I started my first weekend here with rounds in OG2, the GYN and antepartum unit. On any given day, there may be 30+ patients that are there for a pretty wide variety of reasons (and not the things we're used to seeing in the US). For example, this weekend, we had 2 patients with advanced cervical cancer (one of which was awaiting transfer to Dar es Salam, where they have a cancer center capable of providing chemo/radiation), an OB patient at 24 weeks, who is HIV positive, and came in with seizures of unknown cause. She was thought to have either bacterial or cryptococcal meningitis, and had begun to improve on antibiotics by the time I saw her on Saturday. Like in Durham, there were also an occasional social admission, for instance, the pregnant, orphaned, 16 year old who had been HIV positive since birth and had lost her entire family to the disease. She had been taken in by someone in her village, but was thrown out when they found out she was pregnant and had no where else to go.
Rounds were also a little different than home- instead of patients having private rooms, there are up to 12 patients in a large room, each in a bed surrounded by curtains, which are usually all pulled back unless we were examining the patient. They all sit in bed and watch us as we make our way around the room. The intern gives a brief description of the patient to the senior resident who listens and then barks out orders, while the intern scribbles... "Discharge." "Continue management plan." "Obtain lumbar puncture." And then we move on. While the patients have no privacy at all, none of them seem to mind. One by one, they greet us and thank us for caring for them as we walk through. I wish I had some pictures of the wards, but I didn't have my camera with me on rounds... I'll post some later
After lunch, we went to a clothing and shoes market, which I can only describe as the largest Salvation Army I've ever seen.... I don't mean that figuratively, either, it literally is. Bales of clothing from donation sites all over (such as Goodwill and Salvation Army) arrive every Tuesday and Friday, are unpacked, and the contents sold for bargain prices to locals and slightly less bargain prices to foreigners. Apparently the best items go quickly after the bales arrived, and things were a little picked over by Saturday afternoon. I have thought about going back on one of the delivery days, but I think I may rather buy some fabric here and have a local tailor make something for me with it- my roommate here has done that several times and the patterned fabric here is so beautiful.
Today, I went to a golf club with Veronica, which is clearly geared towards tourists, but was still picturesque. It's outside of Moshi, near a sugarcane plantation. It's called TPC Club and in addition to golf, they also have tennis courts, a swimming pool and a restaurant (with all outdoor seating). We went just for brunch, which was quite a meal. There were at least 6 courses, including fruit/ granola, a strawberry parfait (seen below), an omelette with sausage and bacon, steak with caramelized onions, potato pancakes with soft cheese and salmon and practically a whole loaf of bread. I could barely eat half the omelette, and there was no hope for the last 2 courses. We wandered around a bit, checked out the pool, etc. The food was good, and we had the added bonus of 1) getting to sit out in the sun and 2) we had a great view of a 7 year old flail around in the sandpit for a good half an hour before she eventually gave up.
The rest of the day I just spend catching up and it cleared up enough to see Kilimanjaro from the road in front of the house. How could it get any more perfect?
So jealous.
ReplyDeleteGreat job on the blog! Did the couple you took a picture of in the cafe think you were a creeper though?
probably.
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