20 May 2019

  • Katie Parrott
    University of Birmingham

"This elective has truly changed my future in medicine"

Our grant impact testimonials show how our grants have helped our grant recipients achieve goals, create networks and further their research. Katie Parrott is a medical student at the University of Birmingham who visited Sri Lanka after receiving a BSH student elective scholarship. Read Katie's testimonial:

Firstly, I would like to thank the British Society of Haematology for the grant they have awarded me. This allowed me to visit the country of Sri Lanka, meet patients suffering with serious diseases and their families. This experience will certainly change the way I practise medicine in the future. Had it not been for this bursary I would not have had the opportunity to study in Sri Lanka, and therefore I could not be more grateful. I studied in the southern state of Sri Lanka, in the city of Galle, splitting my time between Karapitiya teaching hospital and various community clinics and medical facilities, allowing me to fully experience a completely different healthcare system.

I chose to do this report on haematological malignancies in Sri Lanka as, after some initial research, I found that after accidental death, haematological malignancy is the second most common cause of death in the entire country, making it an important public health concern for Sri Lanka. Furthermore, although Sri Lanka has some public funding for healthcare, there are limited resources, which makes charity assistance a necessity; particularly with regards to patient support. However, in the southern province of the island, there is very little charity support for paediatric patients suffering from leukaemia. The northern province has its own charity, so I was intrigued to speak to patients and their families and find out their personal experiences.

I first spent 2 weeks with paediatric hospital inpatients, going on the oncological specialist ward rounds that visited the unit, and then speaking to the families of the patients on the ward. It struck me how much a role the child’s parents play on the wards here; it is essential for there to be a family member with every patient, and they are much more intricately involved in the patient care than we see in Great Britain. The parents would be with the child all day during their stay on the wards, making sure the child’s needs were met and acting as the responsible adult for each child. A lot of treatment for leukaemia is carried out as a hospital inpatient in Sri Lanka, therefore the child will spend a great deal of time in hospital. As mentioned, the parents are vital in the child’s care, and therefore it is a great difficulty for the whole family to be caring for the child whilst in hospital. I learnt that there is a large paediatric haematological malignancy unit in the countries capital, Colombo. This means that for the patients who live outside of one of the large cities, they may need to travel to one such a facility, and spend a long time there caring for the child, with relatively little charitable support compared with what we experience in Great Britain.

Furthermore, the time spent on the wards really helped develop my scientific understanding of haematological malignancies, and their chemotherapeutic treatments, in the paediatric population, which is something I have never had much experience with before. This was invaluable for my learning; I now understand what it is that these patients truly go through on a day to day basis, which is so important to see first hand to fully appreciate the immensity of it.

I spent the following two weeks on community medicine posts, which focused on serious paediatric conditions, prioritising haematological malignancies. Here, my focus was much more on the family experience of the disease and the treatment and care they received. The thing that struck me most about this period of study was the difficulty experienced by parents if they are worried that their child may be showing signs of illness. There are no publicly funded GPs, instead children receive basic health checks whilst at school. Doctors visit larger schools at grades 1, 4, 7 and 11, giving the children vaccinations and giving an overview health check. However, even in these situations, it would be difficult to pick up signs of a haematological malignancy, unless the child verbally discussed any complaints themselves. Other than the school checks, the only other ways a parent can get their child seen would be to pay for a private general practitioner; which many patients do not have access to; or to queue up at the hospital, from the early hours of the morning and hope to see a general paediatrician who can examine the child thoroughly. However, it can take hours to be seen by a doctor in this way; arriving at the hospital at 9am, the corridors would already be filled with patients and families hoping to be seen by a doctor. Other than the access to care, most families reported feeling incredibly lucky to be treated at such an amazing facility, and had nothing but praise for the care they had received.

This elective has truly changed my future in medicine. It has taught me not only a great deal about the scientific and medical intricacies of treating haematological malignancies in paediatrics, but also it has truly opened my eyes to another healthcare system, which has such a core role for the patient’s family, and I feel very lucky to have witnessed this first hand. Thank you to BSH for giving me this opportunity and helping to shape my future career.

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