Francistown Supplement - Penn Un

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                                  UPENN-Botswana Program
                                   Francistown Supplement

Welcome to the Penn Botswana Program in Francistown! The program here was started in November 2005.


Arrival……………………………...                   i
Contacts in Francistown……………            i
Penn Flat……………………………                    ii
Nyangabgwe Hospital ………….…..            ii
Daily schedule and conferences……        iii
Call and admissions…………………              iii
NYH Physicians/phone numbers……          iv
NYG Computer access………………               v
In and around Francistown………….          vi


Whether you arrive by bus, train or plane you must let Maria (in Francistown) and Gill (to coordinate the
Gaborone end) know your exact itinerary so that we can arrange for you to be picked up.

Important Contacts in Francistown

    -   Maria Bibiana Ristig, phone 72485183
    -   NYH 2411000, transport extension 247
    -   Rose-manager Tllhaleng Park Flat 11 phone 71314822
    -   Security Service 2415555
    -   Gill Jones (Gaborone) 72768605
    -   Katha Rose Jack, private transport, inquiries Francistown, 71731589


Francistown PENN Flat
Address: Tllhaleng Park, Plot 6762, Residence No.11, Francistown (Tati River Plot)
Penn has a beautiful flat in Francistown. The Penn flat is located within a twelve-flat complex, which is
close to the Marang Hotel, the city‟s most prestigious luxury hotel. To reach the flat by car one turn left
across from the entrance to the Marang Hotel. There is a gas station and little grocery store at that corner.
Proceed about 1 km and turn right on the second road (dirt). Then go straight ahead for about 150 meters
and the road will enter the housing complex, Tllhaleng Park. The PENN flat is to the right and the second
to the last (NO 11). The complex is very comfortable with a wonderful garden, a swimming pool, a tennis
court. The complex is adjacent to the Tati River. Overall it offers a fine place to rest and enjoy after
working hours. There are three bedrooms, kitchen, dining+living room, 2 bathrooms and a little garden
within the big public garden. We planted to little trees when we moved in, in the front and back garden,
hopefully they grow strong and fast as our program in Francistown should.
The house is a few minutes from the hospital by car. The hospital driving service will pick you up and
bring you back on a daily basis. But they need to be informed in advance. For private trips Katha Rose
will be happy to get you around. (see phone registry)

Images: PENN House in Francistown, frontal view and on left view from garden

Meclina is doing the maid service and will keep the house clean, make beds, doing laundry and ironing.
She may prepare a lunch for you if you tell her in advance and if you have the food available in the
kitchen or if you tell her what to buy and cover the costs. Meclina has off Saturday and Sunday. Note, that
Nyangabgwe Hospital does not have a cafeteria. The cost of food is shared; the living rules are the same
as at the Penn Flats in Gabs. Our flat is very safe. There is a security guard 24 hours available and the
whole complex is surrounded by an electric fence. In addition we have an alarm system in the flat.

Nyangabgwe Hospital (NYH)

phone 2411000, fax 2416706
Postal address: Bag 127 Francistown Botswana

NYH belongs to the three big Referral Hospitals in Botswana. It has about 550 beds with approximately
120-150 beds at the Internal Med Department. It is similar to Princess Marina Hospital (PMH) in
Gaborone including being linked to the national computerized data system. NYH is very similar to PMH.
Each hospital as some unique advantages and problems

The internal medicine department encompasses the male medical ward, the female medical ward, isolation
ward (which is shared with other departments, but most patients are from the internal med dept), ICU
(which is also interdisciplinary), and the Private Ward.

PENN presence at Nyangabgwe Unlike PMH the University of Pennsylvania is the only international
medical program working at NGY. They are thrilled to have us in Francistown. NGY has an international
staff with physicians from many different countries around the world. Our main mission is to care for the
patients at NGY and to educate the physicians. Remember that everything we do can have an impact on
the environment at NGY. We believe that one of the benefits of your presence is to raise the general level
of clinical care and teaching; some of this will be direct and much of this will be by example.
Your experience at NGY will not be structurally too dissimilar from what you presently do. We have
conferences, we round, we do procedures, etc. What will be notably different are the diseases, the
diagnostic support, and the therapeutic options. You will have the opportunity to really develop your


clinical skills. You will be oriented to the specific expectations and responsibilities on your arrival by Drs.
Rustig and Nicklin.

Daily Schedule
         Intake conference: Similar to PMH there is intake at 7:30AM at the conference room at the IDCC.
During this meeting the previous day‟s admissions and deaths are presented by the admitting house
officers and specialists. You will present cases here. It is one of a number of good opportunities for us to
“role model” good clinical reasoning.
         Rounds begin shortly after the morning intake report is completed (around 8:30-9am). You will
round with a Penn faculty member and HO‟s from NYH. We try to complete rounds in the morning. We
have a lunch break between 1 and 2. At this time the hospital has no cafeteria so that options are to walk
into town (about 1 km), bring your lunch, or return to the flat. A hospital driver will pick you up at 12.45
pm and bring you back an hour later, but he needs to be informed.
         The afternoon should be used to do procedures, discharges, patient counceling. The official time
off when not being on call is 4.30 pm.
         Note: There are days when the attendings (called “specialists”) work in the clinics and are
not available to do bedside rounds. During these days the PENN students round with the
experienced Botswana HO. The PENN resident and student can always review problems with the
attending by phone or after clinic on those days.

Internal Medicine Meetings and Weekly Conference Schedule
       7:30 a.m.         Intake (IDCC conference room)
       7:30 a.m.         Intake (IDCC conference room) with special x ray cession by radiologist
       7:30 a.m.         Intake (IDCC conference room)
       8:30 am           Clinical case conference (IDCC conference room)
       7:30 a.m.         Intake (ICDD conference room)
       8:30 a.m.         Didactics (IDCC conference room)
       7:00 pm           South African AIDS society conference-every first Wednesday per month
                         (large conference room)
         7:30 a.m.       Intake (IDCC conference room)
         8:00 am         Grand Rounds (Administration Building) monthly
         2:30 pm         HIV conference and journal club (IDCC conference room, Administrative
                         building) twice monthly

Call and Admissions. You will take call and admit patients in the general call schedule (about 2 x week)
On those days call will be until 8.30 pm. We only take call on weekdays, not weekends. You should take
as many new cases as possible to get a good experience. Admissions come through the A+E department
(ER), from the clinics, or referrals from other primary hospitals. There is no system in place for “doc-to-
doc” or handoffs. The patients will show up on the ward with some or no information and the house
officer will be informed of their presence on the ward. (One of the many challenges of practicing in

Access to Educational Material. Similar to PMH NYGH has a medical library that has many outdated
textbooks. We are starting to contribute texts to the library to help upgrade the resource. Each nursing
station has two computers with internet access (slow) and there is a doctor‟s room between male and
female medical room with computer equipment. In our flats we have medical text and internet access.


Important Contacts NYGH:
   1. Superintendent: Dr.Japhter Masunge
   2. Deputy Director: Dr.Chansa
   3. Hospital Manager: Mr.Bonga
   4. Secretary of the Superintendent: Cecilia
   5. Superintendent Assistant: Tim Jones at PMH
   6. Clinical Director Internal Medicine: Dr.Lawrence
          a. Specialists: Dr.Carlos, Dr.Grezl, Dr.Chen, Dr.Ibrahim, Dr.Maria
          b. Houseofficers (rotating)
   7. Surgery: Dr.Mcharo (head, also specialized in thoracic surgery), Dr.Shoab, Dr.Mohanty,
       Dr.Alemu, Dr.Mbantang, Dr.Ladu
   8. „Ortho`: Dr.Nyamuzhwe
   9. Anesthesiology: Dr.Chansa, Dr.Gesheva, Dr.Creme
   10. Neurosurgery: Dr.Katumba
   11. Obstetrics-Gyn: Dr.Ivanov (head), Dr.Valery, Dr.Jashala, Dr.Nyrenda
   12. Microbiology: Dr.Gokhale
   13. Ophthalmology. Dr.Madlene
   14. Radiology: Dr.Zhang
   15. Urology: Dr.Thoma, Dr.Sheng
   16. Oncology: Dr.Li
   17. BOTUSA: Dr.Samba Nyirenda

Nyangabgwe Phone Numbers
Main switchboard: 2411000, 997
NYH Transportation: extension 247
Switchboard: dial 9 and ask to be transferred to a person or department
Beepers (“Bleep”): dial 400 or ask the operator to “bleep” the specialist
       Internal Medicine
       MMW             247, 248
       FMW             250
       Isolation       361
       Private Ward 233, 232
       ICU 333, 332\
       IDCC main desk
       OPD clinic
       Dr.Lawrence ( head, neurology) pager 433
       Dr.Maria                pager 527
       Dr.Carlos (PD)          pager 359
       Dr.Grezl (GI)           pager 305
       Dr.Ibrahim              pager 174
       Dr.Cheng                pager 605
       Dr.Li (Oncology)        pager 604
A&E –Emergency Room            phone 351, 398
Dr.Mcharo              pager 149
Dr.Shoab               pager 005
Dr.Alemu               pager 012
Dr.Mohanty             pager 061
Dr.Ladu                pager 421


Dr.Madlene            pager
Dr.Katumba            pager
Obstetrics            phone 278
CT             361/338, 339
X ray
Dr.Zhang       361

Dr. Masunge            phone 204
Cecilia, Secretary     phone 205
Dr.Chansa, deputy assistant
Mr.Bonga, hospital manager

Computer assistance

Pharmacy     phone 288, 119, 117
IDCC pharmacy phone 22

Procedures performed at the Med dept:
   1. LP (LP set available)
          a. Check opening pressure and note in file
   2. Thoracentesis, Paracentesis, arthrocentesis, for large joints may call the surgeon/ortho
   3. Lymph node aspiration, for biopsy call surgery
   4. Chest tube placement (for complicated cases, Dr.Mcharo, surgery)
   5. PD placement (done at ICU)
   6. Pericardiocentesis (may be done at ICU)
   7. Intubation/ventilation, usually done by anesthesiology, they have all the equipment readily
      available and usually first transfer to ICU.

Computerized Order Entry
Similar to PMH, but
    Log in: “RISMAR00” username,
    MARIA1 password
    password for order entry; 2701


Francistown Information

   - Transportation in Francistown:
      Katha Rose Jack, 71731589, offers private service for transportation and also great assistance while staying
      in Francistown.
   - Official taxi 72871238, cap – Milton 72873153 (NYG lab tech), are not always available!

   1. Barbara‟s Bistro. (I know Barbara, so let her know that you are from the Penn team)
   2. Diggers Inn located at a side road from Blue Jacket Street. Also offers Sunday Brunch about 30-40 P.
   3. Restaurant at the Marang Hotel, offers Sunday Brunch about 45-50 P-nice Park like area. Phone 2413991
   4. Tati River Lodge Hotel Restaurant offers Jazz for about 35 P on Sundays Happy Hour. Phone 2406000.
   5. Indian Restaurant
   6. and others, Katha also can guide you

Other Places in Francistown:
   1. Museum: Supa-Ngwao Regional Museum for the Northeast, open Sat 10-4, Mo-Fr 8-5, closed on Sunday.
       Special Tours through Francistown, book in advance 24 hr. Fax 267-2403088,
   2. Katha Rose Jack, 71731589, will be happy to guide you through Francistown, to give you a special tour or
       to bring you to one to the outside lodges. Ask for special pricing and refer to Maria.
   3. Bird Watching. Bird Club-here are many beautiful different birds!. Phone 2412913
   4. Malls e.g. Nzano Center, Spar, Game City
   5. Blue Jacket Street-main road and shopping area
   6. African print/material shop Marothodi, next to Diggers Inn
   7. Garden/Park Marang Hotel, Golf course (primitive) next to NYH
   8. African wooden crafts etc. Opposite Marang hotel, a larger one is opposite of the Blue Jacket Road
   9. Gyms: Across from the Marang Hotel/Fuel station, which is in walking distance from our flat. More than
       adequate aerobic equipment, machines, and weights.

Weekends: (see main handbook)
One of the advantages of Francistown is that it is much closer than Gabs to the major sites of interest in Botswana.
All of these can be reached with a fairly manageable car ride.
    1. Modumela Lodge, about 80 km from Francistown. Special arrangement Katha Rose Jack, 71731589
    2. Tuli Block. Beautiful area with excellent game viewing
    3. Maun: jumping off point to the Okavango Delta
    4. Kasane: jumping off point to Chobe park
    5. Victoria Falls. Recommend to travel to Zambia site not to cross Zimbabwean border.


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