Clinical experiences - Dr. Sneha Kirubakaran

In October 2005, Dr Sneha Kirubakaran, a graduate of our medical course, traveled to East Timor and Indonesia as a member of a multi-disciplinary health care team

Sneha had previously attended a three-week intensive ‘International Health and Development’ course, coordinated by Dr Anthony Radford of Intermed SA. This course trains doctors, nurses and other health professionals to provide health care in developing countries and third-world situations.

The outreach trip to East Timor and Indonesia was an opportunity for the students who had attended the course to experience the provision of health care in two different developing countries first-hand and to consolidate their learning.

Dr Radford and nurse Nathan Willis, a previous Intermed student and National Director of Partners Relief and Development Australia, led the outreach trip.  Eleven students from across Australia made up the team, including one doctor (Sneha), one dietician, one pharmacist, one health scientist, one midwife and six nurses.

Sneha talks about her outreach experience:

“We went to Hera (East Timor), Nias Island (Indonesia) and Banda Aceh (Indonesia), spending one week in each place.  We ran health clinics, gave health education talks, visited local hospitals & health services, visited local NGO & aid organizations and conducted public health assessments. 

As the only doctor on the Outreach team apart from Dr Radford, I was unexpectedly given the responsibility of leading one of the half-teams.  The two half-teams were often separated to run health clinics in two different towns – with no way for me to ask Anthony urgent questions!  As a junior doctor, this was both a terrifying and exhilarating experience for me. I found that all the usual props I used to validate my clinical decision-making in Australia such as further investigations, senior advice and specialist referrals were luxuries of developed-world medicine!

Another unforeseen experience that ensued from this situation was that I eventually stopped seeing patients myself but began spending time teaching my team-mates how to think like a doctor.  I needed to encourage them to use hypothetico-deductive reasoning to think through a patient’s presenting complaint, to think about possible causes, to devise ways to differentiate between diagnoses, to finally make a reasonable diagnosis and to make a plan of management.  This was vital for their training as this is precisely what they would be required to do if they were the only health professional available in a remote village in Africa or some such place.

It was an amazing and unexpected opportunity for me to indulge my love for teaching.  It was also a marvelous opportunity to lead a multi-disciplinary team of health professionals who had been taken out of their normal contexts and roles.  It was very gratifying to watch my team-mates growing in their confidence and consultation skills within the few weeks that we worked together. 

And if all that was not enough, Dr Radford also invited me to join the 2006 Outreach as an official team leader, returning to East Timor and Nias in August.”

Sneha graduated from the Flinders Doctor of Medicine in 2003 and is now a Resident Medical Officer at Flinders Medical Centre. For further information about the Intermed course and outreach program, contact: Intermed SA, PO Box 223, Torrens Park SA 5062. Web: http://cmdfa.org.au/news/national.html