Tuesday, July 1, 2014
Signing Off
This concludes my Iringa blog posts. Already missing everyone from the Gap Medics house and the hospital, as well as the crazy wonderful African lifestyle. Nakupenda.
Last Day in Iringa
6/27/14
I can't believe it is my last day in Iringa. It's hard to imagine that I have been here a full 4 weeks and will probably never see most of these people I have spent every hour of every day with again.
This morning we did rounds with Dr. Msigwa, discharging many of the patients from minor surgeries. Then we went back ton another ward and Dr. Rahib lectured us on the prostate. Of course he always asks us questions and has us guess the answers, though I rarely knew the answers. For the first time in my life, I am one of the youngest people on the trip and don't really know much about medicine, which puts me at a slight disadvantage because the doctors don't know this.
After the morning shift, I had planned to go to lunch with some friends and finish shopping, but there were 7 C-sections that were going to be happening and it was rumored that Gap Medics students could have the chance to assist. After watching 5, I gave up on the idea of assisting and called it a day at the hospital. Though I didn't get to assist I protect much checked everything else off my list.
For dinner, a group of us stayed at the house and made Mexican food and enjoyed the last night in the house. Definitely a night well spent with everyone.
I can't believe it is my last day in Iringa. It's hard to imagine that I have been here a full 4 weeks and will probably never see most of these people I have spent every hour of every day with again.
This morning we did rounds with Dr. Msigwa, discharging many of the patients from minor surgeries. Then we went back ton another ward and Dr. Rahib lectured us on the prostate. Of course he always asks us questions and has us guess the answers, though I rarely knew the answers. For the first time in my life, I am one of the youngest people on the trip and don't really know much about medicine, which puts me at a slight disadvantage because the doctors don't know this.
After the morning shift, I had planned to go to lunch with some friends and finish shopping, but there were 7 C-sections that were going to be happening and it was rumored that Gap Medics students could have the chance to assist. After watching 5, I gave up on the idea of assisting and called it a day at the hospital. Though I didn't get to assist I protect much checked everything else off my list.
For dinner, a group of us stayed at the house and made Mexican food and enjoyed the last night in the house. Definitely a night well spent with everyone.
Losing Streak with Patients
6/26/14
Another surgery day today! It is much nicer actually being in the surgical department so I can have inside access to all the surgeries and not be turned away if there are too many people. In our morning meeting, Dr. Msigwa (another really good surgeon at the hospital) told us that the woman who had gotten the leg amputation the previous day had died. They didn't know the cause of death yet, though they suspected it may have been sepsis. The surgery had gone well and she was doing well for a while... the woman asked the nurse to get her some soup and by the time she came back the woman was dead. Even though I had only seen her twice, it was really crazy to think she was gone... I had literally just seen her surgery yesterday.
The surgeries started right at 9am and we saw a tonsillectomy, the repairing of a shattered patella, the suturing of the top layer of skin on a man's stomach (he had previously gotten an abdominal surgery and was now stable so they could finish sewing him and up and send him home), a circumcision, and an abdominal hernia surgery. They also brought in the little boy (I'm pretty sure I mentioned him in an earlier post) who had burned his legs and were redressing them. I stayed for part of that procedure and then decided to call it a day as it was late in the afternoon by that point.
I had my last BBQ that night and then we all went to Shooters for the last time. For the past couple days, the power has also been unreliable (it went out during dinner on Wednesday night for 30 min) and it probably went on and off more than 6 times in the 2 hours we were at the bar. "This is Africa", an already very common excuse was used a lot that night.
Another surgery day today! It is much nicer actually being in the surgical department so I can have inside access to all the surgeries and not be turned away if there are too many people. In our morning meeting, Dr. Msigwa (another really good surgeon at the hospital) told us that the woman who had gotten the leg amputation the previous day had died. They didn't know the cause of death yet, though they suspected it may have been sepsis. The surgery had gone well and she was doing well for a while... the woman asked the nurse to get her some soup and by the time she came back the woman was dead. Even though I had only seen her twice, it was really crazy to think she was gone... I had literally just seen her surgery yesterday.
The surgeries started right at 9am and we saw a tonsillectomy, the repairing of a shattered patella, the suturing of the top layer of skin on a man's stomach (he had previously gotten an abdominal surgery and was now stable so they could finish sewing him and up and send him home), a circumcision, and an abdominal hernia surgery. They also brought in the little boy (I'm pretty sure I mentioned him in an earlier post) who had burned his legs and were redressing them. I stayed for part of that procedure and then decided to call it a day as it was late in the afternoon by that point.
I had my last BBQ that night and then we all went to Shooters for the last time. For the past couple days, the power has also been unreliable (it went out during dinner on Wednesday night for 30 min) and it probably went on and off more than 6 times in the 2 hours we were at the bar. "This is Africa", an already very common excuse was used a lot that night.
Bucket List Amputation
6/25/14
Today we just did rounds in the male surgical ward with Dr. Rahib. Most of the cases were post-op abdominal or fracture surgeries. As we saw each of the patients we learned about the different methods for fixing fractures and the importance of immobilizing the joints above and below the break. It was really interesting, but the methods of realigning the bones using weights attached to the casts or screwed into the bones themselves would never be used in the US... or at least I am not aware of this. Dr. Rahib also gave us a lecture on the appendix before we took a break for lunch.
When walking outside through the hospital after coming back from lunch, my friend and I randomly ran into Dr. Ombati, who excitedly told us to get scrubbed in because there was going to be an amputation in the surgery building. We had previously seen this patient on Monday during rounds. The patient was a 28 year old female with type 1 diabetes who had burned the top of her left foot. This burn had become infected and since she was not taking her insulin, the condition had worsened drastically. The week before, Dr. Ombati did a minor surgery to clean the wound, but ended up removing lots of dead tissue and realizing her foot and leg were consumed by gangrene. Today they had to perform and above the knee amputation because the woman had refused the surgery for so long that it had spread from her foot up her leg. After lots of counseling, the doctors had finally persuaded her that she needed to have the surgery in order to live.
The surgery went very smoothly, taking exactly 50 minutes. No description can really do justice to how incredible it was to see someone's leg being cut off... not that it is a good thing, but it was incredible to be standing right next to the surgeons and taking videos of the whole thing... I never imagined that happening for a long time.
Today we just did rounds in the male surgical ward with Dr. Rahib. Most of the cases were post-op abdominal or fracture surgeries. As we saw each of the patients we learned about the different methods for fixing fractures and the importance of immobilizing the joints above and below the break. It was really interesting, but the methods of realigning the bones using weights attached to the casts or screwed into the bones themselves would never be used in the US... or at least I am not aware of this. Dr. Rahib also gave us a lecture on the appendix before we took a break for lunch.
When walking outside through the hospital after coming back from lunch, my friend and I randomly ran into Dr. Ombati, who excitedly told us to get scrubbed in because there was going to be an amputation in the surgery building. We had previously seen this patient on Monday during rounds. The patient was a 28 year old female with type 1 diabetes who had burned the top of her left foot. This burn had become infected and since she was not taking her insulin, the condition had worsened drastically. The week before, Dr. Ombati did a minor surgery to clean the wound, but ended up removing lots of dead tissue and realizing her foot and leg were consumed by gangrene. Today they had to perform and above the knee amputation because the woman had refused the surgery for so long that it had spread from her foot up her leg. After lots of counseling, the doctors had finally persuaded her that she needed to have the surgery in order to live.
The surgery went very smoothly, taking exactly 50 minutes. No description can really do justice to how incredible it was to see someone's leg being cut off... not that it is a good thing, but it was incredible to be standing right next to the surgeons and taking videos of the whole thing... I never imagined that happening for a long time.
Did I Mention I Like Watching Surgeries?
6/24/14
Today was surgery day, and since I am in the surgery department I got to see a lot of procedures, but nothing that stood out or was very interesting. One boy was having his tonsils removed, another man was having his leg reopened from a previous orthopedic surgery and getting it cleaned out to prevent sepsis. A 17 year old boy dislocated his elbow, so he needed it to be popped back in and get a cast, while an older man had previously had his prostate removed, but now his urethra was blocked with puss and the surgeons needed to clear the pathway and insert a catheter. Needless to say, it looked very painful and luckily he was under anesthesia. It's really interesting because in some of the minor procedures such as draining abscesses or removing lipomas and other masses, they only put the patient under local anesthesia and even then it can be quite painful for them. It makes me realize how privileged we are to not only never feel anything during any surgery, but to also be asleep and completely unaware of what is happening... which is not the case in many surgeries here. Though they don't have the medical resources here like back in the states, the kindness of the doctors and the relaxed environment more than makes up for everything.
Today was surgery day, and since I am in the surgery department I got to see a lot of procedures, but nothing that stood out or was very interesting. One boy was having his tonsils removed, another man was having his leg reopened from a previous orthopedic surgery and getting it cleaned out to prevent sepsis. A 17 year old boy dislocated his elbow, so he needed it to be popped back in and get a cast, while an older man had previously had his prostate removed, but now his urethra was blocked with puss and the surgeons needed to clear the pathway and insert a catheter. Needless to say, it looked very painful and luckily he was under anesthesia. It's really interesting because in some of the minor procedures such as draining abscesses or removing lipomas and other masses, they only put the patient under local anesthesia and even then it can be quite painful for them. It makes me realize how privileged we are to not only never feel anything during any surgery, but to also be asleep and completely unaware of what is happening... which is not the case in many surgeries here. Though they don't have the medical resources here like back in the states, the kindness of the doctors and the relaxed environment more than makes up for everything.
First Day in Surgical Placement
6/23/14
It's hard to think that I only have 4 more days in Iringa. My weekdays in the hospital and weekends exploring the city have become natural, and though people shout "mazungu" (white person) at us, I know the culture and I feel like I live here now. Some of the medical customs are really refreshing despite the limited materials and relatively unsanitary conditions. Most children in the hospital have developed a fear for anyone wearing a white coat, associating them with needles and IVs. When a doctor needs to check the child's chest sounds, he puts the stethoscope in his ear and shows the mother where to place it... it's such a smart idea that I've never seen in the states. A bit of a tangent from the rest of the day, but I've been slacking in my recent updates, so I thought I would go back and cover what I missed.
Today was the first day of my last week, and first day in surgery. I have literally been waiting for this placement the entire trip, so I'm excited to see what the rest of the week brings. I was with Dr. Ombati today, who I have met previously from observing many of his surgeries in previous weeks. We were able to see a lot of cool cases and a minor surgery in the ward, which is really unusual on dryas besides Tuesdays and Thursdays. One 5 year old girl had burned 30% of her body from her face to her neck, shoulders, arms, and abdomen. The top layer of skin was still attached in places, which looked like dampened tissue paper. Her eyelids were red and a yellow liquid/oozed from under them. The doctors needed to put in an IV to rehydrate the girl, however, they could not find a vein due to the burns, so that had to do a "cut down"... surgically finding a vein in her ankle and inserting the IV there. This took a while, and instead of moving her to the surgical theater, they did the operation in the ward because the girl was in too fragile a condition to be moved. Of course this is completely unsanitary except for the instruments the doctors used, but they had no other choice.
The rest of the time was spent just doing rounds and brief lectures by Dr. Ombati... he was also the one who performed the cut down, so that was really cool to see. For the rest of the day we played volleyball and I hiked up to the big rock with everyone for the last time.
It's hard to think that I only have 4 more days in Iringa. My weekdays in the hospital and weekends exploring the city have become natural, and though people shout "mazungu" (white person) at us, I know the culture and I feel like I live here now. Some of the medical customs are really refreshing despite the limited materials and relatively unsanitary conditions. Most children in the hospital have developed a fear for anyone wearing a white coat, associating them with needles and IVs. When a doctor needs to check the child's chest sounds, he puts the stethoscope in his ear and shows the mother where to place it... it's such a smart idea that I've never seen in the states. A bit of a tangent from the rest of the day, but I've been slacking in my recent updates, so I thought I would go back and cover what I missed.
Today was the first day of my last week, and first day in surgery. I have literally been waiting for this placement the entire trip, so I'm excited to see what the rest of the week brings. I was with Dr. Ombati today, who I have met previously from observing many of his surgeries in previous weeks. We were able to see a lot of cool cases and a minor surgery in the ward, which is really unusual on dryas besides Tuesdays and Thursdays. One 5 year old girl had burned 30% of her body from her face to her neck, shoulders, arms, and abdomen. The top layer of skin was still attached in places, which looked like dampened tissue paper. Her eyelids were red and a yellow liquid/oozed from under them. The doctors needed to put in an IV to rehydrate the girl, however, they could not find a vein due to the burns, so that had to do a "cut down"... surgically finding a vein in her ankle and inserting the IV there. This took a while, and instead of moving her to the surgical theater, they did the operation in the ward because the girl was in too fragile a condition to be moved. Of course this is completely unsanitary except for the instruments the doctors used, but they had no other choice.
The rest of the time was spent just doing rounds and brief lectures by Dr. Ombati... he was also the one who performed the cut down, so that was really cool to see. For the rest of the day we played volleyball and I hiked up to the big rock with everyone for the last time.
Shopping with Akiba
6/22/14
This morning I woke up super early to go with Akiba (our cook) and two friends to the market to get food. It took us in total about 5 hours to do all the shopping and on average, he spends 2 million Tanzanian shillings a week (~$1300). No words can really describe the chaos of the shopping we did. We went to countless little shops and open air markets getting fruits, vegetables, meat, fish, and processed food. Each is found in a different store, so we went to probably 10 different places and piled the food we bought in front of several of the stores and picked it up in the end. We took a small truck back to the house, filling the back completely with the food and water we bought and squeezing in with it for the drive through town and back to the house.
The rest of the day we relaxed, played a lot of volleyball in the yard, and helped the newbies settle in. All of my roommates left, so I have 3 new ones. Beside that, nothing else really happened... before and after dinner we spent hours playing card games and then all went to bed early in preparation for our new placements tomorrow.
This morning I woke up super early to go with Akiba (our cook) and two friends to the market to get food. It took us in total about 5 hours to do all the shopping and on average, he spends 2 million Tanzanian shillings a week (~$1300). No words can really describe the chaos of the shopping we did. We went to countless little shops and open air markets getting fruits, vegetables, meat, fish, and processed food. Each is found in a different store, so we went to probably 10 different places and piled the food we bought in front of several of the stores and picked it up in the end. We took a small truck back to the house, filling the back completely with the food and water we bought and squeezing in with it for the drive through town and back to the house.
The rest of the day we relaxed, played a lot of volleyball in the yard, and helped the newbies settle in. All of my roommates left, so I have 3 new ones. Beside that, nothing else really happened... before and after dinner we spent hours playing card games and then all went to bed early in preparation for our new placements tomorrow.
African Pageants
6/21/14
Not much went on on Friday, since I was sick, so I didn't end up going to the hospital and therefore I'm including the events of that day in Saturday's update. In the evening I felt much better and ended up going to see Miss Iringa... pretty much like Miss America, but in Africa. It was entertaining to say the least.
Today, I got up around 10 and went to the hospital for 3 hours. There wasn't too much going on, but we saw a man who's bowels were moving into his scrotum and they had to surgically correct that and separate the two. Another surgery was of a woman who had 3rd stage hemorrhoids and also needed surgery... it did not looking comfortable in the least. There were also some natural births and I weighed a baby, but nothing exciting or new.
After picking up quilts at the Masai Market in town, we went back to the house and rested for the remainder of the day. Most people had gone on safari or left (like last week) so the house was really quiet... a nice change. In the evening a bunch of us went to Shooters and watched most of the Germany v. Ghana World Cup game... Shooters is definitely becoming the hangout place on the weekends.
Not much went on on Friday, since I was sick, so I didn't end up going to the hospital and therefore I'm including the events of that day in Saturday's update. In the evening I felt much better and ended up going to see Miss Iringa... pretty much like Miss America, but in Africa. It was entertaining to say the least.
Today, I got up around 10 and went to the hospital for 3 hours. There wasn't too much going on, but we saw a man who's bowels were moving into his scrotum and they had to surgically correct that and separate the two. Another surgery was of a woman who had 3rd stage hemorrhoids and also needed surgery... it did not looking comfortable in the least. There were also some natural births and I weighed a baby, but nothing exciting or new.
After picking up quilts at the Masai Market in town, we went back to the house and rested for the remainder of the day. Most people had gone on safari or left (like last week) so the house was really quiet... a nice change. In the evening a bunch of us went to Shooters and watched most of the Germany v. Ghana World Cup game... Shooters is definitely becoming the hangout place on the weekends.
Surgery Junkie
6/19/14
Today was by far one of the best I've had at the hospital so far. In peds, we did the normal rounds and then saw walk-in patients because it was a clinic day. One boy what was 1 year and 7 months had hydrocephalus, meaning there was a build up of cerebrospinal fluid in his head, causing it to swell to a circumference of 51cm. Previously, I had only verse seen pictures of this condition, so it was amazing to see it in real life.
Right after pediatrics, we went straight to OB and watched a C-section. Despite the efforts of the nurses after the delivery, the baby didn't make it. Seeing 2 deaths in 2 days is pretty tough, but it helped that there were other healthy babies in the ward. After the C-section we went to surgery and watched Dr. Ombati drain pus from the arm of a women who we had seen previously (she had had pus drained from leg and breast a couple days before). We found out that the reason she was developing so many abscesses was because she had HIV.
The next surgery was an exploratory abdominal surgery really similar to the one I watched on Saturday. In this case however, the man had gangrene in his rectum and Dr. Rahib had to reroute his intestine through a hole in the side of his stomach. They left the dead tissue inside for observation, but the man would have to have his intestine protruding out his side for the rest of his life (he was 70).
Another surgery was on another elderly man who had a mass of fat in his upper right thigh. The surgery was pretty quick and only took about 15 minutes, resulting in a clean removal of fat the size of a baseball. It was a pretty cool surgery.
Finally, I watched the end of the removal of an external fixate in a man's leg and then Dr. Ombati put on a back slab. Due to poor handwriting and pronunciation, I have realized that it is not in fact "back stab" like we all thought, but rather "back slab"... important correction.
After the surgeries were over everyone left and I stayed in OB to see if there was anything going on. I weighed two babies, cut umbilical cords, and delivered a baby... pretty successful afternoon. I also observed a C-section of a disabled woman. She was very small (I don't really know the appropriate term, but she was a midget for lack of a better word), her head sunk into her shoulders, and the bones in her legs were curved and bent at the knee so she couldn't walk. Because of her legs, the doctor had to make a vertical incision, running around her belly button, instead of a horizontal one. The delivery itself was pretty easy, but the baby was very small and didn't seem to have any muscle control at all (it's arms flopped everywhere). The baby also did not appear to be breathing, but the nurse took him away and I have no idea what happened after that. Based on what I saw, I don't think it ended well.
I ended up leaving the hospital at 5:45, exactly 10 hours after I arrived, so it was a really long day. It was definitely worth staying the extra time, though because the surgeries and C-sections were amazing. Definitely becoming a surgery junkie already.
Of course it was Thursday, meaning BBQ then Shooters, which was super fun... such a fantastic day.
Today was by far one of the best I've had at the hospital so far. In peds, we did the normal rounds and then saw walk-in patients because it was a clinic day. One boy what was 1 year and 7 months had hydrocephalus, meaning there was a build up of cerebrospinal fluid in his head, causing it to swell to a circumference of 51cm. Previously, I had only verse seen pictures of this condition, so it was amazing to see it in real life.
Right after pediatrics, we went straight to OB and watched a C-section. Despite the efforts of the nurses after the delivery, the baby didn't make it. Seeing 2 deaths in 2 days is pretty tough, but it helped that there were other healthy babies in the ward. After the C-section we went to surgery and watched Dr. Ombati drain pus from the arm of a women who we had seen previously (she had had pus drained from leg and breast a couple days before). We found out that the reason she was developing so many abscesses was because she had HIV.
The next surgery was an exploratory abdominal surgery really similar to the one I watched on Saturday. In this case however, the man had gangrene in his rectum and Dr. Rahib had to reroute his intestine through a hole in the side of his stomach. They left the dead tissue inside for observation, but the man would have to have his intestine protruding out his side for the rest of his life (he was 70).
Another surgery was on another elderly man who had a mass of fat in his upper right thigh. The surgery was pretty quick and only took about 15 minutes, resulting in a clean removal of fat the size of a baseball. It was a pretty cool surgery.
Finally, I watched the end of the removal of an external fixate in a man's leg and then Dr. Ombati put on a back slab. Due to poor handwriting and pronunciation, I have realized that it is not in fact "back stab" like we all thought, but rather "back slab"... important correction.
After the surgeries were over everyone left and I stayed in OB to see if there was anything going on. I weighed two babies, cut umbilical cords, and delivered a baby... pretty successful afternoon. I also observed a C-section of a disabled woman. She was very small (I don't really know the appropriate term, but she was a midget for lack of a better word), her head sunk into her shoulders, and the bones in her legs were curved and bent at the knee so she couldn't walk. Because of her legs, the doctor had to make a vertical incision, running around her belly button, instead of a horizontal one. The delivery itself was pretty easy, but the baby was very small and didn't seem to have any muscle control at all (it's arms flopped everywhere). The baby also did not appear to be breathing, but the nurse took him away and I have no idea what happened after that. Based on what I saw, I don't think it ended well.
I ended up leaving the hospital at 5:45, exactly 10 hours after I arrived, so it was a really long day. It was definitely worth staying the extra time, though because the surgeries and C-sections were amazing. Definitely becoming a surgery junkie already.
Of course it was Thursday, meaning BBQ then Shooters, which was super fun... such a fantastic day.
Wednesday, June 18, 2014
Seeing Everything
6/18/14
It was especially hard to get up this morning. On top of not getting enough sleep on Sunday and Monday night, I have gotten a sore throat and cough (probably TB), which is also wiping me out. We had the weekly hospital meeting, which involved a brief lecture on non-communicable diseases and how the hospital was adapting and expanding in order to better treat patients with these diseases. Then we did the regular rounds in pediatrics, and though we covered the other wing in the hospital, we only saw about 9 patients (so it went really quick) and most of the kids just had pneumonia or respiratory tract infections... nothing unusual or out of the ordinary like we had hoped.
In the afternoon, I went back to the hospital and wandered to OB and surgery and finally OPD because nothing was happening in the other two. Here I saw a boy get a "back stab" on his leg. This is pretty much a cast that doesn't go all the way around the leg, but stabilizes the joints so that the fracture can heal. The boy was about 4 or 5 and had a small fracture by his knee. It was also good to learn that a "back stab" isn't actually what it says because I had previously seen it written in the chart detailing the patient conditions and assumed there were a lot of back stabbings in Tanzania... good to know this is not the case. They next patient was driven up to OPD in a large car and wheeled in on a stretcher. The man looked to be in his late 50's and was very large in both height and weight. He wasn't moving when they put him on the stretcher, but I saw his eyes rolling back when they wheeled him to the minor surgery theater. I watched the doctor who had put on the little boy's cast come back into the room (he had been about to leave the hospital) and take the man's bp and pulse. After several tense minutes he spoke in Swahili to the nurse and 2 male relatives in the room and then turned to me and my friend and told us "dead body". I haven't really seen anyone die so far, besides the bodies in the morgue, so this was pretty eye-opening. The doctors said he was pretty much already gone by the time the man got there, though they didn't do anything to really help him... they just checked his vitals and accepted the fact that he was dead.
After that, I took it easy the rest of the day... seeing a man die was a pretty shocking experience.
It was especially hard to get up this morning. On top of not getting enough sleep on Sunday and Monday night, I have gotten a sore throat and cough (probably TB), which is also wiping me out. We had the weekly hospital meeting, which involved a brief lecture on non-communicable diseases and how the hospital was adapting and expanding in order to better treat patients with these diseases. Then we did the regular rounds in pediatrics, and though we covered the other wing in the hospital, we only saw about 9 patients (so it went really quick) and most of the kids just had pneumonia or respiratory tract infections... nothing unusual or out of the ordinary like we had hoped.
In the afternoon, I went back to the hospital and wandered to OB and surgery and finally OPD because nothing was happening in the other two. Here I saw a boy get a "back stab" on his leg. This is pretty much a cast that doesn't go all the way around the leg, but stabilizes the joints so that the fracture can heal. The boy was about 4 or 5 and had a small fracture by his knee. It was also good to learn that a "back stab" isn't actually what it says because I had previously seen it written in the chart detailing the patient conditions and assumed there were a lot of back stabbings in Tanzania... good to know this is not the case. They next patient was driven up to OPD in a large car and wheeled in on a stretcher. The man looked to be in his late 50's and was very large in both height and weight. He wasn't moving when they put him on the stretcher, but I saw his eyes rolling back when they wheeled him to the minor surgery theater. I watched the doctor who had put on the little boy's cast come back into the room (he had been about to leave the hospital) and take the man's bp and pulse. After several tense minutes he spoke in Swahili to the nurse and 2 male relatives in the room and then turned to me and my friend and told us "dead body". I haven't really seen anyone die so far, besides the bodies in the morgue, so this was pretty eye-opening. The doctors said he was pretty much already gone by the time the man got there, though they didn't do anything to really help him... they just checked his vitals and accepted the fact that he was dead.
After that, I took it easy the rest of the day... seeing a man die was a pretty shocking experience.
CP and Seizures
6/17/14
In pediatrics this morning we had morning meeting and then waited around for a bit for Dr. Isaac to show up. Luckily he wasn't as late as yesterday. One girl we saw (named Mesi) was 2.5 years old and was diagnosed with cerebral palsy and showed symptoms of seizures, fever, fast pulse (189bpm), and when the doctors examined her she had a reduced level of consciousness since yesterday... thought it was really hard to compare because she was pretty much unresponsive both days. On top of this, they suspected she had meningitis, so they were going to do a lumbar puncture. Another girl nearby was also having seizures, which they suspected were caused by epilepsy, but hadn't pinpointed the cause. She was being treated with anti-seizure medication to prevent further brain damage.
After, we went to the malnutrition room and got a lecture from Dr. Isaac about malnutrition and other common health complications found in children and how to treat them.
In the afternoon we went down to the field where we played soccer and set up the volleyball net we have at the house. Around the soccer field there is also a track, so after we finished playing 5 games (which was way too much), my friend and I ran some laps and while she was finishing up I made friends with one of the guys who was hanging out there (lots of people come to play soccer and hang out, so by the time we left it was really busy). The night was pretty low key... I was so exhausted from the day that I ended up crashing around 9pm.
In pediatrics this morning we had morning meeting and then waited around for a bit for Dr. Isaac to show up. Luckily he wasn't as late as yesterday. One girl we saw (named Mesi) was 2.5 years old and was diagnosed with cerebral palsy and showed symptoms of seizures, fever, fast pulse (189bpm), and when the doctors examined her she had a reduced level of consciousness since yesterday... thought it was really hard to compare because she was pretty much unresponsive both days. On top of this, they suspected she had meningitis, so they were going to do a lumbar puncture. Another girl nearby was also having seizures, which they suspected were caused by epilepsy, but hadn't pinpointed the cause. She was being treated with anti-seizure medication to prevent further brain damage.
After, we went to the malnutrition room and got a lecture from Dr. Isaac about malnutrition and other common health complications found in children and how to treat them.
In the afternoon we went down to the field where we played soccer and set up the volleyball net we have at the house. Around the soccer field there is also a track, so after we finished playing 5 games (which was way too much), my friend and I ran some laps and while she was finishing up I made friends with one of the guys who was hanging out there (lots of people come to play soccer and hang out, so by the time we left it was really busy). The night was pretty low key... I was so exhausted from the day that I ended up crashing around 9pm.
Pediatrics with Dr. Isaac
6/16/14
Today got off to a slow start, as it was my first day in pediatrics and after getting to the hospital at 7:45am, our doctor, Dr. Isaac showed up a little before 10 (we had to do a bunch of waiting around, but we did follow the nurse for a while). The joke in Tanzania is that everyone is on African time, meaning that they are always late. Once someone is 45 or more minutes late, this is no longer African time and something is actually wrong, but anything less is African time. We always use the excuse T.I.A. (this in Africa) for short. In this case, Dr. Isaac was definitely not on African time, he was just really late. Pediatrics was really interesting though, it was just like internal med but with babies and children, which makes things a bit more interesting. We did rounds until 1pm and then left for the day.
Just before sunset, we hiked up to the rock that overlooks the city (the same one we climbed on the first Monday) and sat at the top and talked and took photos. After dinner I went on night shift with 6 other people. To save money, we all took one taxi, which should technically only fit 4 people... but we put 2 in the front and 5 in the back. Dr. Lyapa was the on-call doctor in OB and we walked around and he lectured us on the different conditions of the women and what stage of pregnancy they were at. I got to do one of the pelvic examinations and feel the baby's head through the cervix. I could fit in 2 fingers and spread them apart a little, so by that point the women was 5cm. We watched a really fast/easy natural birth around 9:30 and then Dr. Lyapa told us he would do 2 C-sections after he got back from dinner. Naturally, we all wanted to watch so we stayed around for a while, but it turns out that TIA applies to night shifts as well and he came back at midnight as we were leaving (he had also told us one of the C-sections would be done by that time). Around 11:30, the nurses started delivering a baby who was supposed to be born by C-section, but Dr. Lyapa wasn't around to do one. The nurse had to cut the woman's vagina so the baby could fit through and it took nearly 15 minutes of pushing before they were finally about to get the baby out. There were moments when it was pretty stressful, but in the end, the mother and the baby were fine.
Today got off to a slow start, as it was my first day in pediatrics and after getting to the hospital at 7:45am, our doctor, Dr. Isaac showed up a little before 10 (we had to do a bunch of waiting around, but we did follow the nurse for a while). The joke in Tanzania is that everyone is on African time, meaning that they are always late. Once someone is 45 or more minutes late, this is no longer African time and something is actually wrong, but anything less is African time. We always use the excuse T.I.A. (this in Africa) for short. In this case, Dr. Isaac was definitely not on African time, he was just really late. Pediatrics was really interesting though, it was just like internal med but with babies and children, which makes things a bit more interesting. We did rounds until 1pm and then left for the day.
Just before sunset, we hiked up to the rock that overlooks the city (the same one we climbed on the first Monday) and sat at the top and talked and took photos. After dinner I went on night shift with 6 other people. To save money, we all took one taxi, which should technically only fit 4 people... but we put 2 in the front and 5 in the back. Dr. Lyapa was the on-call doctor in OB and we walked around and he lectured us on the different conditions of the women and what stage of pregnancy they were at. I got to do one of the pelvic examinations and feel the baby's head through the cervix. I could fit in 2 fingers and spread them apart a little, so by that point the women was 5cm. We watched a really fast/easy natural birth around 9:30 and then Dr. Lyapa told us he would do 2 C-sections after he got back from dinner. Naturally, we all wanted to watch so we stayed around for a while, but it turns out that TIA applies to night shifts as well and he came back at midnight as we were leaving (he had also told us one of the C-sections would be done by that time). Around 11:30, the nurses started delivering a baby who was supposed to be born by C-section, but Dr. Lyapa wasn't around to do one. The nurse had to cut the woman's vagina so the baby could fit through and it took nearly 15 minutes of pushing before they were finally about to get the baby out. There were moments when it was pretty stressful, but in the end, the mother and the baby were fine.
Time for More Updates
6/15/14
Hoping to see as much action as we did yesterday, a bunch of us got to the hospital by 11am, but it was completely dead. We ended up wandering around town doing some shopping, and then went out to lunch on our way back to the house.
For the rest of the day, I read and lay on the deck... so pretty much did nothing. The newbies came around 6pm and they seem like a nice group.
The only interesting part of my day came when I went on night shift with one other girl. There were supposed to be 2 C-sections, and the nurses said they just had to consult the doctors, but after waiting an hour, we realized this wasn't going to happen. However, when we wandered into surgery there was an emergency surgery starting on a man who had been involved in a road traffic accident and had a huge gash on the top of his right foot. From the X-ray, only a small piece of bone appeared to be chipped from the ankle, but when the man came in and Dr. Ombati unwrapped his foot and began cleaning it, it was clear that most of the tendons had been severed and though no other bones were broken, there was a huge hole in the man's foot when the doctor bent it forward. We only stayed for a short time, but it was an exciting end to a pretty uneventful day.
Hoping to see as much action as we did yesterday, a bunch of us got to the hospital by 11am, but it was completely dead. We ended up wandering around town doing some shopping, and then went out to lunch on our way back to the house.
For the rest of the day, I read and lay on the deck... so pretty much did nothing. The newbies came around 6pm and they seem like a nice group.
The only interesting part of my day came when I went on night shift with one other girl. There were supposed to be 2 C-sections, and the nurses said they just had to consult the doctors, but after waiting an hour, we realized this wasn't going to happen. However, when we wandered into surgery there was an emergency surgery starting on a man who had been involved in a road traffic accident and had a huge gash on the top of his right foot. From the X-ray, only a small piece of bone appeared to be chipped from the ankle, but when the man came in and Dr. Ombati unwrapped his foot and began cleaning it, it was clear that most of the tendons had been severed and though no other bones were broken, there was a huge hole in the man's foot when the doctor bent it forward. We only stayed for a short time, but it was an exciting end to a pretty uneventful day.
Sunday, June 15, 2014
Surgery Doesn't Stop on Weekends
6/14/14
Most everyone left early this morning for the trip back to Dar or on Safari. I had an easy morning, making pancakes with some friends, doing laundry, and lounging in the deck.
In the afternoon, I went to the hospital, and though there were no C-sections happening, surgery was extremely busy. I first watched the end of a basic hernia surgery, which wasn't too extraordinary, but then after watched surgeons drain abscesses from a women's left leg and right breast. They literally cut into her legs and drained her legs of milky white puss that filled tray after tray... there was so much fluid, it was disgusting. The surgeon followed the same procedure for her breast. Must say, I was not expecting to see abscesses that large... they drained about 3+ liters of liquid which was the color and consistency of milk.
Right when we all thought the day couldn't get any better, there was an emergency exploratory abdominal surgery that was done by Dr. Rahib (the doctor who had done the abscess surgery as well... it was a busy day for him). A 33 year old man was brought into the operating room on a stretcher and he was vomiting greenish/yellow liquid through a tube in his nose and into the attached bag. His stomach was severely distended and when Dr. Rahib cut into him, more of the green liquid pored from him and onto the floor. There was so much that it got all over the doctors and nurses and covered the floor (we quickly learned that the green fluid was vegetables and other food that had been digested in the stomach and leaked into the abdomen, causing it to swell. For the next 2 hours, Dr. Rahib cleaned the abdominal cavity with saline solution and meticulously scraped the intestines of a brownish skin coating that had resulted from inflammation. While cleaning the intestines, he found a hole in one area, which was causing the man's food to leak into the abdominal cavity. They cut around the hole to clean it up a bit and then sutured it closed. Meanwhile, the man's bladder was extremely full because of all the IV fluid and when they tried, they could not insert a catheter because his penis had undergone trauma. As a result, Dr. Rahib was forced to surgically insert the catheter into the man's bladder, with the tube and bag coming out near the belly button. Then they sutured up the abdomen, though not completely (just the muscle and not the skin) in case of infection and to be able to easily remove the catheter in a couple days. By the end, the surgery took almost 3 hours, and was by far one of the most interesting procedures I have seen thus far.
By the time we left the hospital, it was about 6pm, so we walked to the Masai Market so one of my friends could pick up her pants that were being made and then to Warthogs's where we got some pizzas (I went with the typical onion, pepper, sweet corn, and pineapple... such a weird combination, but nothing gets much better). We got back to the house just before sunset and then made some chocolate cake from a mix (turns out they have Pillsbury in Tanzania) before calling it a night. Definitely a pretty perfect day.
Most everyone left early this morning for the trip back to Dar or on Safari. I had an easy morning, making pancakes with some friends, doing laundry, and lounging in the deck.
In the afternoon, I went to the hospital, and though there were no C-sections happening, surgery was extremely busy. I first watched the end of a basic hernia surgery, which wasn't too extraordinary, but then after watched surgeons drain abscesses from a women's left leg and right breast. They literally cut into her legs and drained her legs of milky white puss that filled tray after tray... there was so much fluid, it was disgusting. The surgeon followed the same procedure for her breast. Must say, I was not expecting to see abscesses that large... they drained about 3+ liters of liquid which was the color and consistency of milk.
Right when we all thought the day couldn't get any better, there was an emergency exploratory abdominal surgery that was done by Dr. Rahib (the doctor who had done the abscess surgery as well... it was a busy day for him). A 33 year old man was brought into the operating room on a stretcher and he was vomiting greenish/yellow liquid through a tube in his nose and into the attached bag. His stomach was severely distended and when Dr. Rahib cut into him, more of the green liquid pored from him and onto the floor. There was so much that it got all over the doctors and nurses and covered the floor (we quickly learned that the green fluid was vegetables and other food that had been digested in the stomach and leaked into the abdomen, causing it to swell. For the next 2 hours, Dr. Rahib cleaned the abdominal cavity with saline solution and meticulously scraped the intestines of a brownish skin coating that had resulted from inflammation. While cleaning the intestines, he found a hole in one area, which was causing the man's food to leak into the abdominal cavity. They cut around the hole to clean it up a bit and then sutured it closed. Meanwhile, the man's bladder was extremely full because of all the IV fluid and when they tried, they could not insert a catheter because his penis had undergone trauma. As a result, Dr. Rahib was forced to surgically insert the catheter into the man's bladder, with the tube and bag coming out near the belly button. Then they sutured up the abdomen, though not completely (just the muscle and not the skin) in case of infection and to be able to easily remove the catheter in a couple days. By the end, the surgery took almost 3 hours, and was by far one of the most interesting procedures I have seen thus far.
By the time we left the hospital, it was about 6pm, so we walked to the Masai Market so one of my friends could pick up her pants that were being made and then to Warthogs's where we got some pizzas (I went with the typical onion, pepper, sweet corn, and pineapple... such a weird combination, but nothing gets much better). We got back to the house just before sunset and then made some chocolate cake from a mix (turns out they have Pillsbury in Tanzania) before calling it a night. Definitely a pretty perfect day.
The Real Deal
This is a photo of the toilets in Tanzania... there are very few modern toilets, but luckily we have them at the house.
Saturday, June 14, 2014
Last Day of Internal Medicine
6/13/14
Today was my last day in internal medicine and tomorrow many of ex people I first arrived with are leaving. When the new group comes on Sunday, I, along with a small group of others will have been in Iringa the longest out of all the other people at the house.
This morning we did rounds interspersed with small lectures on anemia and diabetes. We also spent a lot of time talking to Dr. Charles about our interests and lives back in America and England.
In the evening, a group of us walked to a restaurant called Tandoori Oven and had dinner. Since there was about an hour wait while they cooked, the owners let us go to the bar next door and watch the World Cup on their huge TV... it definitely did not feel like Tanzania there. In the bar there were large leather chairs and I have no idea how they got a TV like that into Africa... it was very Americanized. We finally got our food, which was a little bland, but after waiting so long, it was great at the time.
Today was my last day in internal medicine and tomorrow many of ex people I first arrived with are leaving. When the new group comes on Sunday, I, along with a small group of others will have been in Iringa the longest out of all the other people at the house.
This morning we did rounds interspersed with small lectures on anemia and diabetes. We also spent a lot of time talking to Dr. Charles about our interests and lives back in America and England.
In the evening, a group of us walked to a restaurant called Tandoori Oven and had dinner. Since there was about an hour wait while they cooked, the owners let us go to the bar next door and watch the World Cup on their huge TV... it definitely did not feel like Tanzania there. In the bar there were large leather chairs and I have no idea how they got a TV like that into Africa... it was very Americanized. We finally got our food, which was a little bland, but after waiting so long, it was great at the time.
Surgery and Shooters
6/12/14
This morning rounds were relatively uninteresting... the 3 other girls and I in in the internal medicine ward, now know the patients and each of their cases relatively well, so doing rounds for 3 hrs each day on a small group of the same patients can get really repetitive.
Since it was Thursday, though, it was another surgery day, so I spent the afternoon in surgery. In one of the operating rooms there was an 8 year old boy who had fallen into a pit of hot ashes and burned most of the skin off his lower legs and knees. There were some places you could see the bone, and his legs were extremely raw even though the doctors had already been doing skin grafts for about 6 months. They had been using his thighs for the skin grafts and attaching the grafts to his knees where skin was slowly starting to scab and grow. The doctors were supposed to do another graft today, but the boy had developed an infection and they were washing his legs with a strong antiseptic that made them bleed profusely, and then carefully wrapped them back up. Since he is so small, the skin grafting is going to be a slight problem because they have already taken almost all the skin they can from his thighs and aware going to have to move to his butt and back. This was a really gruesome procedure, but by far one of the most interesting things I have seen thus far.
We got back to the house in time for our last global health lecture, then we had our weekly BBQ around the 2 fire pits outside, and around 9, a group of us went to a local bar/club called Shooters. This was actually a lot more fun. Than I anticipated and we were also able to watch the majority of the Brasil/Croatia World Cup game before going back to the house.
This morning rounds were relatively uninteresting... the 3 other girls and I in in the internal medicine ward, now know the patients and each of their cases relatively well, so doing rounds for 3 hrs each day on a small group of the same patients can get really repetitive.
Since it was Thursday, though, it was another surgery day, so I spent the afternoon in surgery. In one of the operating rooms there was an 8 year old boy who had fallen into a pit of hot ashes and burned most of the skin off his lower legs and knees. There were some places you could see the bone, and his legs were extremely raw even though the doctors had already been doing skin grafts for about 6 months. They had been using his thighs for the skin grafts and attaching the grafts to his knees where skin was slowly starting to scab and grow. The doctors were supposed to do another graft today, but the boy had developed an infection and they were washing his legs with a strong antiseptic that made them bleed profusely, and then carefully wrapped them back up. Since he is so small, the skin grafting is going to be a slight problem because they have already taken almost all the skin they can from his thighs and aware going to have to move to his butt and back. This was a really gruesome procedure, but by far one of the most interesting things I have seen thus far.
We got back to the house in time for our last global health lecture, then we had our weekly BBQ around the 2 fire pits outside, and around 9, a group of us went to a local bar/club called Shooters. This was actually a lot more fun. Than I anticipated and we were also able to watch the majority of the Brasil/Croatia World Cup game before going back to the house.
Friday, June 13, 2014
IDS
6/11/14
I'm feeling bad about taking it easy today, but after such a busy day yesterday, it was definitely needed. Like yesterday, we spent an hour in the morning in the male ward with Dr. Tatu (though instead of lecturing us, they needed her to do rounds, so we did rounds with her). Then we went to the female ward and did rounds with Dr. Charles until 12pm. The rounds are interesting for about half an hour to an hour, but after that, they get really repetitive and tiring, so after 4 hours we were very done.
We saw one 22 year old woman today who was expected to die within the next 2 days so her family was taking her home. She had no muscle control and her head kept rolling back as they took her out in the wheelchair. She looked as if she had a mental disability... it would have been interesting to have seen her before she became so sick. The patient had IDS (HIV), anemia, cryptococcal meningitis, and liver failure along with symptoms including difficulty breathing, fever, and body rashes... not a good combination. It was really hard to see her in the ward at so advanced a stage... Dr. Charles told us that they console the patients by telling them that whatever happens will be God's wish.
For the rest of the afternoon, I went back to the house, made lunch, napped, read, went to the global health lecture on accident and emergency medicine (which unfortunately was not well presented and I didn't learn anything new), had dinner, and went to bed. Pretty mellow/not exciting day, but tomorrow will be packed and more than make up for it.
I'm feeling bad about taking it easy today, but after such a busy day yesterday, it was definitely needed. Like yesterday, we spent an hour in the morning in the male ward with Dr. Tatu (though instead of lecturing us, they needed her to do rounds, so we did rounds with her). Then we went to the female ward and did rounds with Dr. Charles until 12pm. The rounds are interesting for about half an hour to an hour, but after that, they get really repetitive and tiring, so after 4 hours we were very done.
We saw one 22 year old woman today who was expected to die within the next 2 days so her family was taking her home. She had no muscle control and her head kept rolling back as they took her out in the wheelchair. She looked as if she had a mental disability... it would have been interesting to have seen her before she became so sick. The patient had IDS (HIV), anemia, cryptococcal meningitis, and liver failure along with symptoms including difficulty breathing, fever, and body rashes... not a good combination. It was really hard to see her in the ward at so advanced a stage... Dr. Charles told us that they console the patients by telling them that whatever happens will be God's wish.
For the rest of the afternoon, I went back to the house, made lunch, napped, read, went to the global health lecture on accident and emergency medicine (which unfortunately was not well presented and I didn't learn anything new), had dinner, and went to bed. Pretty mellow/not exciting day, but tomorrow will be packed and more than make up for it.
Thursday, June 12, 2014
Wednesday, June 11, 2014
First Surgery Day
6/10/14
Today was by far one of the longest/busiest days at the hospital so far. In the morning we had an hour lecture on how doctors go about diagnosing patients and how to present a case. After this, we went with Dr. Charles to the TB ward and discussed patient cases and were lectured on the 7 main opportunistic infections (which are commonly present in HIV patients). Most of the doctors are really casual and not concerned about contracting TB themselves because it is not infections after the patients have undergone treatment for several days (just a note for any paranoid readers). Then, Dr. Charles brought us to the morgue and we saw 3 bodies in the freezer... there were surprisingly few because most families bring patients home when they are malbound (nearing death) since it is cheaper... plus the morgue is more commonly used in the case where cause of death is unknown.
In the afternoon, we got out of internal medicine and walked over to the surgery building (which is very small and only has maybe 3 operating rooms) where we saw a huge femur fracture surgery. The man had been in a motorcycle accident and the X-Ray showed a really bad break that needed serious realignment of the bone. After taking plenty of photos and videos and observing the surgery, we watched a catheter replacement surgery since the first one was not done correctly and leaking urine into the abdomen. The doctors who originally inserted it really screwed up.
By the time I got back to the house it was 4pm and at 6, we all had a global health lecture on HIV/aids, presented by Dr. Tatu. After dinner I went on the night shift with 5 others and watched a C-section. There were 4 other babies that had been born earlier in the day that were lying under the heating lamp and another 4.9kg baby who was in a cart because there was no room for him (he was massive... in the record book they literally wrote "big baby"). After this my friends and I were seriously worn out after working such a long day... tomorrow I plan on taking it much easier).
Today was by far one of the longest/busiest days at the hospital so far. In the morning we had an hour lecture on how doctors go about diagnosing patients and how to present a case. After this, we went with Dr. Charles to the TB ward and discussed patient cases and were lectured on the 7 main opportunistic infections (which are commonly present in HIV patients). Most of the doctors are really casual and not concerned about contracting TB themselves because it is not infections after the patients have undergone treatment for several days (just a note for any paranoid readers). Then, Dr. Charles brought us to the morgue and we saw 3 bodies in the freezer... there were surprisingly few because most families bring patients home when they are malbound (nearing death) since it is cheaper... plus the morgue is more commonly used in the case where cause of death is unknown.
In the afternoon, we got out of internal medicine and walked over to the surgery building (which is very small and only has maybe 3 operating rooms) where we saw a huge femur fracture surgery. The man had been in a motorcycle accident and the X-Ray showed a really bad break that needed serious realignment of the bone. After taking plenty of photos and videos and observing the surgery, we watched a catheter replacement surgery since the first one was not done correctly and leaking urine into the abdomen. The doctors who originally inserted it really screwed up.
By the time I got back to the house it was 4pm and at 6, we all had a global health lecture on HIV/aids, presented by Dr. Tatu. After dinner I went on the night shift with 5 others and watched a C-section. There were 4 other babies that had been born earlier in the day that were lying under the heating lamp and another 4.9kg baby who was in a cart because there was no room for him (he was massive... in the record book they literally wrote "big baby"). After this my friends and I were seriously worn out after working such a long day... tomorrow I plan on taking it much easier).
Tuesday, June 10, 2014
Internal Medicine
6/9/14
Since I have been asked about the food, I will detail a typical breakfast we have at the house. There is always porridge, a type of egg (scrambled, etc.), either pancakes, French toast, or Tanzanian donuts (pretty much large plain donut holes), toast with jam, butter, and Nutella (a staple here), and pineapple, watermelon, and papaya or mango. Today we had pancakes, which are much more like creeps, and usually everyone has Nutella with theirs... we went through 2 jars this morning.
Today was also my first day in the Internal Medicine Department with Dr. Tatu and Dr. Aisha. The students who had just arrived did rebounds with Dr. Tatu in the female part of the department while I went with the other students (who had been here a week or longer) with Dr. Aisha in the male department.
One case we saw was a 73 year old man who had been admitted because he was unconscious and initially had a bp of 210/160. The doctors determined that he had a stroke due to severe hypertension and were going to do a CT scan to determine the type of stroke. When we took the patient's blood pressure during rounds, it was 260/120... with a bp that high, it was amazing he was still alive.
Another 28 year old man we saw had been in a coma for 3 days and hade HIV, malaria, pneumonia, and meningitis. It's interesting because when a patient is HIV positive, the doctors never use that term... instead they say the person is PITC positive, which is the name of the HIV test.
For lunch we went to a cafe in the town called Warthog's. For all you foodies (Mama especially) I got a pizza with sweet corn, pineapple, green peppers, onions, and mushrooms... sooooo amazing. I will definitely have to go back again soon. The group I had lunch with then went to the Masai market, which is practically right next to Warthogs, down a broad alley. Everyone bought African pants from a women who makes them there... we pick the fabric and she measures us and has our pants finished by the next day... super impressive.
The rest of the afternoon was quiet. I read up on the deck while the new students took the weekly hike up to the rock above the house. We then had dinner and the dance group came to put on a show for everyone, but I am calling it an early night tonight, since it is surgery day tomorrow (the major procedures are scheduled for Tuesday/Thursday afternoons) and I have another night shift... definitely in need of some sleep.
Since I have been asked about the food, I will detail a typical breakfast we have at the house. There is always porridge, a type of egg (scrambled, etc.), either pancakes, French toast, or Tanzanian donuts (pretty much large plain donut holes), toast with jam, butter, and Nutella (a staple here), and pineapple, watermelon, and papaya or mango. Today we had pancakes, which are much more like creeps, and usually everyone has Nutella with theirs... we went through 2 jars this morning.
Today was also my first day in the Internal Medicine Department with Dr. Tatu and Dr. Aisha. The students who had just arrived did rebounds with Dr. Tatu in the female part of the department while I went with the other students (who had been here a week or longer) with Dr. Aisha in the male department.
One case we saw was a 73 year old man who had been admitted because he was unconscious and initially had a bp of 210/160. The doctors determined that he had a stroke due to severe hypertension and were going to do a CT scan to determine the type of stroke. When we took the patient's blood pressure during rounds, it was 260/120... with a bp that high, it was amazing he was still alive.
Another 28 year old man we saw had been in a coma for 3 days and hade HIV, malaria, pneumonia, and meningitis. It's interesting because when a patient is HIV positive, the doctors never use that term... instead they say the person is PITC positive, which is the name of the HIV test.
For lunch we went to a cafe in the town called Warthog's. For all you foodies (Mama especially) I got a pizza with sweet corn, pineapple, green peppers, onions, and mushrooms... sooooo amazing. I will definitely have to go back again soon. The group I had lunch with then went to the Masai market, which is practically right next to Warthogs, down a broad alley. Everyone bought African pants from a women who makes them there... we pick the fabric and she measures us and has our pants finished by the next day... super impressive.
The rest of the afternoon was quiet. I read up on the deck while the new students took the weekly hike up to the rock above the house. We then had dinner and the dance group came to put on a show for everyone, but I am calling it an early night tonight, since it is surgery day tomorrow (the major procedures are scheduled for Tuesday/Thursday afternoons) and I have another night shift... definitely in need of some sleep.
Relaxing Day
6/8/14
Sorry in advance for the late posting... turns out Tanzanian internet is not so reliable and with all the new students who have come, the wifi is super slow.
Nothing much happened today, most of the first week students were still on the weekend safari, so there were few people at the house. This gave me the perfect opportunity to wash my dusty safari clothes, as well as the other ones I had been wearing. The washing area is outside at the back of all the houses. It consists of a cement wall about waist-high with two faucets sticking out above and large, round, plastic buckets in which we wash out clothes. After we finishing washing, we dump the water out on the ground and it drains through a pipe (and just washes down the hill away from the houses), and then the laundry is hung on a long line. I am definitely experiencing every aspect of African life on this trip.
Around 5pm, 23 new students came by bus and we helped them settle in and bring in their suitcases. Since my two roommates left, I had the room to myself on Saturday night and last night, had three new roommates who are all very sweet. While the newbies had their orientation, the rest of us played volleyball right outside the main house.
For dinner, our cook, Akiba, made omelets with chips (omelets with French fries cooked it... yeah, weird for me too), confetti rice, beef stew, fresh salad (which is tomatoes, green peppers, onions, and cucumbers), peas/lentils in a type of coconut sauce (though it doesn't taste much like coconut, but still very good), mashed purple yams, and one other dish that I don't remember... it may have been something with fish.
I also did a night shift at the hospital with about 6 other students, but not much was happening and we had to wait an hour before seeing a natural birth. We left after, because by that time it was late and nothing else was going to happen.
Sorry in advance for the late posting... turns out Tanzanian internet is not so reliable and with all the new students who have come, the wifi is super slow.
Nothing much happened today, most of the first week students were still on the weekend safari, so there were few people at the house. This gave me the perfect opportunity to wash my dusty safari clothes, as well as the other ones I had been wearing. The washing area is outside at the back of all the houses. It consists of a cement wall about waist-high with two faucets sticking out above and large, round, plastic buckets in which we wash out clothes. After we finishing washing, we dump the water out on the ground and it drains through a pipe (and just washes down the hill away from the houses), and then the laundry is hung on a long line. I am definitely experiencing every aspect of African life on this trip.
Around 5pm, 23 new students came by bus and we helped them settle in and bring in their suitcases. Since my two roommates left, I had the room to myself on Saturday night and last night, had three new roommates who are all very sweet. While the newbies had their orientation, the rest of us played volleyball right outside the main house.
For dinner, our cook, Akiba, made omelets with chips (omelets with French fries cooked it... yeah, weird for me too), confetti rice, beef stew, fresh salad (which is tomatoes, green peppers, onions, and cucumbers), peas/lentils in a type of coconut sauce (though it doesn't taste much like coconut, but still very good), mashed purple yams, and one other dish that I don't remember... it may have been something with fish.
I also did a night shift at the hospital with about 6 other students, but not much was happening and we had to wait an hour before seeing a natural birth. We left after, because by that time it was late and nothing else was going to happen.
Sunday, June 8, 2014
Safari
6/7/14
This morning, I woke at 5 to go on a day safari with 3 other people who had not signed up for the full weekend safari (which all the other people we had arrived with on Sunday had decided to go on). The drive took 2.5 hours to get to Ruaha National Park, which is about 20,000 square kilometers. We drove around in the safari car from 9 until about 4:30pm, stopping along the way to take photos of giraffes, elephants, warthogs, zebras, lions, and plenty of other animals. It was amazing how big the park was, as well as how much dust we all got covered in (my clothes were so dirty by the time we got back to the house).
Most of the good photos won't be posted until I get back because they were taken on my camera, but some came out ok on my phone. Looking forward to a relaxing day tomorrow where I don't need to be anywhere or do anything, but I will probably end up doing a night shift at the hospital anyway.
This morning, I woke at 5 to go on a day safari with 3 other people who had not signed up for the full weekend safari (which all the other people we had arrived with on Sunday had decided to go on). The drive took 2.5 hours to get to Ruaha National Park, which is about 20,000 square kilometers. We drove around in the safari car from 9 until about 4:30pm, stopping along the way to take photos of giraffes, elephants, warthogs, zebras, lions, and plenty of other animals. It was amazing how big the park was, as well as how much dust we all got covered in (my clothes were so dirty by the time we got back to the house).
Most of the good photos won't be posted until I get back because they were taken on my camera, but some came out ok on my phone. Looking forward to a relaxing day tomorrow where I don't need to be anywhere or do anything, but I will probably end up doing a night shift at the hospital anyway.
Saturday, June 7, 2014
Last Day in OPD
6/6/14
For our last day, Dr. Lyapa took us to the room within OPD where they do circumcisions. We of course helped with the patients for several hours and then watched the circumcision of at a 28 year old male. The forceps procedure was relatively simple and straightforward, though it was initially very painful for the man before the local anesthesia was put in (obviously). My friend and I were able to make it through most of the procedure before feeling faint and having to sit down. Surprisingly, the wound only takes about 1-2 weeks to heal, which is much faster than anticipated.
I also asked Dr. Lyapa about drug resistance because so many antibiotics are frequently prescribed to patients. Many patients and also misdiagnosed or given antibiotics just in case, which further promotes immunity to the drugs because so many people are using them when they don't necessarily need them. Oftentimes many doctors assume the worst case scenario and I have heard from other students that even when tests come back negative for malaria, etc., the doctors assume it is a false negative and treat the patient for the disease anyway. I'm not sure how this compares to drug resistance in the U.S., but I want to assume that it is greater in Tanzania because of how common antibiotics are prescribed.
For the rest of the afternoon, we all came back and a group of the first week students went on a safari that will be lasting the weekend, while the rest of us stayed at the house and napped (I won't miss out on the safari though because I am going on a day safari with 3 other students).
The night shift initially started out boring because there was nothing happening in obs and gyney. We spent some time chatting and laughing with two doctors who were there, and then while we were waiting, a women in one of the beds started to give birth, so we were finally able to observe and assist with a natural birth. I then got to bring the baby (girl) to the scale and weigh her and wrap her back up in the blankets. The doctors always wrap the babies in 2 or 3 thin, brightly colored blankets, which appears easy, but when you try to wrap a baby yourself it's pretty challenging. Anyway, that's it for today, we would have stayed later because there were 2 C-sections that for scheduled, but we had to get out to catch the taxi and we are off early on safari tomorrow.
For our last day, Dr. Lyapa took us to the room within OPD where they do circumcisions. We of course helped with the patients for several hours and then watched the circumcision of at a 28 year old male. The forceps procedure was relatively simple and straightforward, though it was initially very painful for the man before the local anesthesia was put in (obviously). My friend and I were able to make it through most of the procedure before feeling faint and having to sit down. Surprisingly, the wound only takes about 1-2 weeks to heal, which is much faster than anticipated.
I also asked Dr. Lyapa about drug resistance because so many antibiotics are frequently prescribed to patients. Many patients and also misdiagnosed or given antibiotics just in case, which further promotes immunity to the drugs because so many people are using them when they don't necessarily need them. Oftentimes many doctors assume the worst case scenario and I have heard from other students that even when tests come back negative for malaria, etc., the doctors assume it is a false negative and treat the patient for the disease anyway. I'm not sure how this compares to drug resistance in the U.S., but I want to assume that it is greater in Tanzania because of how common antibiotics are prescribed.
For the rest of the afternoon, we all came back and a group of the first week students went on a safari that will be lasting the weekend, while the rest of us stayed at the house and napped (I won't miss out on the safari though because I am going on a day safari with 3 other students).
The night shift initially started out boring because there was nothing happening in obs and gyney. We spent some time chatting and laughing with two doctors who were there, and then while we were waiting, a women in one of the beds started to give birth, so we were finally able to observe and assist with a natural birth. I then got to bring the baby (girl) to the scale and weigh her and wrap her back up in the blankets. The doctors always wrap the babies in 2 or 3 thin, brightly colored blankets, which appears easy, but when you try to wrap a baby yourself it's pretty challenging. Anyway, that's it for today, we would have stayed later because there were 2 C-sections that for scheduled, but we had to get out to catch the taxi and we are off early on safari tomorrow.
Friday, June 6, 2014
Relaxing Day
6/5/14
After a late night in obs and gyney last night I only worked 6 hours in the morning and decided not to watch the surgeries that were going on in the afternoon (they are on Tuesdays and Thursdays). There were no particularly interesting cases in OPD and when I got back to the house, made lunch, and relaxed on the porch near the house that overlooks the city. It is a beautiful view and the weather was very nice.
Then a group of people went on a trip to a local orphanage, though I stayed behind and caught up on some sleep. After, we had an hour long lecture explaining common diseases in Tanzania and the local area.
Every Thursday, we also have BBQ's outside so that's what we did for dinner tonight. The food was super good, as always, though it started raining in the middle and we had to go inside.
That's about all that happened today. Most people are going out clubbing tonight but I am way to tired to attempt going anywhere and have my last day in OPD tomorrow along with a night shift.
After a late night in obs and gyney last night I only worked 6 hours in the morning and decided not to watch the surgeries that were going on in the afternoon (they are on Tuesdays and Thursdays). There were no particularly interesting cases in OPD and when I got back to the house, made lunch, and relaxed on the porch near the house that overlooks the city. It is a beautiful view and the weather was very nice.
Then a group of people went on a trip to a local orphanage, though I stayed behind and caught up on some sleep. After, we had an hour long lecture explaining common diseases in Tanzania and the local area.
Every Thursday, we also have BBQ's outside so that's what we did for dinner tonight. The food was super good, as always, though it started raining in the middle and we had to go inside.
That's about all that happened today. Most people are going out clubbing tonight but I am way to tired to attempt going anywhere and have my last day in OPD tomorrow along with a night shift.
Wednesday, June 4, 2014
"There's no 'maybe' in medicine"
6/4/14
Today was by far the interesting in terms of medical cases I was exposed to. When we arrived at the hospital we went to a meeting with all the doctors about violence, suicide, murder, rape, etc. and how to fill out forms regarding these matters. Then we went with Dr. Lyapa and saw the OPD patients. Nothing really new came up here, one man had an STI and needed to be tested for HIV, while many of the patients were coming in for hypertension follow-ups. I enjoy taking blood pressure, but the number of hypertensive patients is through the roof and is starting to get old.
Early in the afternoon, we went to the other OPD building to the minor surgery room and watching and assisted with some procedures. One man had an external stabilizing brace drilled into his leg with some of the muscle protruding from the skin (this was from a motorcycle accident). He was coming back to get it redressed, the problem is, many patients do not have their wounds redressed as often as the need to be, and instead of every day, the gauze is changed about once a week. This makes infections and sepsis really common. A little boy, about 5 years old, came in with a fractured radius or ulna (can't remember) just above the wrist. I got to assist in this procedure and the doctor had me take his thumb and fingers and pull very hard to realign the bone. Of course the boy wasn't on any painkillers and he screamed and cried while I did this and the doctor wrapped his arm in a cast. He was a real trooper, poor guy.
In the afternoon, most of us went and played soccer and then came back to the house for a global health tutorial on the transmission of HIV from mother to child, what is called MTCT.
I finally ended the day by going on the night shift in the obs and gyney department. This was really amazing because we got to see the end of a C-section with twins and another 2 full C-sections after that. The doctors all let us take videos and photos of the operation, as well as selfies with them, which was really cool. Definitely an incredible experience to see how they pull the baby out and hold it upside down by its feet... and definitely not the care I was expecting. Such an exhausting day, like always, but tonight made it especially worth it.
Today was by far the interesting in terms of medical cases I was exposed to. When we arrived at the hospital we went to a meeting with all the doctors about violence, suicide, murder, rape, etc. and how to fill out forms regarding these matters. Then we went with Dr. Lyapa and saw the OPD patients. Nothing really new came up here, one man had an STI and needed to be tested for HIV, while many of the patients were coming in for hypertension follow-ups. I enjoy taking blood pressure, but the number of hypertensive patients is through the roof and is starting to get old.
Early in the afternoon, we went to the other OPD building to the minor surgery room and watching and assisted with some procedures. One man had an external stabilizing brace drilled into his leg with some of the muscle protruding from the skin (this was from a motorcycle accident). He was coming back to get it redressed, the problem is, many patients do not have their wounds redressed as often as the need to be, and instead of every day, the gauze is changed about once a week. This makes infections and sepsis really common. A little boy, about 5 years old, came in with a fractured radius or ulna (can't remember) just above the wrist. I got to assist in this procedure and the doctor had me take his thumb and fingers and pull very hard to realign the bone. Of course the boy wasn't on any painkillers and he screamed and cried while I did this and the doctor wrapped his arm in a cast. He was a real trooper, poor guy.
In the afternoon, most of us went and played soccer and then came back to the house for a global health tutorial on the transmission of HIV from mother to child, what is called MTCT.
I finally ended the day by going on the night shift in the obs and gyney department. This was really amazing because we got to see the end of a C-section with twins and another 2 full C-sections after that. The doctors all let us take videos and photos of the operation, as well as selfies with them, which was really cool. Definitely an incredible experience to see how they pull the baby out and hold it upside down by its feet... and definitely not the care I was expecting. Such an exhausting day, like always, but tonight made it especially worth it.
Tuesday, June 3, 2014
Long Day... Again
6/3/14
Today started much like yesterday, however, it involved a lot more work. As a general outline of the day, we started work at 7:45, had a half hour lunch break at 1, and then went back to work until 3:30. At 5, we had an hour long Swahili lesson and at 6, we had an hour long global health lecture... another very tiring day.
One of the most interesting cases in OPD (outpatient department) was a woman who had been in a road traffic accident and had several holes in her foot. The largest was near her toes and about 6cm in diameter and 2cm deep. This was filled with gauze, but was becoming septic because it was not changed regularly. Luckily he wound was not as bad as anticipated and the flesh had not started to rot so as long as it is regularly redressed, the foot will be fine and not need amputation.
After lunch we went to the wards, where a young woman in her 20's with hypertension and an enlarged heart had developed a blood clot which traveled to her brain, and caused a stroke... this also caused paralysis on her right side. Dr. Lyapa casually told us that she would end up dying (as will patients in similar conditions) because there is very little they can do for her. Another woman in the ward was hypertensive, which had caused her liver to start failing. Her distended abdomen was a sign that blood was filling her abdominal cavity and she was throwing it up (blood) as well. Overall, the cases were much more interesting than the work we were doing in OPD.
The two lectures were also really helpful, especially the Swahili. We learned common words, greetings, etc. which are key to the culture of the hospital because it is important that you try your best to communicate with the doctors and patients in there language. The global health lecture was given by one of the doctors from Iringa Regional Hospital (I'm not sure if I mentioned this before but this is where I will be working my entire stay) on malaria, covering everything from definitions, to treatment, to classifications of the disease, to complications and symptoms of each type of malaria. After, I was planning on working the night shift at the hospital in the obstetrics and gynecology department (otherwise called "obs and gyney"), but after such a long day I will go tomorrow night.
P.S. I apologize for the lack of photos... they are much harder to upload on Tanzanian internet, and I know much more interesting than my long posts, but some will definitely be posted by the end of the week.
Today started much like yesterday, however, it involved a lot more work. As a general outline of the day, we started work at 7:45, had a half hour lunch break at 1, and then went back to work until 3:30. At 5, we had an hour long Swahili lesson and at 6, we had an hour long global health lecture... another very tiring day.
One of the most interesting cases in OPD (outpatient department) was a woman who had been in a road traffic accident and had several holes in her foot. The largest was near her toes and about 6cm in diameter and 2cm deep. This was filled with gauze, but was becoming septic because it was not changed regularly. Luckily he wound was not as bad as anticipated and the flesh had not started to rot so as long as it is regularly redressed, the foot will be fine and not need amputation.
After lunch we went to the wards, where a young woman in her 20's with hypertension and an enlarged heart had developed a blood clot which traveled to her brain, and caused a stroke... this also caused paralysis on her right side. Dr. Lyapa casually told us that she would end up dying (as will patients in similar conditions) because there is very little they can do for her. Another woman in the ward was hypertensive, which had caused her liver to start failing. Her distended abdomen was a sign that blood was filling her abdominal cavity and she was throwing it up (blood) as well. Overall, the cases were much more interesting than the work we were doing in OPD.
The two lectures were also really helpful, especially the Swahili. We learned common words, greetings, etc. which are key to the culture of the hospital because it is important that you try your best to communicate with the doctors and patients in there language. The global health lecture was given by one of the doctors from Iringa Regional Hospital (I'm not sure if I mentioned this before but this is where I will be working my entire stay) on malaria, covering everything from definitions, to treatment, to classifications of the disease, to complications and symptoms of each type of malaria. After, I was planning on working the night shift at the hospital in the obstetrics and gynecology department (otherwise called "obs and gyney"), but after such a long day I will go tomorrow night.
P.S. I apologize for the lack of photos... they are much harder to upload on Tanzanian internet, and I know much more interesting than my long posts, but some will definitely be posted by the end of the week.
First Day at The Hospital
6/2/14
As of now I have been writing every day since I have arrived (all two of them), however I am most likely going to be posting observations from the day etc because time/internet access does not permit me to post as often as I would like.
As a little background, the house I am staying at is called Rock House and has a main building with couches and space to hang out, a dining room, and kitchen. Spread out from the main building are about 10 small houses where we stay with beds, dressers, and modern style toilets (quite a luxury in Tanzania since most toilets are holes in the ground... more to come on that). I live in "Arusha" with 2 other girls who arrived the week before.
Today (and many to follow) we woke at 6am, had breakfast at 6:45, and started walking to the hospital at 7:15 (the food is delicious by the way). The walk takes about 30 minutes and actually very pleasant. It is not a very urban area... think African suburbs... and it was still cool outside so the temperature was bearable.
The department I am working in this week is the Outpatient department which involves emergency and walk-in cases. It's basically equivalent to GP. From 7:45 to 1 I was with Dr. Lyapa and another girl from England on the trip. We first attended a general meeting of all the doctors and nurses and then went to Dr. Lyapa's office to see patients. Cases of hypertension are extremely common so after a lecture on blood pressure, I quickly became very good at taking bp's. When seeing the patients the doctor first speaks to them in Swahili and then explains the case to use, including symptoms, treatment, and other details. Dr. Lyapa also only sees patients with national healthcare so we we're only exposed to people who are slightly better off.
After going back for lunch all the students who had just arrived went on a tour of the city, checking out internet cafes, restaurants, banks, and vendors. This is extremely helpful because I now have places I can go on the weekends besides safari and staying at the house. The restaurants and cafés are also a 2 minute walk from the hospital and good for lunch breaks, rather than walking an hour to the house and back to get lunch.
After walking for quite a while we made it back to the house and then went on a hike up to a huge rock above the house that overlooks the city. We stayed there until the sunset and finally got to have diner, finishing the day with a dance/musical performance put on by locals. Over the course of the day I probably walked about 8 miles or more... needless to say, I am exhausted.
As of now I have been writing every day since I have arrived (all two of them), however I am most likely going to be posting observations from the day etc because time/internet access does not permit me to post as often as I would like.
As a little background, the house I am staying at is called Rock House and has a main building with couches and space to hang out, a dining room, and kitchen. Spread out from the main building are about 10 small houses where we stay with beds, dressers, and modern style toilets (quite a luxury in Tanzania since most toilets are holes in the ground... more to come on that). I live in "Arusha" with 2 other girls who arrived the week before.
Today (and many to follow) we woke at 6am, had breakfast at 6:45, and started walking to the hospital at 7:15 (the food is delicious by the way). The walk takes about 30 minutes and actually very pleasant. It is not a very urban area... think African suburbs... and it was still cool outside so the temperature was bearable.
The department I am working in this week is the Outpatient department which involves emergency and walk-in cases. It's basically equivalent to GP. From 7:45 to 1 I was with Dr. Lyapa and another girl from England on the trip. We first attended a general meeting of all the doctors and nurses and then went to Dr. Lyapa's office to see patients. Cases of hypertension are extremely common so after a lecture on blood pressure, I quickly became very good at taking bp's. When seeing the patients the doctor first speaks to them in Swahili and then explains the case to use, including symptoms, treatment, and other details. Dr. Lyapa also only sees patients with national healthcare so we we're only exposed to people who are slightly better off.
After going back for lunch all the students who had just arrived went on a tour of the city, checking out internet cafes, restaurants, banks, and vendors. This is extremely helpful because I now have places I can go on the weekends besides safari and staying at the house. The restaurants and cafés are also a 2 minute walk from the hospital and good for lunch breaks, rather than walking an hour to the house and back to get lunch.
After walking for quite a while we made it back to the house and then went on a hike up to a huge rock above the house that overlooks the city. We stayed there until the sunset and finally got to have diner, finishing the day with a dance/musical performance put on by locals. Over the course of the day I probably walked about 8 miles or more... needless to say, I am exhausted.
Monday, June 2, 2014
Made It!
After a 9hr flight to Istanbul, a 7hr flight to Dar es Salaam, and a 10hr bus ride, I have finally made it to Iringa. I arrived with 2 other Gap Medics students on the last flight where we were then picked up by a man from the program at 4:30am and drove to the Landmark Hotel in Dar where we could nap, shower, and then meet the rest of the 12 other students for breakfast.
The difference in culture was immediately striking as we drove to the hotel. Many people walked along the dark streets or gathered around stalls selling goods, slept on motorcycles or huddled around fires fueled by trash. Even though it was so early in the morning, it was surprising to see so many people walking around.
When we finally left the hotel, we crowded onto a "chicken bus" and drove to the coach buses. It's really important to note that when I say driving, it's a lot more like 4-wheeling with large buses. The dirt roads and parking lots are filled with massive ruts and the highways frequently have series of 4 consecutive speed bumps, but this still doesn't stop the drivers from going nearly 90mph and upwards. Any driving standards we considered normal in the US are completely disregarded in Tanzania. Drivers pass anyone and everyone, even if there is oncoming traffic... which often leads to 3 buses in 2 lanes. During the drive we saw several large buses that had crashed and tipped over or slid into the river, and despite the the giant ravine we drove above (easily hundreds or thousands ft deep), we all miraculously made it unscratched.
The landscape itself is beautiful in a chaotic way. Colorful, rundown shacks and buildings line the main highways and there are palm trees and bushes everywhere. There are also expanses of of grasses and trees and farmland that is otherwise unpopulated. The landscape is so unlike anything that can be found in the US that it is initially a huge cultural and sensory overload. I will eventually post some photos of that as well. For now, that catches me up to Sunday evening and actually arriving at the house I am staying at. I have written about Monday already, but will post whenever internet permits.
The difference in culture was immediately striking as we drove to the hotel. Many people walked along the dark streets or gathered around stalls selling goods, slept on motorcycles or huddled around fires fueled by trash. Even though it was so early in the morning, it was surprising to see so many people walking around.
When we finally left the hotel, we crowded onto a "chicken bus" and drove to the coach buses. It's really important to note that when I say driving, it's a lot more like 4-wheeling with large buses. The dirt roads and parking lots are filled with massive ruts and the highways frequently have series of 4 consecutive speed bumps, but this still doesn't stop the drivers from going nearly 90mph and upwards. Any driving standards we considered normal in the US are completely disregarded in Tanzania. Drivers pass anyone and everyone, even if there is oncoming traffic... which often leads to 3 buses in 2 lanes. During the drive we saw several large buses that had crashed and tipped over or slid into the river, and despite the the giant ravine we drove above (easily hundreds or thousands ft deep), we all miraculously made it unscratched.
The landscape itself is beautiful in a chaotic way. Colorful, rundown shacks and buildings line the main highways and there are palm trees and bushes everywhere. There are also expanses of of grasses and trees and farmland that is otherwise unpopulated. The landscape is so unlike anything that can be found in the US that it is initially a huge cultural and sensory overload. I will eventually post some photos of that as well. For now, that catches me up to Sunday evening and actually arriving at the house I am staying at. I have written about Monday already, but will post whenever internet permits.
Thursday, May 29, 2014
Heading Off
As a background and introduction for those who are unfamiliar with my trip, I am off to Iringa, Tanzania (the map below indicates where I will be) on Friday, May 30th and participating in a medical placement through the month of June. I will be staying in Iringa at the Gap Medics house with approximately 40 other students from different countries and will be working at Iringa Regional Hospital. Here, I will shadowing doctors in different departments in addition to attending "global health tutorials", which are classes to teach us about local health concerns and challenges.
On the first week, I will be in the outpatient department, which is similar to a hospital emergency department and on the second week I will be shadowing doctors in the internal female medicine department. My final two weeks, I will be in pediatrics and surgery. For now, those are all the background details... more to come when I arrive!
*For more information about the program, hospital, etc. the following links are helpful (Mama and Papa, check them out)
http://www.gapmedics.com/destinations/tanzania
http://www.gapmedics.com/programs/pre-medicine
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