Well this is our 3rd day waking up in Africa, and we have developed quite the routine. Getting ready for uni here takes forever.
Firstly we take our anti-malarials, then we make our beds with our mosquito nets. After this is the simplest of breakfasts...usually cornflakes. We put on our money belts, and wear the same, dirty clothes we have worn for the last 3 days with a white coat over the top. We always bring our own gloves and face masks to the hospital as they have none. The only nice thing about waking up here is that we walk to hospital with a gorgeous view of Mt Kili and the sound of an African gospel choir.
We have been all talking a lot about what we take for granted in Australia. Apart from a car and the Internet, the next necessity I miss is clean water. Although bottled water is cheap here (1000 shillings for 1.5L), we have to use it for everything - like brushing our teeth, washing our hands, and cooking rice and vegetables. This process becomes so tedious especially in the mornings when we are in such a rush.
Again we started the day with chapel, and then waited to go on the outreach clinic. We have learnt a lot about 'Tanzanian time' by being here. If someone here is planning on picking you up at 9:30, they mean 11:30 or hours later. No one here has a watch or any concept of time. So we waited 2 hours for the outreach service to pick us up from the hospital. Luckily it gave us some time to talk to the locals... and yes (ndio) in Swahili!
The outreach service is a sort of domiciliary care - and although like in Adelaide you can't do anything for geriatric Dom patients, here you really can't do anything for them. It consists of a nurse, volunteers, and a driver with no equipment or supplies. We went to people's homes, and basically they tried to convince the patient to come to hospital for simple things, like checking blood pressure. It would be much easier if they had a portable BP cuff and sphygmo to take take with them. And getting to the hospital was not easy, especially since most of these patients either, (a) had no car, (b) all their relatives were dead, or (c) were too sick to walk for miles through a rainforest.
The roads in the rural area of Machame are all dirt, narrow, steep and windy which lead around the rain forests and cliffs. There are still people walking the long journey from their mud huts to the local markets.
We went to 5 homes today. Most of the patients were old, frail and bed-ridden. One lady had a stroke 4 years ago and has been in bed ever since. We saw lots of patients with severe heart failure, one with oedema up to his thighs and hands. But there was nothing we could offer them - there is no echocardiography to check their ejection fraction, no warfarin or INR measurements to treat their AF, and certainly no interventional angiography to help their angina.
Most of the homes are mud huts and slums without a toilet, electricity, kitchen or garden. An entire family would live in a small, dark hut with mosquitoes flying everywhere and chickens running around their house. Although these patients had very little, they welcomed us into their homes.
An interesting case we saw today - we went to the home of a 38 year old male, who is HIV positive. He presented to the hospital with a CD4 count of 1 and is now doing well on antiretrovirals. His wife is also HIV positive and because of the stigma here of having HIV/AIDS, she refused treatment. Fortunately their daughter is not HIV positive. Although over 6% of Tanzanians are HIV positive, there are so many people who refuse to be tested and treated because of this stigma.
Next we went to a local market. It was a typical African market - full of people, and all the merchants on the dirt ground with their fruit and veggies to be sold. It was hectic, and we stood out like a white person with a white coat at an African market. Then we went to a dairy farm... although there were no cows, we did get cheese and butter for pretty cheap! As in 5$ for 1/2 a kilo of gouda cheese! Omg.
It's strange to see a different culture living in such a primitive way. Back home if we need food or other necessities, we drive our European car down a bitumen road, in a safe neighbourhood to a supermarket where we can find anything we want. Here, you have to leave your mud hut, walk miles and miles through dirt streets, under the harsh African sun. Then get to a busy market and spend your only 1000 shillings for the day on a few tomatoes and bananas. This is every day for them, unlike at home - they have no job to give them money, no TV to keep them entertained, and no family to talk to as most of them have died of AIDS.
On a happier note we had a great dinner - pizzas made by two hot Swedish girls!
Today was incredible.
Asante,
Justin
Things that went wrong: Day 4 edition
- Growing old waiting for the outreach team to arrive.
- Learning that the hospital patron's surname means 'vagina' in German.
Picture: One of the mud hut homes we visited today.
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