Katherine Franklin is a medical doctor from Melbourne who recently returned from her second placement with Médecins Sans Frontières, where she spent four months in Wau, South Sudan. Katherine reflects on the differences between working in Wau and Australia.

“Doing a field placement does affect your clinical approach and patient care when you return to Australia. It is sometimes really hard to come back and to see everything that people have in the healthcare system in Australia, when you know how hard you would have to fight to get some of those things, basic things, when you are somewhere like Wau. In Australia you have oxygen coming out of the wall, which is very different to Wau where you simply have two oxygen concentrators functioning in the dust and dirt. Or if you open the drawer you will always have a cannula that you can use. You don’t have to think about how the cannula has to come from France through multiple airports to Juba, then from Juba you have to organise planes or trucks to get them to your warehouse and then from the warehouse to the hospital. Or to face an outbreak of a vaccine preventable illness such as measles, like we saw in Wau. We had families lining up for hours to get immunisations for their children, compared to some people in Australia who refuse immunisation. It is completely different and you have to separate those things to an extent.

I think my clinical skills are a lot better because in a place like Wau you often don’t have diagnostic tests so you have to go back to your clinical judgement. The patients I saw were also a lot sicker than most of the children I’ve seen in Australia. Being able to manage an emergency quickly, using whatever you have and with the team around you, is important. It is something that working for Médecins Sans Frontières has taught me that I hadn’t learnt in Australia. Médecins Sans Frontières also offers you a chance to work with people you never would back home. The national staff, who are the main part of your team, are a special group. I think I’ve learnt far more from them than they ever did from me. They work hard for Médecins Sans Frontières and the children, despite facing insecurity where they live and often personal tragedies. 

The management opportunities that Médecins Sans Frontières gives you are entirely different to what you get in Australia. For me to be managing a team of four clinical officers and nursing staff is something I wouldn’t do for years in my training in Australia. The main things I have learnt from Médecins Sans Frontières are management, training and how to run a hospital. In the field it is hard of course, but the experiences you have are awesome; with the other international staff, with national staff and with the children. It is an experience you don’t get in medicine in Australia. Upon returning from my second placement I feel amazing. I really loved it and I can’t wait to go again. Médecins Sans Frontières is special, it is completely different.”

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