Unique Cases - Facing Diseases Rarely Seen Back Home

     Almost every patient I saw during my rotation tested positive for malaria - especially during the rainy season, when mostly every patient routinely gets a rapid malaria test. Here, malaria is as common as the flu or strep throat back in the States. What initially shocked me was just how normalized it is in daily clinical practice. 

    I was also stuck by how prevalent tuberculosis (TB) is in this region. Because of its high disease burden, TB is always on the differential - you simply can't afford to miss it or delay treatment. After a month of seeing it so regularly, I realized how desensitized I had become to something that once seemed rare and alarming. It's wild to think how quickly that shift in perspective happened.

    Another surprise was seeing several children diagnosed with measles - something we rarely encounter in the U.S. due to routine vaccinations. But in many of these remote villages, access to vaccines is limited and lack of knowledge, making outbreaks more likely. This experience reminded me how diseases we consider rare or eradicated in one part of the world are still part of everyday life in another.

My thoughts - unique cases: Reflection from the Field

    This rotation has opened my eyes to just how different - and challenging - medicine can be in a resource-limited setting. Diseases like tetanus, malaria, tuberculosis, and measles are not on common here - it's expected. Some of these conditions are so rare in the U.S. that I realized how little I actually knew about them beyond textbook definitions. I found myself confronted with unfamiliar symptoms and presentations, unsure of the full clinical picture, and even more uncertain about the step-by-step management and long-term consequences. It was humbling to admit that there are still so many gaps in my knowledge.

    The case of the young boy with tetanus was especially striking. I had never seen such clear muscle rigidity before, and without lab confirmation, we had to rely entirely on out clinical judgement. It taught me to think critically and trust careful observation. Similarly, the patient with atrial fibrillation with RVR was a pivotal moment. He was truly on the edge - his heart racing between 200-250 bpm with no cardioversion or standard medications readily available. It was one of those life-or-death situations where you either find something that works or the patient doesn't make it. We used every available resource we could find, digging through emergency kits and thinking outside the box just to keep him alive.

    These cases reminded me that medicine is not always clean-cut or protocol-driven - especially not in places like this. It's often messy, urgent, and deeply reliant on teamwork, improvisation, and a willingness to learn quickly. I'm leaving this experience not only with more knowledge but also with a much deeper respect for the kind of medicine practiced in under-resourced areas. It's where true clinical grit lives.