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Sunday, November 7, 2010
Photos!
Much to my family's frustration and annoyance, I finally got around to organizing the 5000+ photos from my summer trip. Life has been hectic since school started. Here is a small collection of photos from my time in Tanzania. More to come later. Enjoy!
Friday, August 13, 2010
Zanzibar In A Nutshell
Sunday, July 25th
- Adam, our local taxi driver, picked us up at the hostel at 5am and took us to the bus station
- 10 hour bus ride to Dar es Salaam
- Met a Denmark couple, Daniel and Stina, on the bus and shared a cab ride to the ferry
- 2 hour ferry ride to Zanzibar
- Spent Sunday night at the Haven Guest House in Stonestown
- Dinner at the outdoor food market with a few British volunteers, Aaron, Emma and Josephine, who we met at the hostel
- 1 hour taxi ride to Nungwi, a beach resort in the northern region of the island
- Found accommodations at the Jambo Brothers beach bungalows
- Ran into our Canadian friends from Arusha
- Walked to Kendwa, the beach resort nearby, and met up with our friend Daaimah to celebrate her last day in Zanzibar/Tanzania
- Candlelight dinner on the beach and bonfire with the locals
- Found cows on the beach
- Met up with Daniel and Stina for a boat ride to Mnemba for snorkeling
- Calamari lunch at the beach prepared by the locals
- Found new friends from Germany, Mark and Johanna, who are on their honeymoon
- Decided to try out a new restaurant/seafood dinner every night for the rest of the trip
- Lazy day at the beach
- Sand castle building contest with two local kids
- Tasted amazingly fresh coconut juice, obtained for us by our landlord who climbed up the 50 feet coconut tree
- Started reading Model Home
- Watched another beautiful sunset
- Laid out under the stars and searched for constellations
- Wished on shooting stars
- Drove out to a nearby village for a Spice tour with our Denmark and German friends
- Tasted some amazing tropical fruits
- The locals decorated us with jewelries made from palm leaves
- Stung by a sea urchin and was treated with local remedy of papaya and kerosene
- Bongo drums, singing and dancing around the bonfire
- Met new friends from Spain, Marc and Oscar
- Hang time with our Canadian friends, Sam and Courtney
- Village tour with the locals
- Being beach bums
- Volleyball match
- Swam in the sea
- Stung by a sea urchin, again
- Taxi ride to Waikiki beach with two sniper trainers
- Kite boarding with Oscar, Chris and Mark
- Philosophical conversations with a few Irish school teachers
- Celebrated a 21st birthday (definitely not mine) with a group of Scottish medical students
- Dance off to Michael Jackson
- Enjoyed a carefree morning with breakfast on our patio
- Last day to work on our tan
- Tropical rain showers
- Card games with Marc and Oscar
- Saying goodbye to my seashells
- Another amazing candlelight dinner on the beach with all the girls
- Back to Stonestown we go
- Music session on the patio with new Canadian friends: Paul, Nalin and Sam who are celebrating the end of law school
- A day out on the town: fish market, meat market, craft market, chicken market, spice market, historical slave market
- The hunt for the perfect red door
- Tried shark meat at the evening food market
- Said our final goodbyes to the island
- Stuck in a rainstorm
- Rough ferry ride back to Dar es Salaam
- Lost in Dar--the search for the YWCA
- Spontaneous daladala ride around the city in search for the Masai craft market
- Celebrated Kent's last day in Tanzania
- Chaotic bus station
- Dropped off Paul, Nalin and Sam in Moshi for their climb up Mount Kilimanjaro
- 10 hour bus ride back to Arusha
- Back at the hostel--our home away from home
Thursday, August 12, 2010
Into the Bush
On Wednesday, July 21st, Amy, Lindsay, Kurt, Jennah and I packed our belongings and crammed into Dr. Lace's old Land Cruiser and began our trip to the Masai village in Lengasti. We made a quick stop at orphanage's office for medical supplies. Our itinerary for the day: meet Gladness (our contact with the Masai) at the Rafiki Orphanage, spend some time with the kids, drive to Lengasti, meet the women at the Masai village, dinner with the village's representatives.
The drive from Arusha to the orphanage took more than two hours since we stopped by corn fields along the way. Once we got to the orphanage, we unloaded donations for the kids and took a tour of the facility. Instead of mud walls and dirt floors, the kids now sleep in clean rooms with bunk beds. They now have a classroom, a small kitchen, and bathrooms with running water. All the little things that I take for granted. A group of about twenty kids greeted us at the entrance with song and dance. They were absolutely adorable in their purple t-shirts.
After lunch, we got back into the SUV and continued or road trip to Lengasti. The bumpy ride through the desert was a trip. It felt more like a roller coaster ride than a car ride. There were no paved roads; they were more like dirt paths somewhat cleared of trees and large rocks. All around me were miles and miles of open space full of dried rivers, baobab trees, termite mounds, mud huts, roaming goats and donkeys, and Masai warriors traveling by foot or bike through the barren fields. It was a completely different world. The landscape in front of me was rustic, untouched, and absolutely breathtaking. Here was a place that has yet to be marred by modern civilization. After two hours of trekking through the desert, Dr. Lace finally pulled into the "Gladness Hotel". The "hotel" was a one-story building with a small courtyard, a kitchen, a small vegetable garden, and a few rooms with beds, toilets and showers. It was a palace compared to the mud huts that the villagers lived in. At the gate, we were greeted by a group of women garbed in colorful cloths and beaded jewelries. They circled us and began chanting and dancing. Not knowing the Masai customs or dances, the girls and I tried to imitate, but we ended up hopping up and down. Instead of looking like Masai women, we looked like a bunch of rabbits. After the welcoming ceremony, the women took us on a tour of the facilities and their work space. Gladness did an amazing job empowering these women and changing the male dominated social structure of the Masai. That first night, we had dinner with the village representatives. I noticed that the men and women sat separately. According to Gladness, this was the first time the men were not served by the women. They were asked by Gladness to retrieve their own meals. It was a historical moment.
The second day at the Masai village started at 5AM. I woke up to a knock on my door: time to milk the cows. By the time Lindsay, Jennah and I got to the boma, the cows had already been unsuccessfully milked by Kurt. But as luck would have it, the goats still needed milking. I rolled up the sleeves and had a grand old time. After breakfast, we hopped onto the back of Gladness's truck with our medical supplies and headed to the clinic. The majority of our patients were children and pregnant women. The women complained of aches and pains, most likely due to a lifetime of strenuous activities. Many of the kids came in with chest pains, trouble breathing, coughs, and watery eyes; all may be due to living in smoky huts. There was no such as a medical record, so we provided documentation by recording the patients' information, diagnoses, and treatments in a booklet provided by the clinic. With so many sick patients and so little medications, we ran out of supplies by the second day of clinic. Since most of the children suffered from malnutrition and worms, we gave away a lot of multivitamins and Mebendazole. But it never seemed like enough.
After every clinic, we would come home to elaborate meals prepared by Gladness's maid, Margaret. The food was amazing. Margaret even taught us how to make Chapati, the Tanzanian's version of pancake/crepe. I'm pretty sure I am 5lbs heavier when I left than when I arrived. Although we did not have water or electricity for a few days, we were still living like kings. During the afternoon, Gladness and the Masai warriors took us on a tour of the village. We climbed up the Masai Mountain, saw the local bar (a small mud hut), and visited nearby bomas (areas of the village that are sectioned off by groups of families and animals). Every evening, we get views of amazing orange-red sunsets followed by clear nights with brilliant stars. Dinners were also grand productions of various African dishes. In our honor, Gladness roasted a goat and had great fun watching us trying to chow down the goat penis. I pretended it was calamari.
On the morning of the third day, I woke up as usual to the croaking of the rooster and made my way towards the boma to milk the cows. As I got closer to one of the huts, I heard a woman's hysterical cry. It echoed through the village. I walked over and say Dr. Lace, Kurt, and Lindsay talking to one of the Masai warriors. The elder explained to us that a young Masai warrior, Paulo, passed away during the night. He had epilepsy and was not feeling well after the village campaign gathering. Dr. Lace examined Paulo's body and confirmed that he had seizures some time that evening. His wife found his body early that morning. He left behind a young wife and a one-week old baby. Based on Masai tradition, a person's dead body must be left on the outskirts of the village for the wild animals. After three days, if the body has been eaten by animals, that meant that the person has lead a good life while he/she was alive. Since Paulo was Christian, however, the village decided to hold a funeral to bury his body. According to Gladness, we were the first foreigners to partake in the village's funeral ceremony. After the funeral, Amy, Lindsay, Kurt, Jennah and I helped wash the women's hands and distributed food. After having been waited on by the maids, it was a humbling experience for us to be able to service others.
When I asked Gladness who will be taking care of Paulo's wife and child, she explained to me that the other Masai warriors will take over Paulo's role as protector. The Masai has a great sense of family and community. They take care of one another. However, their social structure is very different from the Western culture's way of life. The men, for example, are allowed to have multiple wives and can sleep with any of the married women in the village, as long as their husbands are away. As a result, STIs are very common and paternity is not always known.
To commemorate our last day at the Masai village, Amy, Lindsay, Kurt, Jennah and I went hunting for kids. We were loaded with bags of candy and were on a mission to supplied every child with candy. Good thing we are all interested in medicine and not dentistry. The road trip back to Arusha was bittersweet as I looked back on my experiences with the Masai. They are a nomadic people forced to settle and assimilate into modern day life. Yet they continued to hold on to many of their customs and traditions. Take their tradition of male and female circumcision, for example. For males, it is a rite of passage, a symbol of strength and masculinity. For females, however, it is meant to prevent pleasure during sex; the female body is used only for child-bearing. As an outsider, I tried to view their culture with an open mind and see the good and not-so-good that is innate to every culture.
The drive from Arusha to the orphanage took more than two hours since we stopped by corn fields along the way. Once we got to the orphanage, we unloaded donations for the kids and took a tour of the facility. Instead of mud walls and dirt floors, the kids now sleep in clean rooms with bunk beds. They now have a classroom, a small kitchen, and bathrooms with running water. All the little things that I take for granted. A group of about twenty kids greeted us at the entrance with song and dance. They were absolutely adorable in their purple t-shirts.
After lunch, we got back into the SUV and continued or road trip to Lengasti. The bumpy ride through the desert was a trip. It felt more like a roller coaster ride than a car ride. There were no paved roads; they were more like dirt paths somewhat cleared of trees and large rocks. All around me were miles and miles of open space full of dried rivers, baobab trees, termite mounds, mud huts, roaming goats and donkeys, and Masai warriors traveling by foot or bike through the barren fields. It was a completely different world. The landscape in front of me was rustic, untouched, and absolutely breathtaking. Here was a place that has yet to be marred by modern civilization. After two hours of trekking through the desert, Dr. Lace finally pulled into the "Gladness Hotel". The "hotel" was a one-story building with a small courtyard, a kitchen, a small vegetable garden, and a few rooms with beds, toilets and showers. It was a palace compared to the mud huts that the villagers lived in. At the gate, we were greeted by a group of women garbed in colorful cloths and beaded jewelries. They circled us and began chanting and dancing. Not knowing the Masai customs or dances, the girls and I tried to imitate, but we ended up hopping up and down. Instead of looking like Masai women, we looked like a bunch of rabbits. After the welcoming ceremony, the women took us on a tour of the facilities and their work space. Gladness did an amazing job empowering these women and changing the male dominated social structure of the Masai. That first night, we had dinner with the village representatives. I noticed that the men and women sat separately. According to Gladness, this was the first time the men were not served by the women. They were asked by Gladness to retrieve their own meals. It was a historical moment.
The second day at the Masai village started at 5AM. I woke up to a knock on my door: time to milk the cows. By the time Lindsay, Jennah and I got to the boma, the cows had already been unsuccessfully milked by Kurt. But as luck would have it, the goats still needed milking. I rolled up the sleeves and had a grand old time. After breakfast, we hopped onto the back of Gladness's truck with our medical supplies and headed to the clinic. The majority of our patients were children and pregnant women. The women complained of aches and pains, most likely due to a lifetime of strenuous activities. Many of the kids came in with chest pains, trouble breathing, coughs, and watery eyes; all may be due to living in smoky huts. There was no such as a medical record, so we provided documentation by recording the patients' information, diagnoses, and treatments in a booklet provided by the clinic. With so many sick patients and so little medications, we ran out of supplies by the second day of clinic. Since most of the children suffered from malnutrition and worms, we gave away a lot of multivitamins and Mebendazole. But it never seemed like enough.
After every clinic, we would come home to elaborate meals prepared by Gladness's maid, Margaret. The food was amazing. Margaret even taught us how to make Chapati, the Tanzanian's version of pancake/crepe. I'm pretty sure I am 5lbs heavier when I left than when I arrived. Although we did not have water or electricity for a few days, we were still living like kings. During the afternoon, Gladness and the Masai warriors took us on a tour of the village. We climbed up the Masai Mountain, saw the local bar (a small mud hut), and visited nearby bomas (areas of the village that are sectioned off by groups of families and animals). Every evening, we get views of amazing orange-red sunsets followed by clear nights with brilliant stars. Dinners were also grand productions of various African dishes. In our honor, Gladness roasted a goat and had great fun watching us trying to chow down the goat penis. I pretended it was calamari.
On the morning of the third day, I woke up as usual to the croaking of the rooster and made my way towards the boma to milk the cows. As I got closer to one of the huts, I heard a woman's hysterical cry. It echoed through the village. I walked over and say Dr. Lace, Kurt, and Lindsay talking to one of the Masai warriors. The elder explained to us that a young Masai warrior, Paulo, passed away during the night. He had epilepsy and was not feeling well after the village campaign gathering. Dr. Lace examined Paulo's body and confirmed that he had seizures some time that evening. His wife found his body early that morning. He left behind a young wife and a one-week old baby. Based on Masai tradition, a person's dead body must be left on the outskirts of the village for the wild animals. After three days, if the body has been eaten by animals, that meant that the person has lead a good life while he/she was alive. Since Paulo was Christian, however, the village decided to hold a funeral to bury his body. According to Gladness, we were the first foreigners to partake in the village's funeral ceremony. After the funeral, Amy, Lindsay, Kurt, Jennah and I helped wash the women's hands and distributed food. After having been waited on by the maids, it was a humbling experience for us to be able to service others.
When I asked Gladness who will be taking care of Paulo's wife and child, she explained to me that the other Masai warriors will take over Paulo's role as protector. The Masai has a great sense of family and community. They take care of one another. However, their social structure is very different from the Western culture's way of life. The men, for example, are allowed to have multiple wives and can sleep with any of the married women in the village, as long as their husbands are away. As a result, STIs are very common and paternity is not always known.
To commemorate our last day at the Masai village, Amy, Lindsay, Kurt, Jennah and I went hunting for kids. We were loaded with bags of candy and were on a mission to supplied every child with candy. Good thing we are all interested in medicine and not dentistry. The road trip back to Arusha was bittersweet as I looked back on my experiences with the Masai. They are a nomadic people forced to settle and assimilate into modern day life. Yet they continued to hold on to many of their customs and traditions. Take their tradition of male and female circumcision, for example. For males, it is a rite of passage, a symbol of strength and masculinity. For females, however, it is meant to prevent pleasure during sex; the female body is used only for child-bearing. As an outsider, I tried to view their culture with an open mind and see the good and not-so-good that is innate to every culture.
Tuesday, August 10, 2010
Reality Check
As much as the government and NGOs tried to campaign and educate the people about HIV/AIDS, the reality of the situation in Tanzania is still very bleak. Every pregnant woman who comes into the labor ward is required to test for HIV. However, not all are compliant or willing. Tests for other STIs, such as syphilis and gonorrhea, are not mandatory and therefore not routinely provided. The knowledge that every patient who comes in for prenatal care or deliveries may carry STIs makes health care providers fearful for their own health and well-being. I recall the times when I became anxious after performing an exam or delivery because I came in contact with the patient’s bodily fluids and was not informed of her HIV status. Even after double gloving, I was still nervous the first time I examined an HIV positive patient.
According to Dr. Quaker, the Russian doctor who works in the pre-mature unit, the vertical (mother to child) transmission rate of HIV at Mt Meru hospital is about 45%. This is mind-blowing since HIV testing is readily available. However, women are afraid to get tested because of the stigma surrounding HIV and the fear that they would be outcasted by their families and friends. Even innocent newborns of HIV positive mothers are subjected to poor treatment. While working in the pre-mature unit, I've witnessed infants being left behind by their own mothers or by other family members because they were considered unwanted burdens. They were abandoned at the hospital and left to the care of the nurses.
Even with attempts of education on STIs and family planning, the country's population continues to grow at a rapid rate. The average woman has five children in her lifetime. It is ingrained in the culture. The women value fertility because it defines their role and status in society. It reflects their self-worth. So despite poverty and poor health status, women will continue to have children. The knowledge and availability of contraceptives are not effective since women cannot ask their husbands to use them. And wives cannot turn their husbands away. It is still very much a man's world, unfortunately.
According to Dr. Quaker, the Russian doctor who works in the pre-mature unit, the vertical (mother to child) transmission rate of HIV at Mt Meru hospital is about 45%. This is mind-blowing since HIV testing is readily available. However, women are afraid to get tested because of the stigma surrounding HIV and the fear that they would be outcasted by their families and friends. Even innocent newborns of HIV positive mothers are subjected to poor treatment. While working in the pre-mature unit, I've witnessed infants being left behind by their own mothers or by other family members because they were considered unwanted burdens. They were abandoned at the hospital and left to the care of the nurses.
Even with attempts of education on STIs and family planning, the country's population continues to grow at a rapid rate. The average woman has five children in her lifetime. It is ingrained in the culture. The women value fertility because it defines their role and status in society. It reflects their self-worth. So despite poverty and poor health status, women will continue to have children. The knowledge and availability of contraceptives are not effective since women cannot ask their husbands to use them. And wives cannot turn their husbands away. It is still very much a man's world, unfortunately.
Sunday, August 8, 2010
A Week In the Pediatric Ward
I spent a week in the Pediatric ward shadowing Dr. Lace, a pediatrician from Oregon who I’ve met in the States. With his help over the years, the hospital established an Intensive Care Unit for patients coming in with severe medical conditions who needed immediate care. The PICU consisted of about five beds with mosquito nets, a sink, a supply cabinet with a few medications, and an oxygen tank.
The majority of my time in the pediatric ward was spent rounding on patients; most of the pediatric patients were admitted with similar symptoms: vomiting, diarrhea, fever, and cough. Most were treated for malaria (if patient has history of convulsions) or pneumonia depending on the physical exam and chest x-ray. Because of the limited availability of medications and treatment options, most patients were given antibiotics.
Every morning when I walk into the PICU, I would hear the screeching screams of a young boy. He was born with cerebral palsy and has been staying in the ICU because his family neglected to care for his basic needs. He suffers from malnutrition and bed sores due to his inability to move. Although he is in a stable condition, the physicians hesitated to transfer him upstairs to the general pediatric ward. They feared that the family and nurses would abandon his care. The only solution left would be to leave him in the ICU until he dies.
Another young boy was brought into the PICU after he was treated at home with herbal remedies for a stomach ache and diarrhea. He presented with a distended and painful abdomen. The scars on his abdomen indicated that he had been treated with traditional herbal medicine that is common in the Masai culture. These herbal remedies have unknown side effects and may be toxic. The x-ray showed that the patient has gas bubbles in his GI tract. The lack of information and language barrier made the case difficult assess. The physicians were at a lost on how to proceed. They were unable to come to an agreement on the diagnosis and treatment. The nurses continued to provide supportive care, but after three days, the patient passed away. It is rare for a day to go by without a patient dying in the pediatric ward.
On a more positive note, I successfully drained an abscess. The patient was a young boy who had a large abscess under his jaw. The poor boy cried, kicked, and screamed every time he saw me. He knew what was coming. I may have scarred him for life—he will never look at another physician or white coats the same way ever again. After three days of draining and a course of antibiotics, the swelling lessened significantly and he was released from the hospital. Is it wrong to feel so good about squeezing out pus? It was like popping a very large pimple. Very gratifying.
The majority of my time in the pediatric ward was spent rounding on patients; most of the pediatric patients were admitted with similar symptoms: vomiting, diarrhea, fever, and cough. Most were treated for malaria (if patient has history of convulsions) or pneumonia depending on the physical exam and chest x-ray. Because of the limited availability of medications and treatment options, most patients were given antibiotics.
Every morning when I walk into the PICU, I would hear the screeching screams of a young boy. He was born with cerebral palsy and has been staying in the ICU because his family neglected to care for his basic needs. He suffers from malnutrition and bed sores due to his inability to move. Although he is in a stable condition, the physicians hesitated to transfer him upstairs to the general pediatric ward. They feared that the family and nurses would abandon his care. The only solution left would be to leave him in the ICU until he dies.
Another young boy was brought into the PICU after he was treated at home with herbal remedies for a stomach ache and diarrhea. He presented with a distended and painful abdomen. The scars on his abdomen indicated that he had been treated with traditional herbal medicine that is common in the Masai culture. These herbal remedies have unknown side effects and may be toxic. The x-ray showed that the patient has gas bubbles in his GI tract. The lack of information and language barrier made the case difficult assess. The physicians were at a lost on how to proceed. They were unable to come to an agreement on the diagnosis and treatment. The nurses continued to provide supportive care, but after three days, the patient passed away. It is rare for a day to go by without a patient dying in the pediatric ward.
On a more positive note, I successfully drained an abscess. The patient was a young boy who had a large abscess under his jaw. The poor boy cried, kicked, and screamed every time he saw me. He knew what was coming. I may have scarred him for life—he will never look at another physician or white coats the same way ever again. After three days of draining and a course of antibiotics, the swelling lessened significantly and he was released from the hospital. Is it wrong to feel so good about squeezing out pus? It was like popping a very large pimple. Very gratifying.
Sunday, July 18, 2010
What I've been up to
Took the daladala and motorbike up to Nkoroanga Lutheran Hospital to visit our Canadian friends for a day—hiked around the neighboring village and hung out with the local children. The hillside was beautiful and the people lived very simple lives. After handing out some M&Ms to the kids, we got a group of children trailing behind us.
Visited Majiachai and the Children for Children’s Future orphanage—helped Mama with the daily chores (carted water and fed chickens), learned how to cook ugali from Amina and Habiba, had a dance-off and played football (or soccer as Americans would call it) with the boys. Even with the hardships that they have been through, the kids are amazingly cheerful and energetic.
Arusha National Park—took the daladala to Usa River Village and then hopped on to another daladala to get to the park entrance. But we ended up at the wrong gate. Luckily, we ran into two Tanzanians, Freddy and his mom, Eva, who were also touring the park. They had three empty seats in their car and offered us a ride through the park. We basically got a free private safari. I saw some amazing animals: giraffes, zebras, gazelles, monkeys. They were literally within a few feet from our car. So cool.
Attended my first African wedding—the wedding took place at Centre House Hostel. It was a small ceremony with about twenty people. I loved the food and dancing.
Pediatric rotation—I saw some interesting cases while rounding in the pediatric ward: malnutrition and cardiomegaly, malaria, pneumonia, cerebral palsy, meningitis, kaposi sarcoma, heart murmurs, abscess
Surgery rotation—with the hazardous driving and crazy traffic, I saw a lot of motor vehicle accidents while rounding in the surgical ward. I scrubbed into a few surgeries and saw reduction of arm and leg fractures and a few internal and external fixations. Interesting photos to come.
Power outage—hung out in the hallway with headlamps, experienced my first cold shower, and had cold instant noodles for dinner. I am living the dream.
Visited Majiachai and the Children for Children’s Future orphanage—helped Mama with the daily chores (carted water and fed chickens), learned how to cook ugali from Amina and Habiba, had a dance-off and played football (or soccer as Americans would call it) with the boys. Even with the hardships that they have been through, the kids are amazingly cheerful and energetic.
Arusha National Park—took the daladala to Usa River Village and then hopped on to another daladala to get to the park entrance. But we ended up at the wrong gate. Luckily, we ran into two Tanzanians, Freddy and his mom, Eva, who were also touring the park. They had three empty seats in their car and offered us a ride through the park. We basically got a free private safari. I saw some amazing animals: giraffes, zebras, gazelles, monkeys. They were literally within a few feet from our car. So cool.
Attended my first African wedding—the wedding took place at Centre House Hostel. It was a small ceremony with about twenty people. I loved the food and dancing.
Pediatric rotation—I saw some interesting cases while rounding in the pediatric ward: malnutrition and cardiomegaly, malaria, pneumonia, cerebral palsy, meningitis, kaposi sarcoma, heart murmurs, abscess
Surgery rotation—with the hazardous driving and crazy traffic, I saw a lot of motor vehicle accidents while rounding in the surgical ward. I scrubbed into a few surgeries and saw reduction of arm and leg fractures and a few internal and external fixations. Interesting photos to come.
Power outage—hung out in the hallway with headlamps, experienced my first cold shower, and had cold instant noodles for dinner. I am living the dream.
Friday, July 9, 2010
Ester and Stella and Happy
Ester and Stella
Two pregnant women giving birth in the same hospital, on the same day, at the same time. Two babies who could have been twins from different mothers. One survived, the other didn’t. Monday morning began with my first patient having her baby on the muddy floor of the labor ward. After catching the baby, delivering the placenta, and giving the mother a shot of Oxytocin, I turned around to a small voice calling for a nurse. Stella was a small woman, pregnant with her first child. Her membrane had already ruptured and she was breathing hard through her contractions. I helped her move to the opposite end of the ward and began prepping for another delivery. Loud screams drew my attention. I rushed over to see Amy assisting a complicated delivery. Ester had been in labor since 5am, but the baby was not delivered until almost 11am that morning. The baby looked blue, was unresponsive to stimulation, and was not breathing.
I heard Stella calling and came over. An hour had already passed since her membrane ruptured, but she was still unable to push the baby out. I called a nurse over and watched her perform an episiotomy to help with the childbirth. The baby came out with the umbilical cord wrapped around its neck multiple times. I unwound the cord and rubbed the baby’s back. I’ve never been so relieved and happy to hear a baby’s cry. I carried Stella’s baby to the next room to be weighed and saw a small bundle placed on a cart underneath the scale: Ester’s dead baby with its tiny blue feet sticking out from the underneath the blanket. My heart broke. I wanted to mourn for a life of a child that might have survived had we had nurses and doctors monitoring or better tools and technology. But the chaos of the labor ward allowed no time for mourning and grief. I repressed the emotions and pulled myself together, left the room and walked back to the beds where the women lay awaiting delivery.
Happy
Her name says it all. Happy was another mom-to-be in the labor ward whose baby I helped delivered. She was another small woman who had a complicated delivery due to her small size. The baby came out unresponsive, cold, and lifeless. I felt numb. Having seen what had happened with Ester’s baby, I rushed Happy’s baby to the crib and started suction and resuscitation. I lost track of time as I stood over the baby, willing it to breathe. When I saw the baby took its first breath, I was truly happy for the first time that week.
Two pregnant women giving birth in the same hospital, on the same day, at the same time. Two babies who could have been twins from different mothers. One survived, the other didn’t. Monday morning began with my first patient having her baby on the muddy floor of the labor ward. After catching the baby, delivering the placenta, and giving the mother a shot of Oxytocin, I turned around to a small voice calling for a nurse. Stella was a small woman, pregnant with her first child. Her membrane had already ruptured and she was breathing hard through her contractions. I helped her move to the opposite end of the ward and began prepping for another delivery. Loud screams drew my attention. I rushed over to see Amy assisting a complicated delivery. Ester had been in labor since 5am, but the baby was not delivered until almost 11am that morning. The baby looked blue, was unresponsive to stimulation, and was not breathing.
I heard Stella calling and came over. An hour had already passed since her membrane ruptured, but she was still unable to push the baby out. I called a nurse over and watched her perform an episiotomy to help with the childbirth. The baby came out with the umbilical cord wrapped around its neck multiple times. I unwound the cord and rubbed the baby’s back. I’ve never been so relieved and happy to hear a baby’s cry. I carried Stella’s baby to the next room to be weighed and saw a small bundle placed on a cart underneath the scale: Ester’s dead baby with its tiny blue feet sticking out from the underneath the blanket. My heart broke. I wanted to mourn for a life of a child that might have survived had we had nurses and doctors monitoring or better tools and technology. But the chaos of the labor ward allowed no time for mourning and grief. I repressed the emotions and pulled myself together, left the room and walked back to the beds where the women lay awaiting delivery.
Happy
Her name says it all. Happy was another mom-to-be in the labor ward whose baby I helped delivered. She was another small woman who had a complicated delivery due to her small size. The baby came out unresponsive, cold, and lifeless. I felt numb. Having seen what had happened with Ester’s baby, I rushed Happy’s baby to the crib and started suction and resuscitation. I lost track of time as I stood over the baby, willing it to breathe. When I saw the baby took its first breath, I was truly happy for the first time that week.
Wednesday, July 7, 2010
A Day in the Life:
It has only been two weeks, but I feel like I am starting to get the hang of things. The landmarks are becoming more recognizable and the people more familiar. After the chaos of the first week, I feel like I’ve finally developed a comfortable routine: breakfast at the hostel, morning walk to the hospital, labor and delivery ward or surgery with Dr. Lee until the afternoon, errands or miscellaneous activities (i.e. reading/blogging/baking at the Blue Heron) after leaving the hospital, work-out/jog around the neighborhood in the early evening, dinner and catch up with friends until bed time. All this is subject to change on a day-to-day basis.
Celebrating Canada Day at the Via Via Café:
During my stay at the hostel, I’ve had the wonderful opportunity to meet people from different parts of the world: medical students from Switzerland and Ireland, girls from Norway on holiday, a bunch of Canadians, high school kids from New Zealand on a missionary trip. My favorite so far is a group of nursing, dental, and medical students from Canada. We all bonded while celebrating Canada Day. It was a Thursday night, so we all decided to go the Via Via Café for some music and dancing. If I was a local and wanted to take advantage of a bunch of foreigners, this was the place to be. It was packed with students, interns, and volunteers from various countries and NGOs. Although we were all there with the same purpose in mind, we were still very much segregated. Even half-way across the world, some things never change.
Happy Independence Day:
A week in the labor ward and surgical theatre made me appreciate the little things in life. Things like having hand soap in the operating room, reliable source of electricity instead of cell-phone light for surgery, running water to wash up after a messy delivery, private examination rooms instead of shower curtains, scissors that are not rusty or dull, gloves and lubricants, anesthetics for patients undergoing surgeries, vaccinations for babies, lab tests for STIs other than HIV, medicine other than amoxicillin to treat any and all illnesses. I see the inconsistencies between my life here and the life I lead back in the states, and I feel guilty and helpless that I cannot restore balance between the two worlds. So what to do when stuck in an unsolvable situation? Escape reality. If only for a few days.
Amy, Lindsay and I decided that it was time to leave Arusha. In honor of July 4th (and of being crazy Americans), we hopped on a minibus heading to Moshi and played a game of how-many-people-can-fit-in-a-minibus. It was approximately a 2:1 ratio of people to seats. We tagged along a group of American/Canadian/Polish students and took the daladala to see Mount Kilimanjaro. The trip took us about three hours (six hours total on the road) and we ended up hiking through the Wachagga village and saw the Ndoro waterfalls. We got back to Arusha just after sunset and haggled with a group of men for a cab ride home. Dinner consisted of a bag of M&Ms and a granola bar. All in all, it was a successful spontaneous adventure, a great celebration of independence, and a perfect excuse to get away and recoup before the madness starts all over again.
It has only been two weeks, but I feel like I am starting to get the hang of things. The landmarks are becoming more recognizable and the people more familiar. After the chaos of the first week, I feel like I’ve finally developed a comfortable routine: breakfast at the hostel, morning walk to the hospital, labor and delivery ward or surgery with Dr. Lee until the afternoon, errands or miscellaneous activities (i.e. reading/blogging/baking at the Blue Heron) after leaving the hospital, work-out/jog around the neighborhood in the early evening, dinner and catch up with friends until bed time. All this is subject to change on a day-to-day basis.
Celebrating Canada Day at the Via Via Café:
During my stay at the hostel, I’ve had the wonderful opportunity to meet people from different parts of the world: medical students from Switzerland and Ireland, girls from Norway on holiday, a bunch of Canadians, high school kids from New Zealand on a missionary trip. My favorite so far is a group of nursing, dental, and medical students from Canada. We all bonded while celebrating Canada Day. It was a Thursday night, so we all decided to go the Via Via Café for some music and dancing. If I was a local and wanted to take advantage of a bunch of foreigners, this was the place to be. It was packed with students, interns, and volunteers from various countries and NGOs. Although we were all there with the same purpose in mind, we were still very much segregated. Even half-way across the world, some things never change.
Happy Independence Day:
A week in the labor ward and surgical theatre made me appreciate the little things in life. Things like having hand soap in the operating room, reliable source of electricity instead of cell-phone light for surgery, running water to wash up after a messy delivery, private examination rooms instead of shower curtains, scissors that are not rusty or dull, gloves and lubricants, anesthetics for patients undergoing surgeries, vaccinations for babies, lab tests for STIs other than HIV, medicine other than amoxicillin to treat any and all illnesses. I see the inconsistencies between my life here and the life I lead back in the states, and I feel guilty and helpless that I cannot restore balance between the two worlds. So what to do when stuck in an unsolvable situation? Escape reality. If only for a few days.
Amy, Lindsay and I decided that it was time to leave Arusha. In honor of July 4th (and of being crazy Americans), we hopped on a minibus heading to Moshi and played a game of how-many-people-can-fit-in-a-minibus. It was approximately a 2:1 ratio of people to seats. We tagged along a group of American/Canadian/Polish students and took the daladala to see Mount Kilimanjaro. The trip took us about three hours (six hours total on the road) and we ended up hiking through the Wachagga village and saw the Ndoro waterfalls. We got back to Arusha just after sunset and haggled with a group of men for a cab ride home. Dinner consisted of a bag of M&Ms and a granola bar. All in all, it was a successful spontaneous adventure, a great celebration of independence, and a perfect excuse to get away and recoup before the madness starts all over again.
Thursday, July 1, 2010
There's a first time for everything
Having spent most of my life in California, I’ve become assimilated into the rich and diverse cultures of my communities. I have forgotten what it was like to be an outsider. It was and is an uncomfortable experience to be stared and hollered at while walking down the street and to be asked constantly if I was from China or Japan after introducing myself as an American. According to one of the nurses, I must be a “mixture” (White and Asian) to identify myself as “American”. I’ve realized how much I took for granted: my life back in southern California and my relationships and experiences with friends from various ethnic/socioeconomic backgrounds.
Before coming to Tanzania, I’ve spent a good number of years traveling and volunteering in various underserved communities. I thought I was prepared to face the poor conditions and health disparities in Arusha. But my encounter with patients and the medical staff at Mt Meru left me somewhat speechless. On my first day doing rounds with Ob/Gyn physicians, I’ve watched a deceased patient, who passed away due to infection from an unsafe abortion (dead fetus was left inside the patient for months), being left unattended in a room full of patients waiting to be seen. She was finally taken to the morgue after the doctor examined her body and checked for a final heart beat, with students and patients all in attendance. I was also drawn to another patient: a 13 year old girl was raped and admitted for HIV and syphilis testing. She sat silently with her mother, waiting for test results to come back. I left the ward with the sad haunting faces of the women imbedded in my mind. Their fates seemed so bleak and hopeless.
A few of my firsts:
1. Watched Dr. Lee perform a leg amputation, manually and with a dull saw
2. “Scrubbed in” for two C-sections and then sat in the dark for an hour, waiting for the power to come back on
3. Held a woman’s hand while she sat naked, shaking and crying on the operating table—with physicians and nurses laughing and chatting about music on their cell phones
4. Rocked a baby to sleep after she was delivered, cleaned, and placed in her mother’s blanket
5. Witnessed a mother giving birth by herself, without physicians or nurses assisting
6. Clamped and cut an umbilical cord and delivered a placenta
7. Felt a baby’s head while doing a pelvic exam
Skills to work on:
1. Blood draws
2. Give shots
3. Put in IV lines
4. Suturing
5. Casting
6. Deliver babies
7. Assist in surgeries
Before coming to Tanzania, I’ve spent a good number of years traveling and volunteering in various underserved communities. I thought I was prepared to face the poor conditions and health disparities in Arusha. But my encounter with patients and the medical staff at Mt Meru left me somewhat speechless. On my first day doing rounds with Ob/Gyn physicians, I’ve watched a deceased patient, who passed away due to infection from an unsafe abortion (dead fetus was left inside the patient for months), being left unattended in a room full of patients waiting to be seen. She was finally taken to the morgue after the doctor examined her body and checked for a final heart beat, with students and patients all in attendance. I was also drawn to another patient: a 13 year old girl was raped and admitted for HIV and syphilis testing. She sat silently with her mother, waiting for test results to come back. I left the ward with the sad haunting faces of the women imbedded in my mind. Their fates seemed so bleak and hopeless.
A few of my firsts:
1. Watched Dr. Lee perform a leg amputation, manually and with a dull saw
2. “Scrubbed in” for two C-sections and then sat in the dark for an hour, waiting for the power to come back on
3. Held a woman’s hand while she sat naked, shaking and crying on the operating table—with physicians and nurses laughing and chatting about music on their cell phones
4. Rocked a baby to sleep after she was delivered, cleaned, and placed in her mother’s blanket
5. Witnessed a mother giving birth by herself, without physicians or nurses assisting
6. Clamped and cut an umbilical cord and delivered a placenta
7. Felt a baby’s head while doing a pelvic exam
Skills to work on:
1. Blood draws
2. Give shots
3. Put in IV lines
4. Suturing
5. Casting
6. Deliver babies
7. Assist in surgeries
Monday, June 28, 2010
Mambo!
Two days of sitting in airports, twenty hours of sleep, three Swahili phrases, and five movies later, I finally arrived in Tanzania. Amy, Lindsay and I got off the plane and were greeted by the warm night breeze and strange scent that reminded us that we were no longer in comforts of our home. Dr. Lee met us at the Kilimanjaro airport and brought us to the Centre House hostel in Arusha, where we are sharing a one bedroom. It’s quite small and rustic, but it keeps the mosquitoes and bugs out. I feel very lucky to be in a place that has electricity, (somewhat) warm running water and a flushing toilet.
We spent the first few days roaming around and getting acquainted with the city. Our checklist:
1. Hunt for drinking water
2. Visit Mount Meru Hospital
3. Obtain a map
4. Buy SIMS card
5. Exchange currency
6. Find an internet café
7. Learn Swahili phrases
8. Bargain for used running shoes
9. Craft market for souvenirs
10. Search for a new place to live
Notable events:
1. Went to bed at 7pm and woke up at 5am, voluntarily and without an alarm
2. Found banana trees and a river in the backyard
3. The Blue Heron restaurant—saw monkeys and met a bunch of Brits who thought we are idiots for spending summer break volunteering in Tanzania
4. Mini si daktari = I am not a doctor
5. Started marathon training and exercised on the balcony while watching the sunset
6. Korean food for dinner with new friends from Korea and Canada
7. The Greek Club bar—USA vs. Ghana world cup game and obnoxious/drunk Americans singing and dancing to Miley Cyrus’s “Party in the USA”
8. Ran into two Canadian men at the hostel who left their jobs in Europe to go on a year-long expedition around the world
9. Hiked to a nearby village, heard beautiful church choir, and trudged along the river to find waterfalls
10. Orthopedic clinic with Dr. Lee at Mt Meru Hospital—man lost four fingers from accident, young girl with congenital finger malformation, baby with sixth digit foot surgery
We spent the first few days roaming around and getting acquainted with the city. Our checklist:
1. Hunt for drinking water
2. Visit Mount Meru Hospital
3. Obtain a map
4. Buy SIMS card
5. Exchange currency
6. Find an internet café
7. Learn Swahili phrases
8. Bargain for used running shoes
9. Craft market for souvenirs
10. Search for a new place to live
Notable events:
1. Went to bed at 7pm and woke up at 5am, voluntarily and without an alarm
2. Found banana trees and a river in the backyard
3. The Blue Heron restaurant—saw monkeys and met a bunch of Brits who thought we are idiots for spending summer break volunteering in Tanzania
4. Mini si daktari = I am not a doctor
5. Started marathon training and exercised on the balcony while watching the sunset
6. Korean food for dinner with new friends from Korea and Canada
7. The Greek Club bar—USA vs. Ghana world cup game and obnoxious/drunk Americans singing and dancing to Miley Cyrus’s “Party in the USA”
8. Ran into two Canadian men at the hostel who left their jobs in Europe to go on a year-long expedition around the world
9. Hiked to a nearby village, heard beautiful church choir, and trudged along the river to find waterfalls
10. Orthopedic clinic with Dr. Lee at Mt Meru Hospital—man lost four fingers from accident, young girl with congenital finger malformation, baby with sixth digit foot surgery
Tuesday, June 22, 2010
Tanzania here I come!
Done with packing! Will be leaving on a jet plane in T-10 hours.
Itinerary:
Wednesday, June 23
| Departs: | 6:05 am from Portland, Oregon |
| Arrives: | 2:29 pm at New York - Kennedy, New York |
| Departs: | 3:55 pm from New York - Kennedy, New York |
| Arrives: | 6:00 am (June 24) at Amsterdam, Netherlands |
Thursday, June 24
| Departs: | 11:00 am from Amsterdam, Netherlands |
| Arrives: | 8:25 pm at Kilimanjaro, Tanzania |
Friday, June 11, 2010
T-12 Days
Only 12 more days until I am on my way to Tanzania! I've booked my flight, found a place to live, completed all my vaccinations, and bought a sleeping bag. Not quite ready to go.
1. Search for a safari hat
2. Costco trip
3. Study for my final exam
I'm all about prioritizing.
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