Monitoring adverse reactions to drugs.

If you're thinking seriously of a short time in a developing country, you would probably enjoy this sort of job. Patients get better, and seem to enjoy doing so, so it is immensely rewarding in terms of job satisfaction. There is excellent clinical experience to be had, and the chance to become clinically more self-reliant. The medicine, however, is probably relatively elementary, and facilities for definitive investigation are limited. Also, demand on scarce medical resources is enormous-at times the resources seem so thinly spread as to be depressingly ineffective. Rural hospitals are very isolated, and doctors and their families are thrown very much on their own social resources. There are all the disadvantages of leaving the NHS for a while, in terms of superannuation, salary increments, and so on, and the posts are not officially recognised by the Royal Colleges as suitable for vocational training experience. Many will not like the political climate of Southern Africa, although Transkei's paramount chief promises a "non-racial society in which race, creed, or colour will not be the criteria of a man's worth." This has certainly been the philosophy of the mission hospitals throughout their history. Transkei has immense potential. It is a land of stark contrasts -wealth and poverty, health and disease, wisdom and ignorance. I marvelled as one evening a white-gloved waiter served wine at a dinner party under the chandeliers of Umtata's Imperial Hotel -four hours and 40 miles away I had been among the flies and smells of a ramshackle mud hut in the bush examining a marasmic infant, poisoned by a witch doctor's herbal medicine. Worlds apart, but perhaps the gulfs that divide them are gradually closing.