Medics2Mongolia

Our Last Day in Arkhaiveer

Tue, 14 Aug 2012 15:15:05 +0100

Our last day at the rural hospital was cut short due to an impromptu trip to the countryside of the countryside (Inception countryside). Our new friends in the form of: Dr Bhaa (Ophthalmologist), ‘Honey’ (Neurologist) and Togi (Interpreter) told us the clinic would finish at lunch time and they would take us for a picnic.

We stopped off at a Ger of Dr Bhaa’s family on the way. Airag was ‘forced’ down us, not a particular favourite but it is rude to refuse as well as point and pass with your right hand. After indulging with the family we went to the river beside a house that looked like it was from ‘Little House on the Prairie’, definitely out of place in Mongolia.

After delving into the picnic we were introduced to a drinking game involving the Mongolian equivalent of Rock, Paper, and Scissors but using all 5 digits of the hand (the one above beats the one below). We were split into 2 adult teams of 4 members and the losers had to drink a bowl or Airag between them. Matt was lucky he had an experienced Mongolian on his side, which went through our entire team without losing. The losers (Sid and Ross) were soon hit with the punishment; you had to drink a full bowl by yourself. The tastes of this ‘speciality’ was highlighted by Sid taking a very long time to down, or sip, the Airag (3min.50) - Ross demonised it (27secs)

He soon paid the price and didn’t make it to the poker night arranged by the peace core, which involved using bottle caps, gambling a hefty £1.50 worth of Tugrog and enjoying the delightful snacks of Mongolia (peanuts and paprika crisps). All this said it was a very enjoyable night with American-English banter comparing the likes of baseball with cricket.

Before leaving we met another team that failed to complete the Rally, this Spanish team had broken down (unfixable) a mere 7 hours away from Ulaanbaatar. We felt their pain but at least they made it to Mongolia.

We wished we had arranged a longer time here.

Rural hospital- Arkhaiveer

Tue, 14 Aug 2012 15:10:53 +0100

Last week we packed our bags left the comfort of our apartment and took a 7 hour bus journey to Arkhaiveer in the countryside to finally meet Jo (if you remember form the post office in the first week). If you don’t remember: Jo is a nurse from England who been volunteering in Mongolia for a while, she got us our placement here. She has worked with peace core volunteers from America and medical professionals from England to help them settle them in and also tries to teach the doctors English, which they are all very eager to learn.

We checked into the Loving Hut which did exactly that to help us feel at home including taxiing us around the town. The vegan food was incredible after over a month of fatty mutton. The shower was interesting; you had to go outside to shower in a redundant modified Volkswagen. The experience was first dreaded but then fully enjoyable; the seats were an added perk.

After some questioning about the shower we soon realised that they had bought the vehicle from the Mongolian Rally (another charity that puts on the rally). Unfortunately he had lost the immobiliser and was unable to start the engine; we are currently in talks with Volkswagen trying to render the situation.

Everyone in the town welcomed us and the doctors were all equally friendly. We were divided into different departments, rotating daily. We were even supplied with a useful interpreter- Togi.

We spent time in many departments:

The majority of our time was in Ophthalmology with a doctor that happily took us under her wing. After a couple of days she was happy enough to leave us in charge of the clinic while she popped to more urgent cases around the hospital. We were diagnosing patients and writing prescriptions from the first day (mainly foreign bodies, allergic and bacterial conjuctivitis), even though these would have to be translated into Mongolian. During our time we tried to help her daughter apply for Dentistry in London, this is on-going.

Sid spent an afternoon in Neurology which involved him examining stroke (which took as many days for them to get a CT scan as it did hours in England) and schizophrenic patients. Most of the time was spent examining the patient and teaching the doctor the English terms for the medical conditions. Matt would say he spent in the gym after catching him mid work-out with who would soon become his Mongolian girlfriend, nicknamed Honey by Togi. Sid’s excuse was that he was told he was going to see the rehabilitation room.

Traditional medicine, from what Matt saw, involved a mixture of acupuncture and light therapy. The former you may know a little about:the placement of stainless steel wires in certain regions of the body to relieve pain and improve function of said parts. The latter is the use of either ultra violet light to improve anything from sore throats to headaches or normal halogen lights to relieve muscle pain…the legitimacy of which claims you can decide for yourselves.

Obs and gynae was fairly similar to what you’d expect in England; big women and little babies. Ross spent a couple of days here witnessing a delivery followed by a postpartum haemorrhage,a c-section and a variety of other operations. There were top quality doctors who, surprisingly, had really good medical equipment to rely on to look after the women in the 25 bed ward. Mongolian women didn’t seem too bothered about having a male English student in the room, made a nice change from standing awkwardly in the corner in England. That is if you are allowed precedence over the midwives or female medical students. This was after some time in maxillofacial surgery with the hospitals senior surgeon, only three years out of medical school. After watching some tooth pulling as the result of generally awful Mongolian hygiene Ross assisted on a surgery to repair a fractured zygomatic arch. His knowledge or lack thereof, of facial surgery was obvious when he congratulated the surgeon on a good operation only to be told it hadn’t fixed the problem. Embarrassing.

GoHelp- Rural hospital and Garage

Tue, 14 Aug 2012 14:52:22 +0100

After a few weeks in Mongolia we were eager to see what work the charity GoHelp did, and subsequently what work our Adrian could have done. The ever helpful Migah was happy to take us to one of the rural hospitals where the ambulances are used. The district the hospital supplied had a 90km radius encompassing 4000 residents (around 2000 in the town). The hospital itself consisted of a triage room with one bed and an upstairs ward separated into children, adult and a maternity wards but in total only had 25 beds. Outside the hospital facilities were clearly in need of development; one fast response ambulance and one large NHS donated ambulance from a previous rally. This seemed adequate until we were informed that firstly only the fast response was really used, due to the cost of running the large automatic petrol NHS ambulance, and secondly on closer inspection the fast response vehicle was in fact merely an aging family saloon it was clear the region badly needs the support GoHelp provides.

After a good look round we were provided with an unexpected gourmet Mongolian lunch in the director’s office and enjoyed the ride back to UB after being piled with mutton, vermouth and Airag. Migah also arranged for us to have a look round GoHelp’s garage with the mechanic preparing to receive this year’s new fleet to add to the 3 vehicles already in storage. The garage could hold around 10 vehicles at a time to be worked on, usually for a few weeks before being designated to the regions hospitals. Seeing some of the vehicles already there was quite hard to take but just appreciating that the work still goes on is important. The money we’ve raised helps maintain other vehicles to improve the services for regions such as the one we had just visited.

'Gobi Desert'

Tue, 14 Aug 2012 14:49:55 +0100

We were picked up bright and early for our first trip in Mongolia after several weeks being cooped up in Ulaanbaatar working in the hospitals and trying to save the pennies after the pounds were spent on the unexpected flights. Matt unfortunately didn’t make it any further than the toilet seat and spent the rest of the weekend recovering on the sofa, after a dodgy khuushuur or twelve.

Our first stop was at a greasy spoon in a lay-by in the form of a Ger. It was located next to an impressive mountain that, because of tradition, couldn’t be named. A little like Voldermort. Here we learnt that Bobo’s (our tour guides) brother was competing in the Olympics. Turns out that he was the first Olympian to win Gold for Mongolia, winning a Gold at Beijing in Judo. A few days later we watched him win the silver medal in London after battling on through an injury in the semi-final.

Anyway, the next few hours was spent weaving our way through sights in the Mongolian countryside using nothing but the shapes of mountains and guesswork. We visited a cave used by Buddhist monks at a nearby secret monastery during Stalin’s rule over Mongolia when Buddhism was banned. Needless to say you can imagine the barbarity when the monastery was found. It’s a shame Matt missed the next location, a natural spring whose waters were fabled to improve eyesight. After a liberal splashing we made our way to the nearest Ger camp to be wined and dined on Mongolian fare listing to tales of the housecat fighting snakes. We awoke the next day excited at the prospect of visiting the Gobi desert only to end up at some sand dunes 20k down the road. Not quite what we had in mind. To make things worse we got a phone call from Matt telling us that our flights to Beijing for a cheeky sightseeing trip had a ‘slight’ alteration…..a 17hr delay. This meant our trip would have to be cancelled unless we found an alternative way to get to China…

Medics2Mongolia Tribute: Chris Martin Every Teardrop is a Waterfall (click here to view)

Sun, 29 Jul 2012 13:53:00 +0100

Medics2Mongolia Tribute: Chris Martin Every Teardrop is a Waterfall (click here to view):

Dave Peacock, what a legend. Dave has filmed a cover of his favourite ‘pop song’ tributed to Medics2Mongolia. He is an up and coming acoustic guitarist/drummer and even covered for the embrace drummer a few year back. He promises that if the demand is there then he will make more. SO…. back Dave and Medics2Mongolia. You may also know Dave from such youtube phenomenons as Sid V Dave

Matt in Orthopaedics

Tue, 24 Jul 2012 12:27:50 +0100

My first couple of weeks in the hospital have been spent mostly in surgery shadowing a young orthopaedic surgeon. The team has got me involved as much as possible scrubbing in to assist in the many femoral and tibial shaft fractures that the hospital sees, predominantly from the ridiculous numbers of road collisions that occur and horse riding accidents (especially around Naadam). There’s been plenty of hip replacements too which have a long waiting list as most patients have to buy their own prosthesis, from private companies, so whereas in the UK patients with hip fractures get fast-tracked to theatre within 2 days here the restraint is patients funds as well as waiting lists, so seeing patients who have waited 7 months for surgery with displaced fractures is not unusual.

As you can imagine surgery is a very different experience in Mongolia; most of the equipment is reused far more than should be hygienically possible, drill bits get replaced only after they have broken and a limited amount of tools make the job they do here that bit more impressive. I’m hoping to see the plastic surgeons in action next week, they have a large burns unit at the hospital holding about 90 patients (when we went to see people were sleeping on the floor in the corridors because there isn’t enough beds) and perform about 4 operations a day as there is only one theatre. Ill update you on that next week.

Ross and I also spent a night in A&E which I know he has told you a bit about so I’ll try not to repeat. On a Friday night the hospital expects to see 200-300 patients, there are two doctors who triage these patients and a third in another room but I didn’t see him often and can’t tell you what he actually did. The doctors we were with started at 4.30pm and finished at 8.30am. They kept the relentless queue of injuries moving at an impressive rate, no doubt partly due to their very brief patient assessments, and are very skilled in determining who needs more urgent care and sending them on. Patients were all seen in the one room regardless of their injury this lead to a very cramped room with probably a minimum of 4 people bleeding all over the place at any one time….it was quite hygienic though as a nurse came and towled the place down every so often. As the night went on the hallways became a dormitory for the large number of inebriated patients, my supervisor seemed surprised to learn that it was a similar situation in the UK and that we sorted of expected this. It was an enjoyable experience though and the doctors were impressive to work with, in Mongolia as part of your training every doctor has to spend a year doing this job before they can go and specialise in surgery or medicine. I can definitely see why this is the case, you quickly learn to deal with high pressure situation and you become highly skilled in reading terrible xrays so when they occasionally get a good one I imagine it’s easy for them. Anyway after a long day starting at 8.30am I was pretty happy to get home in the early hours of the morning, did have to share the bed with Ross though…ups and downs.

Matt in Orthopaedics

Mon, 23 Jul 2012 08:00:33 +0100

Matt in Orthopaedics

Ross- Intensive Care Unit, Anaesthetics and a Friday night in A&E

Mon, 23 Jul 2012 07:59:00 +0100

Over the past couple of weeks I’ve divided my time between the intensive care unit (ICU), shadowing anaesthetists in theatre and a couple of shifts in A&E, including a Friday night.

My supervisors first stuttered words in ICU were, “I speak bad English” as he ushered me towards a reluctant looking doctor who soon palmed me off to another anaesthetist. This doctor, a friendly ex-wrestling champion, employed me as his English teacher in return for some lessons in putting patients to sleep. Using his basic translation books we started to get along and he explained the ins and outs of inserting a spinal anaesthetic, which all patients having lower limb orthopaedic operations at the hospital receive. The doctor’s love of wrestling soon became apparent as he spent the whole day watching live matches on the flat screen TV in the doctors lounge, leaving me in charge of a sedated patient’s airway with nothing but a piece of string to check she was still breathing and the mumbled word “watch” followed by a point to the vital signs monitor. No big deal. This went fairly smoothly apart from the patient basically waking up three of four times. In England we would use a continuous infusion pump to keep someone under but the lack of equipment here means they administer a little more anaesthetic when the patient starts to come round. Effective, but not ideal.

After watching a few operations, that I’m sure Sid and Matt will give you the details of, we wandered back up to ICU. When you walk into Intensive Care in England you are confronted with a barrage of bleeps and buzzers, hand washing reminders and towering, expensive looking equipment operated by a dedicated nurse surrounding each vulnerable patient. Quite the opposite is true in Mongolia. The ICU has between ten and fifteen beds depending on who you ask (the actual number changes daily) and, from what I could gather, three nurses to operate two ventilators offered to the sickest patients on the ward at that time. I’ve yet to see anyone wash their hands. Most patients have severe brain injuries with little to no chance of recovery. Perhaps the most shocking aspect of their care is the apparent lack of pain relief offered to most patients, something that would rightly not be tolerated in the UK, although this is more down to a lack of resources than a lack of moral responsibility. After several morning ward rounds where my main job was to usher flies away from prone patients while trying to understand their prognosis through hand gestures I realised there was little more I could learn or help with in ICU. I decided to try and spend some time in A&E.

Last night Matt and I worked in the triage department helping the only two doctors in A&E. On average they see around 250 patients a day between them; an epic task! This is reflected in the way they assess people. No matter what the injury, be it head injury after a car crash, suspected broken pelvis or a wound requiring stitching the patient is in and out within 5 minutes, all without a neck collar in sight (unless the patient brings their own). There’s no logical system to who’s seen next, more of a free for all in front of the only desk in the department. Although this sounds like a terrible system it’s surprisingly effective when run by incredibly experienced doctors. Within seconds they know the extent of an injury and whether a patient needs urgent assessment and referral or can wait to be seen. They can never match the standard of care people receive in the UK but they do a good job in difficult circumstances with limited resources. Even so, I don’t think I’ll ever complain about having to wait a few hours to be seen in A&E back home ever again.

Sid in Paediatric Orthopaedics

Mon, 23 Jul 2012 07:42:57 +0100

Sid in Paediatric Orthopaedics

More of Sid in Paediatrics

Mon, 23 Jul 2012 07:39:00 +0100

My second week in paediatrics saw me mainly in theatre with the paediatric orthopaedic surgeons. In the beginning I was mainly stood in the corner of the room, unscrubbed, trying to keep enough distance to prevent contamination whilst getting close enough to see- a little. During this time I was re-trained as a radiographer.

They had me operating the C-Arm (X Ray) in theatre as the room mainly comprised of two sometimes three surgeons, a scrub nurse, and occasionally an anaesthetist that spent her time dashing between multiple theatres as surgeons shouted her name. I was surprised by the role of the scrub nurse, in some instances she assisted a single surgeon in operations despite me and trainee Mongolian surgeons watching on, unscrubbed! When I was the only person unscrubbed I was given the task of operating the C-Arm as radiographers seemed inexistent or scarce at least.

Operating the C-Arm under Basic English explanations was easy enough, judging the duration they wanted the X-Rays for was difficult. The constant use of the X-Rays seemed unnecessary, especially considering the lack of protection. You were lucky if you had a body protecting lead apron with a broken zip never mind a full length apron with a thyroid protector as implemented by many hospitals in England. I say you would have been lucky because most of the time the X-Ray is used without prior warning. In these instances I found myself trying to keep my distance, covering my ‘exposed’ testicles with both hands, even though I knew it wouldn’t make a difference. I found comfort in the fact I was taking action to protect something so precious. The best strategy I implemented was fresh from the streets of Mongolia and involved using a blocker preferably choosing someone that had an apron on.

After a day or two I was asked to scrub in to assist in an operation on a 7 year old boy that had fell off his horse during the Naadam Festival and fractured his femur. The operation involved reducing the fracture and inserting an intramedullary nail (a nail that connects the two sides of the fracture through the middle of the long bone) to align the fractured femur and allow it to heal. This was surprisingly difficult in the heat as the surgeon and I attempted to reduce (align) the fracture and hold it in place. The Mongolian heat was amplified by a full length lead aprons, a surgical gown, mask, hat and double gloves. The difficulty reducing the fracture increased as I felt the boy elbowing me as I tried to reduce the fracture. All of the operations I have seen have been done under spinal with the patients awake; General Anaesthetics are rare. The sight of my surgical scrubs after the operation was not pleasant as it was difficult to see the lighter green colour that they started.

I assisted in many more operations in the week including fractured femurs, humeri and tibias secured by different methods depending on the case. This helped me gain a lot more experience in orthopaedics (a speciality I had little exposure to in England) whilst practising my suturing skills.

A particularly interesting operation involved a 12 boy with polydactyl of the foot. An operation I thought would be quite uncommon in England, depending on where you are from.

Grimsby Telegraph Coverage (click to see)

Wed, 18 Jul 2012 08:57:00 +0100

Grimsby Telegraph Coverage (click to see)

Naadam horse racing

Fri, 13 Jul 2012 10:11:00 +0100

Naadam horse racing

The Naadam Festival

Fri, 13 Jul 2012 10:10:00 +0100

The Naadam Festival is a double celebration to celebrate the creation of the Great Mongol Nation by Genggis Khan in 1206 and the Mongolian Independence from the Manchu Empire in 1911. For the Mongolians, a predominately Buddhist race, this festival was the equivalent to our Christmas. Even the hospitals seemed to close down working with a skeleton crew.

We very nearly missed out on the festivities as the tickets were sold out for tourist’s weeks before. Luckily for us Migah & Co. from GoHelp came up trumps…again. They managed to get us tickets to the opening ceremony including the first stages of the wrestling and tickets to the horse racing and archery the following day.

The opening ceremony was packed, we were told to make sure we got there half an hour early as there would be queues and it didn’t disappoint. We use the word queue loosely as it involved a crowd of people surging towards the gate waving their ticket in the air with children getting lost or slightly crushed.

Once inside, the ceremony was impressive but we were more eager to see the traditional Mongolian wrestling than the traditional songs and dances. It turns out we were a minority as many ticket holders left after the opening ceremony. Apparently the Mongolians aren’t really interested in the opening rounds of the wrestling as it is spread over a couple of days and the men need to be separated from the boys (so to speak). We didn’t grumble as this instantly upgraded our seats to the front row with a brilliant view of the wrestling. To make it more interesting large wagers of 500 Togrog were placed- the equivalent of 25p. Unfortunately some of the bouts went on for a long time and it was difficult to remember and locate the wrestler you had bet on in the sea of wrestlers contesting at the same time. Nevertheless we left with a new football celebration.

After the wrestling we sampled the Monoglian delights in the form of khuushuur, deep fat fried mutton pancakes. We all had a few as they were so cheap but soon after Sid developed chest pains- typicalmedical student.

The next day we found ourselves in what we thought was going to be a short taxi ride to the horse races on the outskirts of the town. An hour and a half and 50km later we arrived on a road that had been turned into a one way street which still didn’t compensate for the number of cars, people were going off-road and driving through fields and ditches to avoid the queues. It was quite amusing to watch some of the cars attempt to undertake this task including a Honda Jazz. The sound of cars bottoming out gave us flash backs to Kazakhstan.

We watched the morning of races and 2 of us were pickpocketed in the busy crowds as people pushed forward to see the finish of the races. We could understand the excitement as the races took close to 2 hours to complete.

Unfortunately due to the congestion we missed the adult’s final of the archery but were entertained with the children’s version for a short while.

Ross and Sid found themselves in the police station the following day reporting the pickpockets. Sid had to leave Ross to get a translator on the phone from the tourist information centre as our mimes and gestures didn’t seem to work. This is when Ross saw Mongolian Police brutality at its finest.

In walked 3 lads aged between 14 and 16 although you would have thought they were older looking at the tattoos and scars that covered their necks and faces. If you were to stereotype you would have said they were in some kind of gang. Anyway instantly off came the policeman’s belt, a few whips later with the buckle and a couple of jabs to the face and the ‘ring-leader’ seemed to be talking. Obviously we didn’t know what he was saying or why they were there but we didn’t ask. On Sid’s return they seemed to remember Ross was in the room and asked us both to wait outside, a relief more than anything. Moments later we saw the youths walking out with a bucket, we assumed they were going to the cells and the bucket was their toilet. The formalities were concluded in the detectives’ office and a glimpse outside revealed that the youths were in fact washing the police cars.

The naadam festival, and the champion

Fri, 13 Jul 2012 10:01:16 +0100

The naadam festival, and the champion

The winning drawings

Fri, 13 Jul 2012 09:43:39 +0100

The winning drawings

Art competition

Fri, 13 Jul 2012 09:32:59 +0100

Art competition

GoHelps art competition, held at a library in a small village...

Fri, 13 Jul 2012 09:23:37 +0100

GoHelps art competition, held at a library in a small village outside UB

GoHelp The Charity and The Art Competition

Fri, 13 Jul 2012 09:20:00 +0100

We were invited to a Book House, which was a library for children in a rural town an hour outside of Ulaanbaatar. This is a project created by GoHelp providing both English and Mongolian books to help develop the language and literacy skills of children in these rural areas. The book house has librarians there during the week providing a place for children to come and learn. GoHelps staff attend every Saturday to help and encourage the children to participate in both games and competitions. Although these book houses are in their early stages the popularity is growing faster than the charities resources. Many of the books are in English with only a small Mongolian section, reflecting the main source of donations.

The Improbables (another team mentioned in previous blogs) had organised an art competition for children up to the age of 14. We were invited to help at the competition and were surprised by the number that attended; there was a register due to the limited places. Everyone seemed to thoroughly enjoy the day and prizes were given to the top three places, which were scrutinised by the judges more than anyone would suspect. Matt can vouch for this after being chosen as an honorary judge, scoring each picture under 4 different categories each out of a maximum 20 marks.

Although the art competition was the main event of the day we got a flavour for what normally happened. We were introduced to different games involving sheep knuckles including flicking matching knuckles onto another to see who gained the most at the end (more complicated than it sounds). We had an excuse to return to our childhoods by helping children with jigsaws, songs and drawings. Despite others preferring to wrestle which reminded some of us of our nursery experience.

We found out more about what the GoHelp charity during the trip, they have several strings to their bow. The charity main aim is to make education and healthcare more accessible to the Asian communities, in particular Mongolia. They do this through the Mongolian Rally which provides both ambulances and money (through donations) to the Mongolian Ambulance Service. We found out after arriving in Mongolia about the book houses stationed in rural areas (mentioned above) as well as providing 7 bursaries to students to attend University.

We hope to visit the mechanic garage in charge of marinating the donated vehicles in the near future.

You can donate to the charity to help maintain and develop such resources through: http://www.justgiving.com/medics2mongolia

Thanks

standard shower in UB, and our pad

Fri, 13 Jul 2012 09:15:24 +0100

standard shower in UB, and our pad

First Week In Hospital

Fri, 13 Jul 2012 09:14:00 +0100

Our first week in the hospital has been exciting; the hospital is one of the busiest in UB seeing over 200 trauma cases a day. The staff have welcomed us and are keen to practice their English, as we try to improve our Mongolian, kind of picking up 5 words in the opening day. We have all been allocated individual supervisors in different departments to enable us to get the most out of our time here. Sid has been allocated a supervisor in Paediatric Orthopaedics, Matt- Orthopaedics and Ross- Intensive Care and Anaesthetics. We will all change around weekly enabling us to understand more about trauma medicine in Mongolia.

A little about Sid’s first week:

I walked into the Doctors office to find one of the older members of the team hanging out of the window smoking. The cultural differences in the hospital immediately struck me, the clinics were the busiest I have seen, people were queuing down the corridor continually opening doors to the clinic hustling the person before them out. At some points there were 3 or 4 patients in a small room with the doctor acting as more of a security guard at times having to usher people out of the door.

The clinics mainly comprised of Developmental Dysplasia of the Hip (DDH), Rickets, fractures and congenital abnormalities which were all more common in Mongolia than England. Surgery mainly comprised of the reduction of fractures, internal and external fixations in a theatre room which you would think was inadequate for the job but it seemed to have the essentials, including a stereo which seemed to be the modernist part of the kit.

All the doctors were amazing and tried to help me settle in as much as possible despite the language barriers. One doctor in particular was especially helpful having treat me to lunch he asked if I would like to go to the countryside for the Nadaam, unfortunately I had to politely decline as I had tickets for Ulaanbaatar’s Nadaam festival. He made sure that I attended the raising of the flags on the National Flag Day, the day before the Nadaam. This consisted of speeches from the clinical director, the national anthem and people going around shaking hands and kissing on the cheek, I was targeted by an elder woman.

My next invite saw me at a party in the Doctor’s office later that day to celebrate the awards for ‘Best Young Doctor’s’. Turns out paediatrics gained 6 of the 7 awards in the hospital calling for celebrations. Obviously this called for cake, chocolate and shots of Chinggis Vodka at the tender hour of 3pm.

Click on the hyperlinks in the text to find out more about the medical conditions.