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.
Sunday, July 18, 2010
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
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