Michiel Notelaers

Studying medicine was always something I wanted to do, even from a young age. Medicine and treating people is, for me, the most beautiful gift.

Saving a life and giving someone another chance is an incredible feeling so it was a natural path for me to take.

I am a recently graduated 6th-year medical student and wanted to go overseas on a medical placement. I picked Sri Lanka as I literally knew nothing about the country. It was a jump in the dark, but I was excited to learn all about the culture and healthcare system. 

When I first arrived in Sri Lanka the Work the World team was there to meet me, and we travelled up to the city of Kandy.

We settled in, and the following day they took us new arrivals on a tour of our placement hospital. The long corridors reminded me of my high school, but that was just about the only resemblance. There were patients everywhere, some who had already been admitted. For many, the corridors acted as wards.

I spent four weeks on placement, rotating through the Emergency Department, Medical ICU and Neurological ICU. 

My time in the hospital was really interesting. The saying ‘you only get out of it what you put into it’ could not be more accurate. The Work the World team said this to us in our welcome briefings when we arrived, so I went with the attitude of getting myself stuck in. Asking lots of questions, I tried to get to know all the staff — the house officer and senior officer for example. By the end of my placement I was familiar enough with the staff that I got invited to one of the consultants' homes for some drinks.

I’ll admit, I did bring Belgian chocolates so this might have helped them warm to me!

The biggest differences between the Sri Lankan healthcare system and the Belgian healthcare system were the infrastructure and the lack of resources.

All the consultants had the same educational level as us, and they had the same reasoning for treatments. But they had to treat patients with what they had on hand, which often wasn’t very much. 

The other big difference was the lack of privacy. Patients were treated in corridors, there were multiple patients in the same bed... There were also fewer consultations with the patients and much more dictation from the doctors as to what the course of action would be.

I saw a lot of cases of spinal shocks, patients having fallen out of trees for example, a lot of patients with sodium disorders. I do see this at home, but in Sri Lanka they were really extreme.

There was one patient whose pH was so low it was incredible that he was still alive. He was treated, and a few days later I saw him in the Medical ICU. His levels were somehow back to normal, it was incredible that he survived.

Every day was different. I was excited to go into placement to see what the day would throw at me. Days could be tiring but it was great to live with other healthcare students and to have the team at the house to support us and discuss what we had seen day to day. 

The consultants at the hospital were really keen to teach. All spoke excellent English and all patient notes were in English.

Outside of placement was great. I went to Sri Lanka on my own but made friends with all the Work the World housemates. Everyone was so welcoming. We’d travel together at weekends and hang out after placement at the house or in and around Kandy. 

The staff at the Work the World house were incredible too. They were friendly, supportive and gave great advice about integrating into society, including top tips for bartering in markets/getting about the country.

I was there during the economic crisis, and although Sri Lanka relies on tourism they wanted to ensure we were not being overcharged for taxis etc. The house staff offered us great advice. Having said that, Sri Lankan’s were welcoming and friendly and so grateful to have people visiting their country. 

The food at the Work the World house was incredible, the house was sociable and the language lessons were so helpful. It was lovely getting to know the staff and hearing about their backgrounds. They felt like friends towards the end of my trip.

On one weekend we travelled to Ella to see the Nine Arch Bridge, which was incredible. On another weekend the whole house travelled to Trincomalee on the coast which was great. We swam with turtles and small sharks.

To anyone considering going overseas on a medical placement I would say do it. If people are in doubt, just do it. I was a little anxious beforehand but I am so glad I did it. 

I got involved, I built relationships, I saw a totally different healthcare system to what I was used to and I really think it will benefit me in my future career.

You need to put yourself out there both on placement and travelling around the incredible country. I would say if you don’t push yourself, you won’t properly experience Sri Lanka. I had the four best weeks of my life.