• asthma
• guidelines
• developing world

I thought it would be easy: basic guidelines for hospital management of asthma. How wrong I was.

Constructing clinical guidelines is one of the tasks I’ve taken on for my year in Oshakati Hospital as a RCPCH/VSO paediatric fellow. Not wanting to be just another Oshilumbo who breezes in expecting the locals to do as I say, I set about trying to introduce my colleagues to evidence based medicine. Current journals and textbooks are hopelessly scarce but the Internet is accessible, and Namibia, classified by the World Bank as a lower middle income nation, qualifies for free online access to many journals.

So, I bravely said, don’t just do what I say, demand evidence (thereby asking them to do as I say). That was the first catch—there is very little evidence for a whole host of conditions one sees here; I’m still trying to work out how best to treat …