Thursday, July 31, 2014

This week: Watoto (babies!)

This week I have been in the OBS and GYN ward at the hospital.
Heather and I began Tuesday by simply walking right in and offering the “sisters”, aka nurses, shortbread cookies.  It is also fair to say we walked in with ONLY the cookies, lacking any previous knowledge or experience in labor. We shuffled into the labor ward and noticed that five beds were occupied, and two of the beds were taken by screaming mothers. The women are not given any painkillers in order to hasten the second stage of labor.  We had no idea what we were doing, or what was going on… so we stood around until one of the nurses snapped on two pairs of sterile surgical gloves.
An injection of oxytocin was prepared and a sterile pack was set on the end of the bed of the birthing woman. I stood at the edge of the bed looking on as the nurse half guided the birth. She wore a very tired, apathetic face. My face was lit with excitement and anxiety. Before I knew it the head was out, and the rest of the body was guided out in a short instant following the head. I felt a rush of indescribable joy and happiness that moment. It was truly a feeling I have never felt before. My body suddenly warmed toe to head, and I heard myself utter an uncontrollable “aw.”
I saw that child take his very first breath of air on earth.
The following day in labor ward a crying baby was slow to come. After about one hour of waiting, the screaming from the mama of bed three began. A baby was born. The baby had low muscle tone and was having difficulty breathing. The births I had seen the day before lacked complications, so when this blue baby was born I was unsure how to stimulate breathing. We rubbed that back of the child vigorously, before the nurse brought him to the newborn warming table. The sister used suction until she entered a suction tube down the baby’s nose and throat. The machine broke, and the nurse reverted back to manual suction. Final the baby was breathing well enough that they ceased suction and let the child lay under the heat lamp. It was clear that the baby was still having trouble getting air in and out of it’s fresh lungs. It was painful to watch the fight of this 15 minute old mototo. All we could do is hope for a happy ending.
Upon walking back into the labor ward we found the doctor who was in distress over a woman who had umbilical cord prolapse. Umbilical cord prolapse is a delivery complication in which the umbilical cord leaves the body before the infant. Because the umbilical cord is the fetus’s lifeline, without it the fetus will die.
This woman had to be rushed into surgery for an emergency cesarean section.
I SCRUBBED IN!
Thankfully I had a second pair of scrubs, thanks to Zigi for running home to get us (Heather, Zigi, and I) an extra pair. What we didn’t have were hairnets, so we used old cotton rags pictured below. We looked pretty official.
If I thought I couldn’t handle blood before, NOW I without a doubt know that I am capable of seeing blood… and lots of it. We saw handfuls of blood in surgery. The mama was first given a vertical cut sternum to lower abdomen. The second small incision was in the fascia, which was made bigger by ripping a bigger hole to make the uterus visible. The last incision was made in the lower portion of the thick uterine wall. The doctor quickly grabbed the baby by the foot (the baby was positioned breach in the uterus) and set her down for the nurse to take over. The nurse whisked him away and we heard a faint but audible cry. We all smiled and awed, thankful that she was healthy. Before the three layers of suturing the doctor showed us the woman’s anatomy (briefly). Looking at the tightly packaged organs was my favorite part. He also showed us the very full bladder, which was the reason behind the initial vertical incision. Next was the bloody suturing… three layers of it.
The doctor did a beautiful job. After the Ketamine (street name: angel dust) had worn off the patient was dazed but awake and healthy.
Heather and I saw the baby in the neonatal ward today, pleased to see it’s happy smiling face.
Today (lao) is Thursday. Our move tonight will be to club ViaVia with many other volunteers and friends! It will be lonely without our crew of 12 but we are anxious for the night regardless!

Tuesday, July 29, 2014

Holiday

Happy Eid al-Fitr from Tanzania!
Eid is a “festival of breaking the fast,” celebrated by 1.6 billion Muslims around the world. It follows Eid al-Adha, which is the “festival of the Sacrifice.” The holiday’s significance comes from the commemoration of Ibrahim (Abraham)'s willingness to sacrifice his young first-born and only son in obedience of a command from God. Today the Islamic population celebrates the end of Ramadan fasting. Celebration includes family and friend gatherings, sweet dishes, using perfume, wearing new clothes, musically performances, etc.
The streets are often loud with backfiring motorcycles and loud rusty cars, but this morning I woke up to Islamic music bursting through my bedroom window; it was a nice change. I knew the holiday was upon us and the music excited me! I went on a run with Ben this morning hoping to see some of the celebration. The streets were much less crowded than we are used to. We noticed many men and women dressed their kufi’s (cap), and hijab’s (head scarf). We passed by a Mosque FULL of people. The ceremony was so loud that we could hear it from across the street. This volume was surely to accommodate the 100+ people outside the building listening in. The experience didn’t stop there. Heather and I decided to go into town to food shop, but before doing so we were invited into our neighbors apartment to have a special treat. We were caught off guard but very pleased to join. We sat on the couch and waited as our Islamic neighbor’s wife set out some sweet dishes for us to try. The first dish is known as, Seviyaan. It is boiled milk, sugar, and Vermicelli. I enjoyed it very much. This experience explains the festival's alternate title of “The Sugar Feast.”
Our neighbors were so kind to allow us to join them in their celebration, which continues into tomorrow. I am pleased to be learning about the many cultures and religions that surround me in Arusha!

Sunday, July 27, 2014

Colorful land, colorful culture

Good morning everyone!
Another adventure to update you all on: a hike halfway up a dormant volcano to see a 50m waterfall.
Clemmons, our tour guide for the day, started us about 12km from our waterfall destination. The scenes weren’t like anything I have ever seen before. I will attempt to describe them but there is no way I can describe the beautiful landscape, no matter what mix of adjectives I use. If I were to paint a panorama of what I saw yesterday, I would only need four colors: green, brown, black, and white. Everything I touched with my feet or my hands was either earthy brown or various shades of green. But, upon a close-up view, I would add every other shade of the rainbow due to the wild flowers that were sprinkled perfectly across the land.
 I couldn’t help but pick one and put it behind my ear.
The land we walked wasn’t a compilation of random backyards it was village farmland. Each way you looked you’d see patchwork of various gardens.  What kind of fresh food vegetation did we see? Maize, carrots, beans, red cabbage, Chinese cabbage, avocado trees, sweet potatoes, brown potatoes, zucchini, COUNTLESS banana trees, and my favorite of all… coffee bean bushes. Did you know that coffee beans are sweet before being dried and roasted?
We also pick our own FRESH carrots…
 I don’t know what heaven is like… but I imagine it’s similar to this magical place.
 According to Clemmons we passed through three villages on the way up, one of them being his own. His village is the Kipande village, which translates into, “a piece of something.”
We were told this while we sipped banana beer provided by his friend since childhood who brewed the batch fresh that morning before we all journeyed on our hike. It was an interesting flavor, very acidic but sweet with bananas. 
The taste didn’t matter because, according to Clemmons, banana beer is a drink that brings people together. It is only served from one shared cup. The people who share it are usually strangers who leave with a tummy full of ndizi beer, and a new group of friends.
After 4 liters of banana beer gone, we taught our new friends the game of Frisbee. We played with a bucket lid that some young children (mtotos) were playing with. Our game consisted of 13 people, and our goal was to get 10 caught passes in a row. We had so many good laughs at falls, and fails before we finally reached our goal. We carried on down the mountain through a number of villages, passing more farming land as the sun set at our backs.
I fell in love with the countryside yesterday. I once thought I was strictly a city girl until I imagined my life in a small hut made from banana tree stalk, running through the hills each morning before tending to my our fruit and veggie gardens.
This morning I woke up at 6:50a for church. I thought it was going to be impossible to wake up, but I was reminded at 6:30a that our complex has a roaming rooster. I was up and ready for mass at seven-thirty. Phabian came to pick me up with Harriet and we were off to church. I was eager to compare the differences between a mass in the states vs. Arusha.
For starters, I soon realized I was the only white person of nearly 300 local Tanzanian people. As mass went on I realized that coming in late to church is no problem. Rather than seeing a your average five late families, the church began with the amount shown in the picture below, and grew about four times that amount.


Of course, this attitude is something readily accepted here. “Pole, pole,” which is Swahili for “slowly, slowly” is the motto here in TZ. I read in the same tour book mentioned in a previous post that arriving 30 minutes late to an appointment is on time, and arriving an hour late is acceptable. Those who know me well know that this place is absolutely perfect for me and my bad habit of being late. Oh and the choir singing was magical. We clapped during the songs, and there was no book to follow, the people in the pews knew the words and sang along with ease. I wanted to dance along with the musical artists! Their enthusiasm during each song persuaded me to ask Phabian if we could sit next to them next Sunday.
The Swahili mass lasted two hours, which is double the time of mass at home. Because I couldn’t understand the words I decided to say a few rosarys on my new 2000 TZ Shillings ($1.30) rosary. The most interesting difference to me was that all those volunteering to give money during the offering and/or participating in communion just got in line when they felt like it (no one was ushered to leave the pew during these events). Although, this felt like disorder to me, all things continued without a problem. I had no clue when to stand up to receive the bread…
Apart from the differences, many things were the same. The progression of the mass was the same. I knew when the sermon was being given. I kind of knew when to stand, sit, and kneel (thanks to watching others, of course). I murmured the Our Father prayer under my breath in English when I knew it was being recited. AND my VERY FAVORITE part of mass was offering peace to those in the pews around me. To those of you reading this who are not Catholic, that is when we offer those around us a sign of peace: handshake, hug, kiss. In TZ this moment was so special to me. Church was a bit cold this morning but this instant warmed me right from my heart out.
amani na awe nanyi – Peace be with you
xo

miss you guys.







Friday, July 25, 2014

Thoughts Tonight

Tonight I lie in my bed wide awake thinking about my time in Arusha since I arrived 11 days 6 hours and 30 minutes ago. I am trying to put into words how I'm feeling right now.
It's a mixture of love, sympathy, frustration, excitement, gratitude, pain, and happiness. All the negative adjectives can be explained by both what I've seen at the hospital and the surrounding cultural environment. 
I finished another night shift at the hospital tonight. We all had a productive night of learning and growing, as we always do.
I felt love today when I held a little boys hand as he received a 5% dextrose IV drip. The little guy was suffering a hypoglycemic coma. He had been rushed into the hospital by his mother who feared she was going to see her son die.
I felt sympathy for the mother who wouldn't even let go of the 7 year olds hand, not even to grab her phone to answer relative's calls or get a drink.
I was frustrated when I was told a patient from gen med wasn't going to get the medications she needed simply because the family refused to get them. Especially because those same family members treated other med students and I terribly upon the young girls arrival into the ER Wednesday, stating the urgent need of attention to her situation. 
I am excited to embark on a 15 mile hike around Mt. Meru tomorrow.
I am extremely grateful… for countless reasons. I am grateful for the small: being able to sleep on a mattress. I am grateful for the big: the chance to be here in Africa exploring a new culture each day.
It pains me to have to see the economic snuggles of a a 500 bed regional hospital... because I know if they had more money and more equipment that could serve the sick better.
I am happy. Happy to be breathing, living, and smiling.
Goodnight world.
Xo

Thursday, July 24, 2014

Loving and Learning

“Nafurahi kukuona” is my phase of the week. I have been slacking on new lingo outside of the hospital. HOWEVER, I have been using the following words in the hospital: pain, where, good job, so sorry, why did you come to the hospital, blood, yes (in response to being called), head, and stomach.
But, my phase this week comes from an encounter I had with an Army man from the Congo. I met him in radiology as he assisted a patient there. I was waiting with Heather, Sophie, and the Elective Africa's assistant coordinator, Phabian, when he approached us. I spoke the little Swahili I knew and introduced myself, and the others did the same. He explained his background in choppy English and we had Phabian translate what we couldn’t communicate in Swahili about our background. We all ran into the problem of not being able to say, “nice to meet you.” He taught us how to say it, and we had a good laugh as we struggled to pronouce it correctly.
He was really good looking… I should add.
After speaking to the head doctor of the radiology department and as we were leaving the ward I ran into the Army man, Nukuna, once more. He grabbed my hand, and as I said bye (kwaheri), he said “I love you.” I asked him to repeat it and he repeated the three words often heard after 7 months of dating not within 7 minutes of meeting. We had a laugh.
Watch out mom, I may come home a married woman.
I want to quickly mention today’s events at Mt. Meru Regional Hospital. We again went on rounds with Dr. Farrah. He encourages us to complete the rounds independently as a team. We are even encouraged to make an educated guess on the diagnosis based on patient history, current symptoms and a physical examination. Today we had five volunteers from Elective Africa, and one from Work the World. We saw everything from chronic renal failure, to gangrene. We ended the shift with a plural tap/pluralcentesis…. AND I ASSISTED. Only with the lung-fluid draining process but I assisted none the less!
Check out that photo bomb ;) 

Tonight is a big night for us in the program. It is one of the last nights we will all be together as 12 (including Phabian). After a great week at the hospital, we are all eager to have a few drinks and relax. I’m lucky to be here in Arusha with such an fun group of people. XO

Wednesday, July 23, 2014

Today:
Completed rounds with Dr. Farrah in General Medicine Ward
            -Walked through SOAP (Subjective, Objective, Assessment, Plan)
            -Performed OBS (Observations/vitals)
Gave my first IM (intramuscular) injection – 100ml Tramadol
Saw my first amputation (tip of the finger to DIP joint-Distal Interphalangeal joint)

FUN FACT: did you know that in our bodies we have a ratio of 10:1, bacteria to cells? It is true.

I am not gonna lie… the amputation had me feeling a bit faint. The boy must’ve been a mere 12 years of age. He was such a champ, only wincing when the med student or Dr. Mlambo hit a spot that hadn’t been numbed by the Lidocaine.  
Going to join some others for night shift in causality tonight. Let’s hope for another busy night!

Types of patients I have dealt with in GenMed, or Cas: HIV, AIDS/ stage IV HIV (CD4 count under 200), Malaria, Brucellosis, Status Asmaticus (acute asthma that remains unresponsive to initial treatment of bronchodilators), Cryptococcal Meningitis, Diabetic Ketoacidosis (DKA), Mitral stenosis resulting from A Beta-haemolytic streptococcal infection (Strep—> Rheumatic fever), Atrial fibrillation, patients with external wounds (broken bones, gashes, burns, generalized abdominal pain).

Tuesday, July 22, 2014

Kwa nini uma kuji hospital?


Most of you who are reading this probably know me pretty well. You may not know, however, that high stress situations involving blood and guts don’t necessarily suit me.
Since the day I began this program, I was told the causality ward (better known in the U.S. as the Emergency Room) is where I would find the most hands on experience. I was unsure about this idea especially after hearing the horror stories from the others. It probably wouldn’t be as scary if the hospital we volunteered at had more money. In the ER, construction paper is used to wipe dirty hands, the scalpel doesn’t have a proper handle, there are no scissors and any metal tools are rusted. I know in my heart that despite the unfortunate conditions, we are all here to dedicate our time and knowledge to Mt. Meru Regional Hospital; and we did just that last night.
Five others and myself decided to work the causality night shift last night. We were picked up by our driver around eight (half an hour after we were meant to leave) and arrived at the hospital ready to work, with the doctor nowhere to be found. Two patients lie on the bed. Patient no. 1 had just been in an accident; patient no. 2 had not urinated in a full day. Patient no. 1 was carried out by his brother (caca) and sister (dada) after two hours of not being treated. We understood the family’s pain and frustration. We knew the English-Swahili language barrier did not allow us to respond to what he needed.
The language barrier makes it so difficult for us to carry out normal tasks at the hospital. When one is in pain and needs help in an instant, communication is everything. Think of all the things communication allows in the hospital: an explanation as to why the patient came to the hospital, a full history, a means to talk through treatment with the doctor/nurse, and a way to console the patient and family. But, as I said before, we do what we can, because that’s all we can do.
After the first two patients were cared for were gone, we all stood around waiting for the doctor. Nine o’clock passed like molasses. In that time we met the lead doctor on shift, Dr. Line (Lean-Ah), and some of the nurses.
Finally some action appeared with the introduction of a drunk patient who had just been in a motorbike accident. He needed three sutures above his left eye. He also had burns on his right arm and knee, and superficial cuts all around his head. Ben, who is a fifth year med student, talked me through a full body physical. Next, I watched Ben perform the suturing job on the man’s eye, providing comfort to the patient by holding his hand.  Let me mention the blood was GUSHING out of this mans deep cut. Heather had explained to me following her first night of causality, “After the first gruesome scene you see, they all begin to look the same.” I felt confident that I could stomach anything.
 I didn’t know what I had coming…
11:30p.
Ane and I were looking on as a mother talked to Dr. Line about her child’s symptoms of pneumonia. Suddenly, a woman ran in yelling, screaming and pointing to her chest. Five seconds later a man was wheeled in with a trail of blood behind him. The doctor looks to Ane and I and says, “bullet wounds.” I then watched as the man took off his first layer of clothes to show an underdress DRENCHED in bright red blood, neck to knee. I turned around for about five seconds, before I got a rush of adrenaline. I walked to the end of the bed where he lay in shock. The family is surrounding him; the surgeon joins the circle around him. The surgeon shows us the entry and exit of a bullet in the ankle, two more in the thorax, and one in the arm. Whoever shot this man wanted him dead.
Not even two minutes later two psychosis patients came in screaming and yelling. They we sedated with diazepam and taken on a stretcher to general med.
A minute after that a female victim of domestic violence came in. I was hovering over the doctors shoulder during this time and she turned to me and said in a whisper, “bite, her husband bit her.” She had a large gash above her left eye. I was told that I would see domestic violence while I was her in TZ. My heart broke as a looked at this woman’s sad, embarrassed face. Another perspective put into place for me… In America girl’s fuss when they don’t receive flowers “just because,” while in other parts of the world women fight for their lives in disputes that could end like this one.
At 12a our night ended reluctantly. We all talked about our busy night on the car ride home with enthusiasm.
Today I am heading to the general medicine ward with four others. This is the in-patient ward. Time to throw on my scrubs and get to Mt. Meru! xo

Sunday, July 20, 2014

As fun as bubble gum!

REPORTING TO YOU LIVE FROM AFRICA
I woke up this weekend with a cold. It all started Saturday, a little (kidigo) congestion and noticeable post-nasal drip.
Regardless, I had a great weekend, hence the title of this post. Friday we all decided we needed a day to relax by a pool and catch some rays. The Norwegian girls in the Elective Africa program did some Google-ing and found the most beautiful hotel I have seen since my arrival in Tanzania (we have been in and around a few). 
When the taxi driver arrived, he pulled to the gate and waited until the security guards screened the car. Before any of us could enter the hotel we were waved down with metal detectors. I should add that the car check consisted of a man with a mirror at the end of a pole making a lap around the car, checking for explosives on the underbelly of our taxi. Also, while I was being waved down with the detector, the wand beeped at least five times and the guards didn’t flinch and just moved on to the next search victim.
The hotel housed four restaurants, most with indoor and outdoor seating, a salon, a massage studio, a gym and pool. We came for the pool. During my time there I completely forgot I was in Arusha. 
We were surrounded by tons of beautiful vegetation, and the greenest fresh cut grass. The lawns that encased the pool area were tidy and neat; one could certainly have a wedding reception there. We played Frisbee, got sun, and I tried to forget about my cold.
Today, Sunday, the roomies and I decided take a canoe safari to Lake Duluti. 
The lake couldn’t have been half of Lake Townsand, but what it didn’t make up for in size it made up for in depth. Lake Duluti is 700m deep. Can you believe it?! According to Tanzania: Culture Smart, Tanzania is home to the deepest lakes in Africa. We saw many Cameroon's, a couple King Fisher's, and five giant lizard things… We lapped the lake once, and finished the adventure with glass bottled Fantas. 
Also… my cold is gone (basically). I swear by Zn+ ya’ll: Taken at the first sight of a cold!!!

Saturday, July 19, 2014

Stayin' fit in Arusha

Nothing feels better than a solid workout. To get the endorphins flowing Heather, Sophie, and I like to do what we call: Circ-outs! The following is an example of what one of these workouts looks like. I also have to add that these workouts are done on the roof of our apartments, in the afternoon, just in time for us to finish with the red African sunset, and the most perfect view of Mount Meru. Mount Meru is an active volcano, destine to blow at any minute (it was scheduled to erupt a few years ago).
AFTERNOON WORKOUT w/ SOPHIE (and a small guest appearance by Adam):
Begin with 25 mins of kick-around soccer
Cardio Circuit (3x):
Flog jumps for 40 ft
1 min jumprope
1 min step-ups
Abs Circuit (2x):
50 90-degree ab crunches
25 lemon squeezes
60 second plank on elbows
Leg/Glut Circuit (2x):
15e leg – butt lift (bridge)
15e leg – fire hydrants
10e leg – single leg donkey kicks
15e leg – lateral leg raises (on the ground)

End with stair runs up and down 8 flights (4x)
The woman and child from A1 on the first floor usually come up to do their laundry and use my jump rope during our Circ-outs. They even mimicked our single leg donkey kicks once we finished to show us their skills!
Exercise between cultures is extremely different. Exercise for them is incorporated into their daily life. For us, exercise is added because our routines consist of much more sedentary time and much less active time. As an exercise science major these cultural difference are very interesting to me. 

Friday, July 18, 2014

Strange

Yesterday was an adventure.
The morning went as it usually does, after my run we all went into the hospital. Heather, Sophie and I felt like the leaders of the lab. I was in charge of organizing the different blood samples into their testing groups (chemistry, hematology, and serology).  I also charted the blood samples, promising Heather and Sophie I would have my first draw SOON. They have been drawing blood like pros!
In the afternoon most of the volunteers of Elective Africa decided to head to an area known as the Njiro Complex that caters to foreigners. The shops provide free wi-fi, a frozen yogurt shop, a cinema and much more.
We decided to take a taxi, and after bargaining for the right price we hopped in. We arrived at the shops with excitement as it felt like a piece of home. The shops were similar to an outdoor mall, u-shaped, with a restaurant in the middle. We all spilt into small groups checking out the two-story mall. We were thrilled to see a big supermarket that housed things we’d see in our home countries.
As we were picking out different wines for the nights festivities, I reached for my wallet and realized it was missing from my purse. I knew I had brought it with me because I had paid the taxi driver on the way there. Moreover, I was pretty sure it never left my purse. I hurriedly called the taxi driver, thankfully we had gotten his number during our ride to the complex, and asked that he return so that I could check his cab for my wallet.
The tears started falling. I was nervous my wallet was in someone else’s hands.  After what felt like an eternity, Rama returned in his cab and without my lost wallet. He promised no one else had ridden since he dropped us off. I was a pathetic puppy dog with tears running down my face. At that point we decided it was time to return home. We got in Rama’s taxi and left. All the others were extremely apologetic and promised me we’d figure it all out one way or another. Even Rama, who knew little English, kept repeating, “This is terrible, just terrible.” I pulled out a worry doll form my purse and held it for the entire ride home.
Once we arrived I made many failed attempts to solve the problem. I needed to cancel my Visa, and transfer funds. My Tanzanian shillings were gone and there was nothing I could do about that, and everything else could be replaced. The problem was I couldn’t call my bank. Of all eleven people here no one had a phone that would dial out to the U.S. I tried Google Voice, and was on the way to use Skype to dial out when I heard voices in the living room.
“Where was it?," "Where did you find it?” followed by Adam saying, “Grace, someone is here to see you and they have something that will make you very happy.”
I ran from my room to see Rama and my missing Visa (which was about the only thing of real value in the wallet). I ran to hug him.
Later I realized that the entire situation was unbelievable sketchy, or dodgy as Sophie would say in her Australian slang. Either way, I was more than pleased, and
decided to use this incident as a reminder that you can NEVER be too safe.
Tanzania isn’t like North Carolina in many ways. But, sometimes I am able to see 
similarities; my experience at ViaVia nightclub was one of those times.
It was a Thursday night, and after a round of Kings Cup/Circle of Death/Whatever You Called It In College, we decided to head to Arusha’s most popular danceclub, ViaVia. We arrived, paid cover, took a free entry drink (made from watermelon juice), and walked it.
I was immediately taken aback by this place. It looked like three bars that had been randomly spread out on a hill. This bar was entirely outdoors. It reminded me of Greenstreet. For those of you not from North Carolina, Greenstreet is a three story nightclub in downtown Greensboro. The set up at ViaVia reminded me of Greenstreet because there were two dance floors; one for the dancer floors meant for minglers, and the other one (downstairs/bottom of the grassy hill) meant for ragers.
One difference… ViaVia’s downstairs dance floor opened up with acrobats instead of headliners from a band.



It was a good ending to a weird day.

Wednesday, July 16, 2014

FIRST RUN IN AFRICA

Habari ya asubuhi! (good morning)
All of you from back home know about my passion for running, which leads me to this post of my VERY FIRST run in Africa. Today marks my 8Th day here. I cannot believe I made it this long without a run. Don’t worry my co-medical volunteers would be the first to know if I lost my pulse.
I reluctantly got out of bed at 6:55a.
Arusha has predictable weather, beginning with a “spitting” rain in the morning, finishing with a sunny afternoon and African red sunset. That being said my friend Ben and I were left to run in the cloudy/rainy weather. I really enjoy rain runs and promised Ben, “it will be great!”
My run began in boxers. I did my wash yesterday (by hand) and all my running clothes were hanging on clothing lines of the roof adjacent to our apartment building (our roof lines get pretty full). It was a fun start as I undressed on the roof into my running attire in a hurry!
Our run was strictly on the sidewalks of the busy street roads to ensure safety. There was a mix of emotions on people’s faces as they saw two "muzungu's" pass by them. Some smiley, others upset, and most were left confused. In America it is so common to see the early morning exerciser, especially in Colorado. In Arusha the people up at 7a are little ones going to school in their uniforms, and the common man and woman heading to work in the city square.
I made an effort to wave and smile at people as we passed. 
P.S. Muzungu is a name often called out to the other white students and I and we were told it meant, "white person." According to Urban Dictionary it directly translates into, "Someone who roams around aimlessly"
I guess that was an appropriate term for Ben and I this morning… 

Okay, enough of the run talk; I have GOT to get ready for the hospital.


Yellow Flower

We began at 8 a.m. at Mount Meru today. 
The supplies around the hospital are always few, which required us to get antiseptic for the phlebotomy clinic right away. On the way there we passed a pair of bloody flip-flops, and a man being rolled out on a stretcher, face covered, dead. Before the hospital I thought I had experienced culture shock, but it wasn't until my first couple of days at the hospital that I felt the true difference in cultures. I could go on and on about the differences in aseptic technique, care for patients, confidentiality, and availability of supplies but I imagine that as my blogs continues you will get a sense of the differences yourself. 
I worked in the lab today. I worked alongside a very sweet, and talented lab aspiring technician by the name of Joseph. Today was clinical testing day, as is every Wednesday. We focused on two tests LFT (liver function test), and RFT (renal function test). LFT consisted of testing for two liver enzymes that appear when damage occurs, and RFT tested creatinine, which appears in high amounts when the kidneys aren’t functioning well. I worked with the lab ladies (and Joseph) testing these levels from various blood samples. The language barriers between us have certainly been difficult encouraging simple word vocabulary, slow speech, and hand signaling.

I have got to tell ya’ll about the most interesting part of my day: my very first blood test of the day was the RFT (creatinine) test. Mr. Machina had a very high level of creatinine in his blood, along with symptoms of chronic hypertension, and edema in the lower limbs. The test reported such a high value that the test was repeated a second time… with the same results. I was then asked to retrieve blood from the patient who was in the general medicine ward. Although asked, I didn’t draw blood myself agreeing to assist. After retrieving the vials of blood, and testing for a third time we, yet again, we got results 8x the normal range. Renal failure? I don’t know, but I promise to check up on the patient tomorrow and report back to you guys!
OH and Dam (blood) is my Swahili word of the day. 
We visited the orphanage again today. We planted trees as I mentioned in my previous post. 
There seemed to be more kids today than we saw last week. They sang songs to us, and we played games us volunteers played as kids. Heather and I taught them the Hokey Pokey!
As me and five other children walked down from the beautiful hidden backyard garden where the trees were planted I decided to pick a beautiful yellow wild flower.
I wanted to give the flower to the little girl beside me. As I walked toward the flowers she darted over to me, and picked one from the same bush. I handed her the flower I had picked and she handed me her freshly picked flower simultaneously. Soon after our exchange, the other five kids picked flowers and we all ran back to the orphanage with a little more color than we started with.

If ever I am down in the dumps I will think about these kids, who have nothing but smile endlessly as long as they have a hand to hold.

Tuesday, July 15, 2014

Playing Ketchup



As a small start to a blog that has been started many adventures too late, I’d like to introduce my very first blog post. I am quite settled in my short-time home location of Arusha, Tanzania. I will do my very best to try and reiterate what I have done thus far on my journey here, although I imagine I’ll miss things as I have a lot to catch up on.
Luckily I have a glass of Balance, South African wine on my bedside table to accompany me as I make an effort to remember my journey thus far.
It all began at 4:30 a.m. at the Piedmont Triad “International” Airport. I hardly got sleep the night before anticipating the long 23 hour trek to Kilimanjaro Airport in Tanzania.  I remember telling my mom and dad in the car that morning that I was unsure whether I had even slept the night before. I had my 70lb bag, a mountain pack, my Jimmy bear, and a smile on my face as I waiting in security waving to my momma and tired daddy. I handed my passport to the TSA guard, entered security and I was on my way.
HERE I GO...
From Greensboro I traveled to Washington, and Washington to Ethiopia.
In Ethiopia I was greeted by a chilling rain, and a stairway off the plane into the airport. I was then instructed to go through another security check. After a long TWO hours in the line, and a marriage proposal by the security guard I was off to board my last plane to my final destination. There were more butterflies in my stomach than are found in a butterfly conservatory. After a final safety brief from the flight attendants, and a long deep sleep, I touched down in my new home. Suddenly everything became real. The Tanzanian flag was waving in front of the small orange airport known as JRO. It was there that I met the Elective Africa coordinator, Phabian. I had been traveling for an hour short of a full day, but felt more alive than ever.
After an hour drive I had arrived at the Premier Apartments. Once the gates opened (it is a gated complex) there stood seven other students that would be staying with me in the apartments! They were heading to a local orphanage, and I was determined to pull myself together and go. I quickly set my bags in my room, put on a fresh pair of pants, met our cleaning and cooking staff and ran back down to meet the others.
On the car ride to the orphanage, I found out so much about my new hometown—some bad, some good. I got the low down very quick and I was glad to have experienced souls fill me in on the ins and outs of Arusha.
Upon arriving at the orphanage we were greeted with open arms by 35 children. I immediately took one into my arms overwhelmed by his happy face. It is not often that people come to love on these children, so when they have other to embrace their presence the fire in their hearts burns so bright.
During our time there we skipped rope, played wall ball, and introduced the kids to games played in our countries (duck-duck goose, ring around the rosie, etc.). Isaac, the orphanage coordinator, then asked the kids to sing for us. I have attached the video of one of the many performances they put on. Lastly we got a tour of the orphanage, which tore my heart into two. The 35 kids were split into two rooms at bedtime; the boy’s room didn’t come with a mattress. Their room for learning was a small room with four pews, and a small chalkboard with the numbers 1-10 written in English. The room connected to the learning room was empty, and meant to house the young children while the others were being taught. My perspective on life was dramatically altered that day, and much different than it has ever been altered before.

The orphanage was the first bit of African culture that I had seen, and it was something I had expected to see in a movie, not in my own life. On a happier note, we will return to the orphanage tomorrow with loads of goodies. We plan to plant trees with the little boys and girls. I cannot wait to see the little kids and share pee-pee (candy) with them.
I ought to quickly mention that people drink here, just like anywhere. We took a trip to a bar known as Bar 40/40, and took shots. Not normal shots, however, these were shots on fire.
In America (at least at all the bars I’ve been too) the shot is blown out before it is taken. Not in Africa, not at Bar 40/40. We, my friend Mike and I, were instructed to take the shots while lit.
This ended with the fantastic aroma of burnt hair, and green stains of Sambucca on my shirt, and Mikes. In a matter of one second, I managed to burn my hair, burn my right eyelashes to mere stubs, and spill the green shot on my own shit and Mikes.
The next day I slept until 1 p.m.
On August 11th we left for a safari. We were to travel three parks: Tarangire, Ngorongoro Crater, and Lake Manyara. To be honest it would be a disaster for me to try and write out the adventures of last weekend for a few reasons: 1. Each day came equipped with loads of funny, embarrassing, interesting, dirty, silly, smelly stories 2. I have already forgotten a number of things, and 3. This wine is getting past my blood brain barrier all too fast. So let me give you the highlights.
The first day we drove from Arusha to Tarangire. Sophie was attacked by a monkey after Adam tried to coax it into taking a selfie with him. The little babe left paw prints on her knee. My sides ached afterwards because I had such a good laugh.
That night we were taken to the place where we would be staying two nights. We arrived at 3 p.m. for coffee and tea, and at 7 p.m. we were given a three course meal.
Did I mention the abundance of banana trees here in Arusha? It is a very popular cash crop here as they are everywhere.
On the first day of safari I had six—six full bananas.
On the second day of safari all the magic happened. We saw many animals, including a simba (lion) that was a short 6 ft or 1.84 meters away. Sophie cried, and Joy screamed shit about 36 times as she attempted a video of the lion we named mufasa walk slowly and carefully across the tall savannah grass. I also must add that the lunches packed for us during our safari journey took me back to elementary school lunches. We were given an assortment of a few snacks… oranges, bananas, mystery meat, strange stuffed pockets, eggs, and muffins among other foods. Heather always begged for the eggs, Sophie the strange stuffed pockets, and I the bananas. Lunch was similar to a trading post for medical interns/volunteers on safari. The last spontaneous story worth sharing is the topless safari, which entails just what the title implies. Denise, a fun, lovable nurse from the U.K., offered the idea and upon leaving Ngorongoro Crater National Park we decided to go topless in the back of our safari car. It was invigorating, up until the other safari car in our group rounded a curve and suddenly appeared at our car’s rear. We screamed, became weak at the knees and rummaged through the backseat looking for our bras and shirts while laughing so hard we could barely speak. Our safari car driver, Alpha, was having a laughing fit so hard that his head was down on the wheel, with tears in his eyes. Joy, another nurse from the U.K., said it is a miracle we made it out alive without a crash. We had a bit too much fun at night, which we can blame on Tanzanaia’s famous Konyagi gin, and the thrill of being around a bonfire on the outskirts of a safari park full of wild animals.
The third day was a struggle to start. The animals were few, and we were dirty and smelly. After our familiar lunch trades we were back to ourselves.
After lunch there were still very few animals to see, so we decided to talk through a fantasied savannah social hierarchy of the animals we saw. For example, according to our imaginations, the elephants are the wise ones, the giraffes are the goofy doctors, the flamingos are the sorority girls, and the warthogs are the frat boys… it was a good convo I swear. We ended the day with a couple of markets and a trip to a barred liquor store in a local village.
All in all, my very favorite part of the safari was the time I had in the safari car with the girls: Heather, Sophie, Joy and Denise… And of course Alpha. I don’t believe I have ever laughed six hours straight for three days in a row, until I embarked on this safari trip. Joy, whom I knew for a short four days, made such an impression. She is most definitely the most vulgar person I have met, but also the funniest person I have ever met… the things that burst out of her mouth are new each time: “fuck a duck,” “back-skuttle,” “Bob is your uncle, Fanny is your aunt,” “you’re getting on my tits” “givin’ it large” We’ll all miss her in the house… Denate too, of course!
Today. Finally. Because I don’t have much more wine to fuel this post.
Heather, Ben, and I received the okay to begin in the hospital thanks to Dr. Mlay (after a 200$ work visa, and a 125$ fee paid to the hospital)… Ouch.
We have been placed in the laboratory for the first week, and today started our cultural experience of a hospital outside of a developed country. We were led around the ward, from microbiology, to “chemistry”, to our final location of phlebotomy.
Straightaway we were labeling vials, being told to find the best vein, and wrapping the tourniquet around the arm of the vein we’d draw from. Before we knew it we were being asked to stick, and draw blood all on our own. Heather was the first to make the bold move, and she did a beautiful job. She gave me the courage to try for myself. Next up was a young man (birthday unknown), by the name of Krukra Muhammad. I decided I would make my move and attempt to draw from him. My arm was shaking, but I knew I could do it. I found the vein, tightened the tourniquet, rubbed antiseptic on the arm, and took a deep breath. Complete dud. The man was in pain, I asked for help, and proceeded to remove the needle. I felt like I had failed until I watched three other nurses try to draw blood without success. Of all 30 patients that came to phlebotomy today certainly I would choose that man to make my very first attempt. I only hear my moms voice, “we learn best from our failures.”
On the bright side we all proficiently labeled vials, conducted malaria tests, and completed medical investigation notes. It was a good day, with high hopes of learning even more tomorrow. We will be heading to the hospital at 8 a.m. We were told we would be on our own tomorrow… My next blog may be a bit juicy! 
My wine is out, and I need rest.
Goodnight, and Tutao Nana Kasho (This was my phrase of the day)