Infectious Diseases Hospital :-)

Ok, so in Constanta there are 2 hospitals. We are associated with the Infectious Disease hospital where you guessed it, only the infectious cases go. They have pediatric and adult services, but the infants (under one year) go to the other hospital. Any intensive care is also done at the other hospital.

Once we got there they had us put of these short white starchy cape things... Infection control???? I don't know. They have a small emergancy room, clinics, and 3 stories of inpatient care. They have seperate wings for HIV infected boys and girls that are separated by two floors since they were "visiting" each other too much. We saw lots of Hepatitis A/B, varicella, and enterocolitis. They also occasionally have measles, and fairly often meningitis. Honestly though, none of the patients I saw would be hospitalized in the states. They seem to hospitalize for smaller things and keep them for the entire treatment course. It is manditory to keep acute HepA and B for 3 weeks before discharge. Not really sure why and they couldn't give us a good reason. The good thing however, is that vaccines are manditory. They started giving Hep B vaccines a few years ago and this has seriously cut down on their rates. They do not routinely vaccinate for HepA, PCV, or HIB (which could explain the high meningitis rates). They do have manditory DTap, MMR, and Polio vaccines. The measles they see is from the gypsy population that does not exist on paper and therefore does not get vaccinated. I wish we had manditory vaccination in the states. Here you can really see what it is like when a subset of the population fails to vaccinate their children. The doctors here are really worried polio will come back.

I forgot to mention there is also a rabies clinic downstairs that gives out vaccines to those bitten by dogs. Did we mention the LARGE stray dog population??

The medical system seems to work like this.. 6 years medical school straight out of high school. One year internship followed by 3-5 years of residency. 3 year residency for family doctor, 5 year residency for pediatrics, internal medicine, infectious disease (its own area on par with the others - not a subspeciality), neonatology. Pathology 4 years. Neurosurg 7 years. Anyway, you always go and see your family doctor first. They then refer to pediatrics, infectious disease etc. Usually only when they think you need to be hospitalized. Pediatrics here is a hospitalist referral! We are considered specialists :-)

The other thing is here the family doctors are quick to give out ampicillin and augmentin for everything resulting in high resistance rates. Often kids have meningitis, but are pretreated with ampicillin by their family doctor so we never get the etiology. Soap box of the day: vaccinate your kids and dont give antibiotics unless you know what you are treating.

Romania
16. Better hospital facilities
17. Better doctors (even if they give out to many meds. you should have seen the ones in Botswana)
18. MRI - I heard her say she had gotten one recently! They do exist!

Botswana
18. Toilets that flush on the first try - Becca made me add that.