just a little idea – a dream to do something to uplift technology infrastructure in the South African industry that needs it the most.

Thank you for all the responses, comments and advice.

Now comes the tricky part. What to do with all this information? Well, thankfully we’ve met a couple of keen individuals who might be able to push this project in some kind of direction – and we’ll be chatting with them over the next couple of months.

A contact in the South African medical administration (ie. Government) would be helpful!? Nothing happens in South Africa if it doesn't go through official channels. It's a project killer - so we'd prefer to meet people who can have those conversations first!

For everyone’s benefit, including my own, here’s a summary of related topics/sites/projects that people have been kind enough to post. I’ve had a look at all of them, and commented where appropriate.

This is an already developed (ver 0.2.3) medical system. The package seems to be built more towards practice management (which obviously entails elements of patient management – a feature we stressed was critical in the South African context). They are careful to say:

GNUmed is not currently intended for hospital IT (Information Technology)

But, it seems like GNUMed does support our Proudly South African operating system of choice - Ubuntu – Debian releases available here.

Here’s what I’d like to know – would GNUMed be interested in putting together a slightly friendlier interface, and seeing if the product could be adapted to a internet-networked hospital environment? If so, post a comment!

Ndiyo is a project based around providing computing power to many users cheaply and efficiently. Their project provides “ultra-thin” clients available to multiple users. Need to do some more research into the offering, but this UK based NGO (it seems) might offer a potential solution to the infrastructure issues SA hospitals suffer.

It certainly sounds more effective than getting a first world donation of aging equipment that would have to be maintained on a per-machine basis?

Linux Medical News
A collection of links pointing readers to what’s going on with Linux and medical applications. I couldn’t find many examples of patient management software currently being developed – but the site seems to be more of an aggregator than anything else. Will keep an eye on it nonetheless.

Linux for Clinics
Now, THIS looked like the jackpot. Linux distribution / software / tools specifically intended for a clinic environment – however, the forums don't seem to be overly active since last year. Is this a common problem with Open Source projects? It’s not people losing interest – it’s people unable to stay dedicated to a time-consuming project? I hope I’m wrong.

Seems like they are using a portion of the Ubuntu logo for their own – but a comment by Wouter suggested they might have moved off Ubuntu to another distribution. Shall register and see!

Debian Med
Debian, as far as I can gather, is what Ubuntu Linux is based on – therefore the tools and projects listed at this site would work perfectly. Overriding concern still stands. Linux is tricky for non-techies – and having to install multiple packages which may or may not talk to each other sounds like a support nightmare.

How to get around that issue? I’m not sure…

There it is for a start. Some forums to join, some people to email. Keep subscribed - and we'll let you know if things get going!

Thursday, January 11, 2007

All Scrubbed Up Reviewed by DomKop!

Domkop, an oddly titled techy-looking reviewer of South Africa's Blogs has done us the justice of a fair review. Love it. Read the review here.

Monday, January 8, 2007

Tequila Medication

Found on Youtube. In South Africa, they should rename this CASTLE QUART MEDICATION. Responsible for 50% of admissions at any hospital in South Africa. Excess consumption results in mate hitting you over the head with one.

Har. Har. Anyway.

Thursday, January 4, 2007

Christmas Grand Rounds...

In case you haven't seen it yet... Christmas Grand Rounds are a great selection of med-on-the-web. Check it out here.

Excerpt from Medical News and Commentary
Bloggers are renowned for their abilities to comment on the news (often, in pajamas) but on a few memorable occasions, bloggers can report news, too. Such is the case with Dr. Steven Palter of Doc in the Machine, who announced his award-winning endometrial diagnosis technology on his blog. It's part of a series Dr. Palter has written, on the radical transformation of surgery.

Mighty GruntDoc, probably the most consistent contributor to Grand Rounds and current favorite to reach Four-Time Host status first, submits this analysis of a case where law and medicine collided in the ED.

The blogger On The Wards digs deeper into an intriguing new finding on obesity -- are certain bacteria responsible for making you fat?

A new blogger on the scene, Sandy Szwarc, whose blog Junk Food Science argues from the perpective of enjoying food and accepting body shapes, pokes holes in recent reporting on the obesity epidemic.

It's getting cold outside -- and outdoor enthusiasts are paying the price. Healthline writer Dr. P.S. Auerbach provides a timely primer on hypothermia.

What if our insurance companies could provide us with "Nutrition Facts"-style info on basic surgeries and diseases? Henry Stern of InsureBlog interviewed the Chief Innovation Officer at Blue Cross Minenesota, to learn about this new initiative in health care transparency.

Please read the full post - it's a lot more in-depth.

"Jozi - H" Puts South African Spin on Medical Dramas

Thanks to Champs for this info.

Reuters, UK

The Canadian-South African co-production follows the same format as primetime U.S. dramas like "ER,'' with breakneck editing, punchy dialogue and overlapping story lines that play out over several episodes.

But it also deals with South Africa's specific problems.

The country has some of the world's highest levels of violent crime, a crushing AIDS epidemic as well as millions of people suffering diseases associated with poverty and need: its busy emergency rooms bear witness to these scourges.

"Jozi-H'' draws inspiration from two of Johannesburg's most pressured trauma wards -- Johannesburg General and Chris Hani Baragwanath Hospital in the sprawling Soweto township.

Finally, someone's going to talk about it. Yes! I just hope it really is a CO-production - or would get some otherworldy views creeping in. Funny, but I seem to remember SA Doc getting consulted in varsity over some kind of potential TV Show. Wonder if this is it?

You can check out the official website here. It's even on IMDB. Is it just me, or are those some ex-Soapie stars? Hmmm.

We're back...

Sorry for the long break in posts - but even bloggers gotta take a holiday sometime. We're back - and goal one is to start going through the Ubuntu posts, comments and suggestions. I'm going to be joining some of the recommended forums and having a look where this idea goes. More info as it becomes available.

In case anyone was wondering, we were here:

It's a little paradise called Tyolumnqa in the Eastern Cape. Thanks to the Faul family for having us!