Fri 30th Dec 2011
Another day waking up in Machame, except this morning it was raining. I was way too tired to go to chapel this morning, so after the best sleep in, I decided to get ready for the hospital. Unfortunately there is no washing machine, and I have to wash my clothes by hand. The most recent load went mouldy, and as we have 1 bucket to share between 4 people... I can't wash my clothes again until Sunday! FML
So after wearing the same, stinking clothes for the past 3 weeks, I went to the outpatient clinic. When we got their this morning the nurses told us that the 'floor was too wet for clinic'....so we had to wait for the floor to dry.
After waiting back at our house with fantastic Swedish company (they can be so delightful sometimes)...I met up with the doctor in clinic. Her name was Dr Minja, and no I'm not joking. As funny as her name is, we did see some amazing cases.
The morning list started with a pregnant female who complained of 'body malaise'...Dr Minge diagnosed this as malaria. She was right. For the pregnant women, they don't say how far along they are. They write down... 'Patient complains of 5 months of amenorrhoea'.
The doctors have to be really knowledgable. They don't have access to specialists and can't make any referrals. They pretty much do everything- obstetrics, general medicine, paediatrics, heaps of general surgery and orthopaedics. They also don't have any access to cultures here. So they can only do a urinalysis dipstick and stool microscopy. They diagnose UTIs and gastro based on the micro result. The blood tests do come back pretty quickly... like within 1 hour for routine tests. Even the obstetric ultrasound comes back quickly.
They love the multivitamins here. A 95 year old male came in with 'unable to stand for a year'. So they prescribed multivitamin, 2 tablets for 5 days. How about checking his legs?!
So a few things went wrong today. After cannulating a female with an acute abdomen, the nurse dropped the needle on the floor and left. I noticed it some time later and told Dr Minja. She is the type of person who hates to get her hands dirty ... So as I expected she freaked out! She doesn't even own a stethoscope. She says she lost it...but I think she threw it away after it got contaminated. Maybe a patient touched it?
Michael also had an interesting morning. He managed to stumble across an emergency resuscitation of an unconscious patient. And discovered first hand how inefficient and ineffective a Tanzanian emergency department is...especially as it consists of just a corridor inside the outpatient department. After 15 attempts at cannulating him..a doctor finally came and put one in. Unlike 3 mins for a MET team to arrive back home...it took 1 hour for the first doctor to arrive. It took 2 hours for him to get to ICU.... where he was finally given oxygen. He must have been the first patient for a while to be given oxygen...as they had to use a spanner to turn on the oxygen cylinder. Ah Tanzanian time.
After such an entertaining and educational morning Michael and I went for a long walk to the local orphanage. The Neema Orphanage is located north of Machame. It houses around 50 children without mothers (orphans are allowed to have fathers here), aged between 4 months to 5 years old. We came and brightened their day with lollies (pi pi in Kiswahili)...but the carers wouldn't let us give the children lollies until they finished their fruit. As soon as they finished they raced to get some 'pi pi'...and even tried to eat the wrapper. They must've been pretty hungry. It was a great experience visiting an African orphanage, playing with the very cute kids and we are looking at helping the orphanage with our fundraising efforts.
Living here, we now know what it's like being an international student like Yang. It's weird when people call us international students... Mostly because I'm not Asian and don't spend my weekends in the Barr Smith library studying. We have though been eating heaps of rice though...
Justin
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