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.
Wednesday, June 18, 2014
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.
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