Medical Resident
Adriano La Vecchia obtained his postgraduate qualification in November 2023 at the University of Milan. He is a medical specialist in Paediatrics and Neonatology and works at the Paediatric Emergency Department of the IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan. He is currently attending a PhD in Public Health Epidemiology, Statistics and Economics at the University of Milan Bicocca.
“In January 2022, in my fourth year of specialisation in paediatrics, I left for the town of Jinka, in South Omo, a region that has always been little considered by the central government and international organisations, with a rural population in desperate need of health,” Adriano says. He worked for six months at the Jinka General Hospital in the Paediatrics and Neonatology department. “In particular, my time as JPO coincided with the opening of the Paediatric Intensive Care Unit (PICU) which was my main clinical activity. The CUAMM team consisted solely of myself and my tutor, Eleni Hagos, a paediatrician from northern Ethiopia hired by CUAMM to support the hospital staff. Besides Eleni,” Adriano recounts, “there was only one other paediatrician in the Jinka hospital; the rest of the medical staff were General Practitioners.
The differences between the Milanese and Ethiopian working contexts are abysmal: patients pay for treatment (bed space, drugs, syringes, gloves, etc.), diagnostic possibilities are very limited (the only haematochemical examinations were blood counts, creatinine and transaminases, also not available every day, while at the imaging level there was an old ultrasound and X-rays, reported by a health professional and not a radiologist), a doctor alone has to follow about thirty patients per shift, and the facilities are often dilapidated. The case history is also very different, with many cases of infectious diseases such as deep-seated leishmaniasis, neonatal tetanus and typhoid. Furthermore, South Omo is inhabited by several tribes that do not speak Amharic, making communication impossible even between locals”.
Places where being a doctor is more than a profession, with the burden of practical difficulties and suffering one encounters: “The patient I remember the most when I think back to my experience in Jinka is Netsanet, a little girl of about one year old burnt in a domestic accident. Netsanet was the first patient admitted to the PICU and was with us for about a month, during which her mother gave birth to a baby brother. Fortunately, thanks to the special care and dedication of the nursing staff, she did not contract any serious infections during medication and survived. Other patients, however, did not make it.”
“As I always tell people who ask me for advice before they leave, working as a doctor in Sub-Saharan Africa exposes you to first-hand contact with the death of babies and children. Despite the emotional upheaval that experiencing this profound injustice of our times can cause, I would advise anyone who feels up to it to go. Eposing yourself to such a different culture,’ he explains, ’is an enriching experience on a human and medical level. From a medical point of view, even as a resident you have the opportunity to manage patients in the ward independently, giving you much more responsibility than in our hospitals. In addition, you learn to work with the few resources available and avoid waste: a lesson to be imported into our public health context as well. From a human point of view, Africa is a continuous discovery, a place with incredible beauty and colours accompanied by poverty and suffering, but also by continuous resilience and frugal happiness”.