Private Practice OB/Gyn in South Africa

Observing Dr. Jack Biko at Femina Clinic in Pretoria, South Africa, made me feel like I was back in the United States. Femina clinic is a private women and children’s hospital in the capital of South Africa, Pretoria. Dr. Biko received his bachelors of medicine from the University of Witwatersrand and his masters in medicine from the University of Pretoria (where I am studying) and specialized in both OB/Gyn and Infertility. Until my time with Dr. Biko, I had only experienced the public health sector at the Chris Hani Baragwanath Hospital, which is the largest public hospital in the southern hemisphere and at the PHRU, which is a non-governmental organization that provides VCT and ARVs for free. The public sector is still in the category of developing and far behind the Westernized world in terms of technology, infrastructure, and resources. The private hospital, on the other hand, is very developed and reminds me of a hospital in the States before its most recent renovation. It was definitely as nice if not nicer in all aspects as a small town hospital in Oklahoma. The demographic population of patients at Bara is nearly 100% black with a few colored patients as well. The majority of patients at Femina are also black, but there are a large number of white, colored, and Indian patients.

Dr. Biko’s office was modern and cozy, as is typical of OB/Gyn offices but he even had a sofa in this consulting room which was actually his office. It reminded me more of a psychologist’s office. Actually he does have a psychologist on hand to counsel his couples and patients dealing with stressful infertility issues. Dr. Biko does have EMR (electronic medical records unlike at Bara where they have the patients keep their charts on them since they don’t have a set doctor nor make appointments. Dr. Biko even has snapshots of his patients in their EMRs to eliminate any risk of incorrect identification. Dr. Biko takes his own vitals, preps the exam room for each patient himself, and conducts his own sonograms and ultrasounds which I found rather impressive. It is not only a convenience for his patients to be able to have a sonogram or ultrasound right then and there, but it also strengthens his relationship and trust with his patients, which is crucial to a successful practice. Plus, getting to see the baby is the best part of the job ;) Dr. Biko’s full-scale, one stop shop care allows him to be fully informed and in contact with his patients.

Before shadowing Dr. Biko I had no experience with reproductive endocrinology despite my interest in it as a sub-specialty (however I am no longer considering it significantly since being to Africa and developing many more, stronger interests. As I mentioned previously, Dr. Biko has a psychologist in his office for patients struggling with infertility problems. I realized how hard it can be counseling couple who cannot conceive on their own. One of the couples who came to see Dr. Biko couldn’t conceive, obviously. The woman was 43 and her husband was in his late forties. Dr. Biko ran fertility tests and had to tell them that if they use her eggs for invitro that they stood a 5% chance to conceive with a 70% chance of miscarriage and on top of that slim possibility, the baby would be at high risk of having down-syndrome or another chromosomal disorder. I about cried for them. And also got rather angry when the husband said, “Doctor, I came in with her today to see if it was a problem on her side or on mine.” Fortunately Dr. Biko took the words out of my mouth when he replied, “When it comes it infertility it is a couple’s issue, not one partner. You contribute to the baby just as much as she does.” I am glad that I got to experience a couple of sessions of infertility counseling.
The second day with Dr. Biko was in the surgery theater. I got to observe two surgeries, one in utero polyp removal and a laparoscopy for endometriosis. We had to switch hospitals for the second because his patient’s medical aid wasn’t accepted at Femina. Femina’s surgical ward was not as modern as the rest of hospital surprisingly. One of the newest pieces of equipment in the room was the cd player which played Beyonce’s I Am Sasha Fierce cd during surgery…. TIA. The second hospital was very modern. I could tell Dr. Biko was a bit jealous that he didn’t get to do more surgeries here. During this surgery we listened to Boyz to Men. Hahaha : )

Tomorrow I will be observing at the maternity ward at Baragwanath, where they deliver an average of 50 babies and conduct 20 c-sections per day, for 24 hours. Oh ya and they don’t have epidurals…. Yikes! I’m just about every emotion you can image right now. It’s going to be one for the books. I’ll blog about it soon!