#badEM16: Sian Geraty – Too wild, too free, too accustomed to death

#badEM16: Sian Geraty – Too wild, too free, too accustomed to death

800 417 Kirsten Kingma


I’m Sian and I’m an Emergency Medicine registrar in Cape Town, South Africa.  I consider myself the luckiest girl in the world to get to do what I love in our incredible country. Here we have the most diverse patients, the craziest stories, the widest range of pathologies, and more opportunities that you can imagine. It’s not always easy, but I’ve got some awesome motivation from God, believing that this is a calling, and from my family and friends.  I also survive by having a healthy-ish life outside of work with lots of running, good food and adventure. I believe that Emergency Medicine can make a difference in Africa, and got to spend some time at the Muhimbili National Hospital in Dar es Salaam, Tanzania earlier this year. These stories come from that amazing time.

My talk stemmed from a desire to share my experiences and what had touched my heart during my time in Tanzania. There is a huge discrepancy between the lack I experienced in Tanzania, compared to the easy wealth of my life in Cape Town.  However, so many aspects of hospital life were familiar to me from my time in Mpumalanga and rural Kwa-Zulu Natal.  Making do. One gets used to not having enough oxygen ports, the right size IV cannula, or enough bed space. Watching both adults and children die, when they may not have died if more resources were available, was difficult.  Between the poverty, poor care at the referring centres and the lack of the specialties at the National Hospital to operate or provide ICU care, the Emergency Medicine Department at Muhimbili shines like a beacon.  An intubated child will lie for 2-3 days on the only paediatric ventilator in the entire hospital.  Wounds are cleaned and broken bones splinted with cardboard, suffering is relieved and the doctors and nurses fight the true fight for their patients.

What I didn’t include in the talk was the magic of Dar es Salaam. The laughter and heat and friendliness and beauty.  I can almost taste the street food…spicy barbequed corn, Indian pani puri and soupy crunchy “orojo” that is apparently made from unripened mangoes, laughingly shared at twilight.  As the heat of the day would start to settle, the air would fill with the sound of the call to prayer echoing in the background and the cheery voices of old men greeting children on the street.  As darkness fell, the chirping of crickets and the repetitive beeping sound of the bats would begin. I would walk past choir practice at the church on the grounds of the hospital and listen to the deep bass voices and look the stars and breathe.

Africa’s story is all of our story.  A really powerful way to make a difference is to support the brave men and women like those mentioned in the talk, who live for emergency care and may not always have the means to learn more.  You can sponsor them to attend high quality conferences and take life saving skills back home at this link: support-a-delegate


Now for the talk:




Making a plan by using an electrode to secure an IV line in this infant



Cardboard box to splint a fractured arm