Today, in and of itself was a fairly normal day expect of the holiday and the fact there was but one doctor in the whole hospital and two nurses to 16 + patients in the OB ward. Nothing was really that crazy or out of the normal (for them). However, the accumulation of the past 4 weeks seems to have gotten to me. The way things are done here are becoming normal to me and I’m starting to expect them. Yet I don’t want to expect the way they are done.
There are stages of being an outsider in a third world.
Stage one: You want to be helpful in anyway
Stage two: You see a need and you think of ways you can meet that need (your mind is full of ideas your heart is beating fast and your certain that you can help even just a little)
Stage three: You start to see the string unravel and realize there are many problems
Stage four: pay more attention take notes ask questions
Stage five: talk to people see what they think, what they believe would help
Stage six: scale down your ideas
Stage seven: scale them down more
Stage eight: pick the most important and present thing
Stage nine: brain storm again
Stage ten: Talk to people on board that also see the problem. Feel hope that your change might be possible and will help
Stage elven: Realize that the people that want the change are the problem and not the solution.
Stage twelve: feel numb, useless and discouraged.
Stage thirteen: ask “where the heck do you go from here?”
Stage fourteen: Think “dose it even matter?”
You don’t really start seeing the big picture until you’re around long enough, the bits and pieces start coming together. What you thought was true, might relieve itself to be false. This can leave you feeling discouraged, frustrated and deflated. After weeks of hearing the nurses say they don’t have what they need, that is the issue that is the issue. Hearing the doctor’s day the nurses are the issue, that money is the issue. I hear, I listen. What I see is that everything is an issues everyone is an issue and everyone says they want change but they are not even doing the little they can do. No amount of money can fix this unless that money replaced the whole staff. I know I’m not magical I was not going to fix everything, I know that but when you see that nothing is what it seemed, its hard to have hope that it can get better.
So I have been in Tanzania for 25 days now. There has been ups and downs twists and turns and that only pertains to the roads. Working at St. Joseph’s hospital for the past 3 weeks has been a mixture of patient gowning, mind expansion, lack of ability to communicate with staff and lots of waiting. The past two weeks I have been working in the OB ward, which means there is a lot of around waiting for mommas to give birth.
Every morning we walk into the ward say our half English half Swahili greetings as we head to the bathroom/locker room to change into scrubs. We then check to see if any mommas are in the delivery room. Yes, I am checking for multiple mommas in one room. There is one delivery room with 3 beds separated by partial walls. This is also the room that mommas are checked to see how far along they are. This is something I get to help with. There are a few steps to checking a momma.
We ask the momma how many pregnancies (gravida )How many kids she has (para)
How many kids she has (para)
When her last menstruation was
Then we do the examinations
Look: we are looking for the roundness and if there is an operation scar
Feel: we feel the top of the belly for the fundus to see how many weeks the baby is. Then we do lateral palpation to find the babies back and feel just above the pubis to check for placement of the babies head.
Listen: With a fetal scope which a metal cone that has a rim on the narrow side we listen to the baby’s heartbeat. To use the fetal scope you place the wide end near the babies back and press your ear on the rim. You let go of your hand and press down with your ear and listen to the babies heartbeat.
Then the cervix gets checked to see many cm the mother is dilated.
More to come about delivery
There just are no words
Within 30 minutes of being in the safari jeep (just on our way to the camp, so on normal road) It was already worth the stress and drama it took to get on this trip. I sat up font with our tour guide. Who introduced himself as Deco but told us. “you can call me Decoration”. On the 3 hour drive to the camp I learned a little about some tribes, about alcohol in Tanzania both how’s it’s made and how it effects the people. We talked about monkeys and chaeta’s and all kinds of other things as we drove.
A little bit about Tanzania every town has a tribe. Most of the tribes are modernized but still keep part of their culture, some people are more tribal than others. The Chaga tribe comes from Moshi which is where I am staying at the moment. Every morning on our way to work we drive passed men and young boys picking apart some kind of plant and laying it on large tarps. The plant is called finger millet and it is used to make a chaga beer (every tribe has their own beer) this one is made with bananas that are boiled until they turn red. Alcohol is quite a problem in Africa. I also learned about a banana wine that cost 400 TZ shillings which would be about 12cents and is quite cheap here. Which means the youth buy a lot and drink all day and don’t go to work or work all day and spend all their money on wine. Deco said it teases like juice so they drink and drink and then get crazy. There is a law that doses not allow you to drink until 330 in the afternoon, punished by fine or thrown into jail until sober and let go for free with no record because no records are kept here. The way to get around that law is to stay inside. Also, there is a drinking age of 18 but it not enforced, Father’s often send their young kids to go get alcohol for them.
The attitude of Tanzania is every slow going and peaceful and I have to say I am fitting in quite nicely. Anyone that has seen me this last year knows that I have struggled with always being buzzy. I have to say I am likening this whole Hakuna Matata viewpoint.
As for the animals it was amazing to see.
I just have to say.
Oh the privilege it is to sit and pee with the luxury of toilet paper and washing one’s hands with clear water and soap.
I came here with respect for Tanzania with a plan to learn the culture and to be used as needed, to help, to lead a hand, but not to change things other than changing the way I do things. So I spend a lot of time watching, listening, trying to understand. It is not that I don’t know what to do, but I don’t know what they would do.
I am a doer so not doing is hard. The hardest part is knowing “when do I move?” when do I do? Of course, the question that follows is “what is ok?” when you see things that could be done, do you not try to do or do you walk away?
There is much I don’t know. But I do know one of the hardest regrets to get over is not helping a child that you could have helped. I know what it is to not listen to your gut. I’m not talking about helping a child have what we think a child needs, like clothes or shoes which are trivial things that westerns think are important. I am talking life or death. I am talking if you don’t move it could mean death or at least lots of unnecessary physical suffering. If you move you may help or maybe not help.
I have trusted that others have it and know what they are doing before and have been shown that I was wrong. I am not saying I know best or even that I know better. But I am who I am, I see what I see. I stay still most of the time but at some point, at some moment, I have to move. I was made to move. The question is when?
THE DOCTOR ARRIVED! Only 30 minutes after nine, a stunning success I say.
(in Tanzania time is kept every different if not at all). We started rounds in the private room, which houses kids of the nurses and doctors. Then to the neonatal room that holds 0-28days and then to one side of the main ward. 5 patients were seen and an hour has gone by. There are still 18 patients to be seen and it is 1030. The doctor was telling us you need to take time with patients and not rush. We saw patients with anima, pneumonia, malaria, URI (upper repertory infections), UTI’s. At 1200 7 patients had still not been seen by a doctor. It was time for us to leave so we did not get to finish.
The doctor was really great and sounded like he knew what he was talking about through this broken English. He kept telling us we needed to use our heads, that we needed to think. “you need to spend some time with your brain” he said. That was by far my favorite quote of the day.
We spent the first 30 min standing outside the doctors meeting listening at the window because we didn’t want to walk in late. Once in the peds ward, we were handed mops to clean the floor. We filed papers and waited for the doctor that showed up at 945 today. The doctor we started with yesterday started with us today and then another doctor took over. He was an older man with glasses and grey curly hair. He spoke clear and had good English ( most people here are very soft spoken). I feel as if this doctor understood why we were here and really took the time to teach us and talk to us about medicine in the country.
This day was awesome! However it is the 4th day and feeling has been building up so the inevitable happened and as my friend would say ‘I got the feels’. Seeing lack all week just got to me. The doctor didn’t have a pen light and that seemed to be my last straw for the day. I will touch more on what it looks like in the ward later on next week.
I am going on safari this weekend!
Yesterday we had an orientation day and we got to meet out mentors.
I got to meet the doctor I was working with and got a little run down of the medical care system.
Most tanzanites don’t believe in doctors and will wait very long before they come get help and often times it is too late. They don’t understand that there are cures if you go early.
Only 4% of the population here have HIV.
Some medical insurance is offered but it only covers a little bit most is out of pocket.
(more to come over the next week weeks on that as I learn more)
1st day at medical placement
After 0630 breakfast we heading to the vans
We bounced down bumpy dirt roads for about 25 min and then we pulled up to a metal gate. Once in hospital me and 3 other students walked in and sat on bench and waited for the Doctor. We have been consistently reminded that we are in Tanzania and they have their own time(quite literally which I will try to explain later ). Unlike western hospitals everyone walks slow and there is no rush to get anything done.
Today was the orientation of the hospital we meet the medical director the hospital who is this lovely women dressed in a white habit with a large golden cross hanging around her neck. Once all introductions were made we went on the tour of the hospital. There are 4 floors with a ward on each to get to each ward you walk outside. Everything is very open. There is a Male ward, Female ward and OB ward and a pediatric ward.
After the tour, I spent the rest of the day in the pediatric ward hanging with kids and waiting for a doctor that never shows.
After checking in with the director we headed up to the pediatric ward. The day started with doing paperwork getting all the charts in order. Then we washed the empty beds and windows and awaited the doctor for 9 o clock rounds. We watched burns being dressed and did HIV testing on all the kids, which is a government standard for all admitted children.
When the Nurse stated the HIV testing I ask if I could do it. She looked at me and laughed and said in her broken English “you want to stick children’s fingers?”
Of course, the first child, I test, freaks out and I have stuck him twice. The nurse laughed I just kept going.
Mothers are in charge of monitoring children there are no vitals being taken and no kids where to check on in the 4 hours I was there today. The doctor never showed for rounds which seem to be the norm. There are a lot of differences and a lot of things would not fly in the states. However for the area, I have to say I am impressed with the hygiene and order.
We got to have a peak in the operating theater today which we will be able to spend more time in within the next few weeks.
When telling people that I’m spending my summer in Africa. The most asked question is why Africa. Being the sarcastic person I am, my response has been “why not Africa”. Going to Africa is not new; it is something I have been wanted to do for a long time. For those that have been around me know that I have been almost jumping out of my skin with joy when I say “I’m going to Africa” I am normally not a shout it on the rooftops kind of girl but I really can’t contain my excitement!
This has been a dream for such a long time funny things is when I started all of this I didn’t know I would be going to Africa this summer.
For years I have been wanting to go back overseas I have wanted to work in the medical field and I have been saying I’ll go over the summer and well summers came and went and I never left the country. I think maybe I was waiting for opportunities to come jump out at me. I was looking and had leads but everything seemed to fall through. This year I told myself it was going to happen no matter what I would just make it happen. So I looked and looked and looked until I found the right program that offered what I was looking for. I had no idea of where I wanted to go at the time. My primary objective of this trip was to learn. I wanted to a medical internship with a focus on pediatrics and the ability to apply and hone my skills as a new message therapist. It was not until I was on the phone with a rep talking about my options that Africa came up. She said it my heart jumped up and down like a little kid saying “there, there let’s go there” my mind was focused on getting all the info before I got to excited. When Tanzania was presented as an option I had this feeling that it was where I needed to be. I don’t know why but it just felt right and when it fell out of the running for a bit I was sad and spent calling and talking to people to make things work.
Long story short I am going to Tanzania near Kilimanjaro for 8 weeks to do a medical internship focusing on pediatrics. I will be working in the local hospital alongside doctors and nurses. The second half of my trip I will be working in a center helped people with physical and mental delays working alongside a Physical therapist.
Few facts about Tanzania:
It will be about 50- 80 degrees when I am there. Most days are hot with cold nights.
The main language is Swahili. English is not taught is schools. I will be learning the language.
From what I hear, there are monkeys everywhere that steal your stuff.
I have 4 days of travel with a few stops along the way. I started my journey just 4 hours ago from writing this.
So far so good!
Love you all, thanks for your support !!