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7 Miranda Ashton Destination: Zomba Central Hospital, Malawi Zomba is a town of people in Southern Malawi. The hospital holds 600 beds and has 4 main departments: surgery, obs and gynae, general medicine and paediatrics. There is also a malnutrition unit. Malnutrition is endemic in Malawi; 50% of children under 5 are chronically malnourished and a large proportion have HIV/AIDS. With the grant money... I bought a variety of small equipment... On my arrival... the consultant with whom I was working went through the equipment with me and told me which wards would benefit the most from it. I was able [to] distribute the equipment throughout the hospital myself, so saw first-hand the reactions of the staff... They were hugely grateful. I witnessed on several occasions the treatment of patients with the equipment I had brought out. One incident which stands out in my mind was the diagnosis of nephrotic syndrome in a young boy with the urine testing strips. We were able to start appropriate treatment promptly which was particularly important in this case because he was suffering respiratory distress. I was aware that without the strips it would have been more difficult to definitively diagnose and treat his condition.

8 Rachael Manning Destination: Mnazi Mmoja Hospital, Zanzibar Tanzania is one of the poorest countries in the world with 88 percent of people living below the poverty line of $1.25 per day. The maternal mortality rates are some of the highest worldwide with a 1 in 24 lifetime risk. Infant mortality rates are approximately 70 per 1000 live births. The hospital I spent my elective in demonstrated the statistics quite clearly. The facilities and availability of equipment, medication and staff were all very limited, and as such the rate of medical complications was high. The majority of my elective was spent in the obstetrics ward and as such I requested money from the IBT to purchase a Foetal Doppler for the hospital. This gift was greatly appreciated and allowed for more accurate assessment of foetal wellbeing during labour. Thank you so much for making this contribution to the hospital and my elective! Angharad Haf Lewis Destination: Queen Elizabeth 2nd Hospital, Maseru, Lesotho We travelled to Maseru which is the capital of Lesotho. Most of our time was spent in the Queen Mammohato Memorial Hospital in Maseru which had recently been built and had received money from many countries across the world. The remaining health facilities in Lesotho, however, were extremely deprived and struggled to provide the appropriate medical care to their communities. I received 200 as a bursary to provide some muchneeded supplies for the people of Lesotho... We visited two different clinics who we felt would benefit from these donations. Both were in extremely rural locations and served communities that often failed to feed themselves let alone receive the best health care. For those that managed to work, their monthly income was around 80. When you think that the cost of calling an ambulance was 60, it is not surprising that many people would neglect their health to some extent and tended to present very late; quite often with significant complications of their disease. Lesotho has high rates of both HIV and TB; many of the patients we saw had one or both of these diseases. When we presented the donations to both clinics, they were extremely grateful.

9 Shaz Rehan Destination: Kuching, Sarawak, Malaysia I spent time at the government hospital and was part of outreach medical projects, travelling on my elective. During the time there I observed and then later gained hands on experience in the role of a junior doctor. The hospital facilities were very basic... I got the opportunity to practice core skills such as blood taking and cannulation... I hope to revisit my elective destination one day when fully qualified to be able to provide further care... I used the money to purchase basic medical equipment... These items were crucial when I was carrying out medical aid work as part of outreach projects. We had limited equipment and thus me having my own equipment was very helpful. At the end of the trip I donated the equipment to the doctors at Sarawak General Hospital who will continue to use this as part of their work... Experiencing healthcare in a country without the NHS was an eye-opener. The NHS is crucially important here in the UK and we take it for granted. Kate Rees Destination: Holdsworth Memorial Hospital, Mysore, India I went to a missionary hospital which had recently started a programme which involved going out to the community to help those with type 2 diabetes and diabetic foot ulcers. Due to the language barrier we only observed but got to experience a week in surgery, ITU, paediatrics and Obstetrics as well as a day with the community nurses. The hospital had very basic facilities but we were informed that this was more than was available at the government hospitals. It was a complete shock to see patients and families having to pay for things like CPR. [We took out equipment] to measure blood pressure and skin thickness... These items will be used as part of the new project by the community nurses to educate, monitor and help those with diabetes. The nursing staff were very grateful for the contribution. The equipment was basic but unlikely to break being transported around. It will hopefully help promote the need for long-term management of their diabetes and overall health. Going to India was a life changing experience. I will never take the NHS for granted and realise how lucky I am to have the healthcare and living conditions that we have in the UK. The people and families that I met in India though were always so happy and grateful for all the help that they received.

10 Luke Cannon Destination: Chikanakata Mission Hospital, Zambia I went on my elective to a rural hospital owned and ran by the Salvation Army. It was a 200 bed second level hospital serving 100,000 people in the Southern province of Zambia... My role at the hospital was to attend the morning briefing daily and then assist with ward rounds on the various wards and in clinics. I was also able to assist in theatre and travel to some local communities once a week. [Facilities were] basic, but... the hospital was able to cope with some minor physical injuries as well as running daily HIV services to the local community. I procured some small-scale items to take with me. These included gauze, tape, dressing packs, gloves etc. The hospital is well known in the Salvation Army and receives lots of...donations... [which it relies upon] for most of their equipment. I want to embark on a career in HIV/Genito-urinary medicine. [New skills learnt included] assisting in theatre, which enabled me to re-visit suturing and anatomy, assessing dehydrated and malnourished patients, recognising signs of anaemia (malaria cases) and working alongside a language barrier.

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