Next stop in the list of horrible foreign diseases you don't want to get is tuberculosis, which just so happened to be the clinic I went to see today at the hospital.
In typical Tanzanian style, I discovered today that patients aren't given an appointment time for any of the hospital clinics, but an appointment 'day' instead. The way it works is that the patients turn up whenever they feel like it on they day they're supposed to come and the doctors wait until the room looks pretty full before they start seeing the patients. So basically this is the worst possible system imaginable for organising a clinic. Today, it wasn't until about 12pm when the doctor decided the critical mass of waiting people had assembled and he could then bring in the first patient. I'm never complaining about waiting for a doctor in Australia again.
Once the clinic had actually started, it was nice to see that TB is diagnosed and treated pretty similarly to back home. The main difference over here is that all the newborns get the BCG vaccine though, which means I now have a matching shoulder scar with most of the locals :) The other big deifference is with the directly observed therapy. Here, directly observed doesn't mean having a doctor make sure you take your medications. It means, nominating a friend to help remind you that you should take it. Probably not the most effective of systems.
One unexpected bonus of living in Machame is that there is no need to conserve water up here, because being on the slopes of Kilimanjaro means that the water is plentiful and fresh from the mountain, so hopefully not too contaminated. We still rely on bottled water (which is ironically also taken from Kilimanjaro) and have avoided getting sick yet, which is a plus!
What isn't so clean though is people's hands. Apparently, a lot of the locals use their left hand as toilet paper, so we've been warned never to touch anyone's left hand. Although I heard this second-hand from a Dutch person, so clearly it must be true.
Speaking of hands, one cultural thing here that has been a little bit unusual is the way the locals hold hands. I've noticed that if people are walking somewhere together, they will often do so hand in hand. So it's not uncommon to see two men walking around holding hands. I think it must be considered something like an extension of a handshake. Either that or there a lot of gay people in this village! I've even noticed that if I ask for directions to another part of the hospital, people will often take my hand and lead me there (I'm pretty sure they've all used their right one's thankfully!). Weird at first, it actually is kind of a nice gesture.
Until tomorrow (the day of goat-eating!),
Michael
PS I discovered today that Machame's clinical school passed it's accreditation this week, so it's nice to finally be able to say that I've studied at a fully-accredited medical school!
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