Well, I’m here in Malta. Arrived on Sunday actually - just haven’t updated, sorry!
The first day didn’t go as planned. My accommodation wasn’t ready when I arrived so I had to wait for hours, then when I got in the room, my heart sank; it was very different from what I had expected from the website. Dark and dingy, with a fake window opening onto a brick wall, one dim light, a single bed, small desk and an empty wardrobe – no coat hangers, mirror, bin, bedside light, drawers… It was really a prison cell. And the ‘self-catering facilities’ I would be relying on… Really a joke. One tiny room in a different building with a microwave and one manky fridge. No workspace, hob, oven, kettle and barely any kitchenware. I couldn’t bring myself to try and cook anything so I had a cereal bar for dinner. I sat and cried for a while, unsure if I could bear 6 weeks with my sad little room as my only refuge. I then went for a shower, which was a small wet-floor room across the corridor. I didn’t realise, but the drain must have been blocked and the water flooded under the door, all along the corridor and into my room, leaving my suitcase sitting in an inch of water, a lot of wet belongings and no space or facilities to dry them. I was feeling pretty dark and desperate at this point. It was late and I was exhausted and now had to spend an hour with a towel and a bucket trying to dry out my floor. But. I didn’t break down and self-destruct, or give up and plan to run home. With a bit of support from some amazing friends I managed to negotiate another room in the accommodation and moved the next day – a studio, with it’s own wee hob, kettle and fridge an en-suite shower and toilet. I feel much better here. There is space to store things and I can cook and store my food and keep things clean and tidy. I obviously have had to pay more which I feel bad about, but as people have reassured me, my health is important and money isn’t everything – I will be earning soon and now I’m here I might as well make the most of the opportunity and try to enjoy it, which would have been impossible if I’d stayed in the original room.
Apart from the accommodation fiasco, things have been pretty good! Early starts and tiring days, but the placement seems great – my consultant asks a lot of hard questions(!) but I’m generally able to answer well which I’m almost surprised about and is a good confidence-booster – guess all that studying I did for finals did sink in somewhere ;) My first 3 weeks are on geriatrics, a mixture of a rehabilitation day hospital, outpatient clinics and inpatient ward and a long-term care facility for patients with severe dementia. Mostly I’m just observing consultations and ward rounds and answering questions, sometimes doing examinations. The language is a seemingly random mixture of Maltese and English, switching back and forth after a few sentences! So I don’t understand everything but the staff are very good at translating for me.
It’s so interesting to see the differences in practice to the UK. The buildings look really quite old and almost derelict from the outside, but inside they seem clean and well-provisioned, if not quite so ‘modern’ as the UK hospitals I’m used to. In Malta there is no government provision of home care packages and so the long-term care facility is huge – over 1200 beds and is always full with a long waiting list. However I think the lack of home-care does have a positive: means that families take more responsibility are a lot more involved with the care of their elderly. Literally every patient in the outpatient clinic had a relative with them who was really involved, asking questions, knew all about their conditions and medications, highlighting issues… A lot of the patients either lived with their children or they visited every day, sometimes several times a day. From what I’ve experienced, that is much rarer in the UK.
Another difference is the funding – Malta’s health service is funded through taxes and national insurance similar to ours, but not all treatments/prescriptions are funded. For example, only one version of a drug (the cheapest) is funded – if you can’t tolerate it you have to pay for an alternative preparation (e.g. one patient couldn’t take oral donepezil (a drug for Alzheimer’s) as it made him nauseous and so had to pay for the patch version. In Scotland he could be prescribed this with no extra cost). It seems most treatments considered beyond the bare minimum have to be contributed towards.
There are subtle differences in people’s attitudes toward health too. For example there is definitely a lot more stigma around psychiatric conditions. In Maltese there isn’t even a word for ‘antidepressants’ – they are called ‘calming drugs,’ and are viewed quite negatively. (Despite this, they seem to be very commonly prescribed, by my consultant at least!)
Those are just a few observations I’ve had but it’s only been a few days – I’m sure I’ll soon be able to bore you with more of my musings!
I have the day off tomorrow and I’m thinking of getting the ‘City Sightseeing’ tour bus around the island, just to get more of an idea of the place. I’ve been doing a lot of walking but still only managed a relatively small area.
I actually have to be aware of my activity I think as I’m doing a lot – between 10 – 20k a day (well it’s a lot for me at least, I know many people, especially with EDs do a lot more and I’ve been through phases of over-exercising too but I’ve not been used to it for quite a while now). Food/eating has been a little difficult but I’m working on it. May write a bit more about that tomorrow as this post is quite long enough I think! Well done if you got to the end.
I hope you’re all doing well <3
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