Thursday, April 18, 2013

Day Nine: Endo 101

Today we attended Endo 101, a prequel session to the SEMDSA (Society for Endocrinology, Metabolism, and Diabetes in South Africa) meeting, intended for general practitioners. The sessions covered the key topics in endocrinology that primary care physicians need to know. As there are only 40 trained endocrinologists in SA, the majority of patients with endocrine issues will be taken care of by general practitioners or nurses (in the public system, as was the case at the Moroka clinic). The morning talks were on basic diabetes management, PCOS, and bariatric surgery. In the afternoon, there were sessions on subclinical thyroid disease, primary hyperparathyroidism, osteoporosis, ED/testosterone replacement, and lipids.

The last lecture of the meeting was a fascinating talk by a linguist, explaining the ways that intonation, grammatical structure, and the increasing use of slang (among others) in the African languages can all contribute to poor understanding between patients and physicians (who speak primarily English). After she reviewed that certain medical concepts (that we assume everyone understands) did not exist in some of the African languages, I definitely understood better why I had noticed that sometimes a simple question from a physician would require a long translation and at other times several physician questions could be translated into a simple phrase.

Some of the more interesting translations provide insights into people’s conceptualization of disease “I am held/captured by the heart” (meaning I have heart disease), “I have a head” (meaning I have a headache – as the only time I am aware I have a head is when it hurts), she is a member of iPAC  -or any 3 letter combination (she has HIV, as given the stigma HIV cannot be said in name, but can be alluded to in a way that everyone understands).  

A much better excuse than the dog ate my homework. 

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