Tuesday 25 July

Our first day at the hospital and we arrived by tuk tuk (3 wheeler vehicle) in an experience I can only describe as being on a bumper car, in traffic with no traffic rules. The first time was scary but it was fun on the journey back.

We met the registrar and the head of clinical medicine at the medical faculty. The final year students are on holiday, so the teaching is very informal and will be based on our requests. We visited the male ward and met the registrar. The staff are so friendly and the patients compliant. Some of the elective students speak Singhalese so they ask for consent. We are learning a few basic medical requests in Singhalese. The working hours are very relaxed and there are a multitude of clinical signs. In the two days on the ward, I have heard mitral and aortic regurgitation murmurs, seen atrial septal defect in an adult, pulmonary hypertension, angina, atrial fibrillation, dilated cardiomyopathy and polycythaemia. Patients with snake bites, bronchiectasis, hepatitis A, alcoholic cirrhosis, renal calculi, diarrhoea, cellulitis, hepatic encephalopathy, hypokalaemia and pelvic mass have presented.

There are many elective students from the U.K and North America. Our rotations differ but we generally stick together. The latter part of the day is spent exploring Colombo, eating, sleeping or relaxing with friends. We went to Borella, probably one of the busiest sections of Colombo. We are semi-celebrities in Colombo. People wave, stare or smile at us as we go past and ask where we are from.

Our accommodation is comfortable and I cannot get used to being waited on by a maid. No cooking or making the bed. I insist on washing my own dishes, it is crazy otherwise.

This weekend we plan to go to clubbing in Colombo and then to Mount Lavinia near the seaside.