Hearts of Gold

Just when I think that this experience couldn’t be more surreal and wonderful, Africans surprise me and show me just how welcoming, kind and thoughtful they really are. After a long week full of C sections (one which got me out of bed at 1 am), appendectomies, vaginal exams and hypertensive patients, Sister Dora invited me to her house (which I should really call an oasis) for a much needed respite. To get to her house we took piki-piki’s, aka motorbike taxis, down a beautiful dirt road that wove in between layered fields of beans, banana trees and papaya plants embedded in the mountain.  When we arrived to her village, Bethel, we were greeted by an army of barefooted children (who of course shouted “muzungu! Muzungu! over and over). We then took a little path all the way to her house, which actually I should call a compound as it has three separate buildings, a chicken coop and a small barn with 2 milking cows.

Our afternoon tea in Dora's lovely home

Sister Dora and her buddy

Sister Dora's beautiful secret garden

Being at her house was like being at a 4 star hotel. Since being here I have been taking ice cold showers and have been scrounging to charge my electronics at every outlet in the hospital because my apartment has no electricity. At Sister Dora’s there were outlets that worked, she brought me warm water to bathe in, there was a toilet I could sit down on, and a lastly I had a really, really, REALLY, comfy bed with 4 pillows. I almost cried I was so happy. She made me an awesome dinner of chipsi (aka French fries), fresh vegetables, rice and beef. We talked about her family a lot during dinner; her husband lives about an hour away in a city because he has a job as a pastor there while she needs to stay up here in the mountains because the hospital and church need her so badly. Her three children also live down in the cities and have successful careers of their own. She talked a lot about how hard her and her husband worked to make sure that their kids did not inherit some of the gender roles that I described in my previous blog. She talked about how proud she is that her son helps with the cooking and fetching of water, while both of her daughters hold degrees and are continuing in higher education. 

After talking with her I realized how things seem to really be changing for a lot of Tanzanians and Africans in general. Africa’s economic and social development has largely been student by post-colonial mentalities, corrupt government, violence, substance abuse, unequal gender roles, lack of education and various violations of basic human rights. However, when you talk to a lot of them, each are doing their part and have hope that the new generation is going to change things. Many talk about how they are becoming intolerant of the government officials keeping most of the money to themselves to buy their vacation homes, and instead are demanding it go to education, health care and infrastructure. They are emphasizing education of their daughters and are pushing for family planning so they can chose when they want to be mothers. Some men are leaving their bar stools and starting to help their wives and children at home. Even some of the resident physicians I talked to in Uganda were very cogniscent of how their practice of medicine was being limited by corruption and improper use of government funds. One young physician said to me, “Our physicians are smart, talented and compassionate, but they work in a broken system every day that eventually breaks a lot of them down personally. That is why I want to go into health policy and change things so we can have a blood pressure cuff that works, operative theatres that are ready for patients and other basic things to help our patients.” While I think anyone will tell you that Africa has a long way to go, Africans themselves are definitely starting to turn the wheel of change in their everyday lives.

Taking a piki-piki to Dora's

After my wonderful night away from my off the grid apartment, I returned to the hospital. I expressed that I wanted to get some photos of the physicians and the hospital, but I was not prepared for the apparent very camera happy Tanzanians. After our morning meeting, everyone wanted a picture with me and then wanted several group photos. They told me I was welcome to take pictures with patients as long as I asked so I was able to get a few photos of some of my favorites, including a mom who we had done a C section on the day before. This particular mom was special to me because she had lost her first baby one day after he was born (I’m still not sure what happened), so needless to say she was very anxious about this pregnancy. Every time we checked on her during antenatal rounds she was tearful and anxious because she wanted a baby so badly. Therefore, I was dismayed when I arrived to the 1 am C section call the other night and realized it was her we were sectioning. Her labor had somehow gone wrong and the baby seemed to not be tolerating it well. When we delivered the baby, things did not look good. The baby was blue, not moving and not breathing on her own. I stood stunned as the doctor left the table to resuscitate the baby, leaving me with a rapidly bleeding uterus and a placenta to deliver. Thankfully, the team was able to resuscitate the baby and now both mom and baby are doing well. Needless to say, this woman had an impact on me and I was so elated that she avoided a second heartbreak.

Using the fetoscope

Me and Mama Msemo!! I'm going to miss my mentor so much!

Later that day I checked on another mom going into labor and decided I would wait around the hospital for her to deliver. Sister Dora told me she wanted to have dinner with me at 6 pm at Mama Joyce’s so I figured I would wait at the hospital monitoring this mom’s labor. Obviously this meant that at 5:15pm the mom I had been waiting for all day finally decided she wanted to start pushing (why can’t babies ever come when it is convenient for me!?!!? J) After a few pushes the team was doubtful this head was going to be able to fit through so they kept saying “Doctor Mali…epi….epi” meaning they wanted me to cut an episiotomy. These are not used a lot in America and definitely are not usually used without anesthesia so I told them I wasn’t comfortable cutting it. The midwife decided to go to bat for me and cut it and then I was able to deliver the baby within a few minutes. However, this baby also did not look good so the midwife and assistant had to go resuscitate baby. Again, I was left by myself with a placenta, bleeding mom and an episiotomy repair that I had to do without any anesthesia. I felt so bad repairing her tear without any sort of pain medicine and just kept saying “pole pole” (meaning “sorry sorry” in Swahili). Towards the end of my repair the midwife came back and kept saying “safi safi Dr. Mali” (meaning very nice, very nice Dr. Mali) so I felt pretty proud that even though I was torturing this poor woman at least I made her vagina look pretty! Again, as a testament to how strong these woman are, she even said a very earnest “asante sana” (thank you very much) to me after the repair and truly was appreciative of me. I could not believe her generosity towards me as I’m pretty sure I would have wanted to punch me right in the nose if I were her.

Gum boots for surgery

While the delivery, the resuscitated baby and my first solo episiotomy repair made me feel like I was on top of the world, I felt terrible as I was late to dinner with Sister Dora. I ran over to mama Joyce’s and was stunned when I was greeted by all the hospital staff. Apparently they had prepared a surprise going away dinner/party for me and greeted me by singing, clapping and handing me flowers. I couldn’t believe it and was in tears at how thoughtful they all are. The delicious dinner also included speeches by several of them who told me that I was a treasure (apparently my name means treasure in Swahili), that they felt like I had been working with them here for years, and that they wanted to thank my parents, family, friends, university and country for letting me come visit them. While this was so nice to hear, I truly believe this has nothing to do with the person I am but more about how deeply loving, thankful, kind and welcoming these people are. I would not have felt like family had they not extended their open arms to me, and I would not have been able to participate as much as I did had they not given me so much room to grow. I am forever indebted to their kindness, and I’m sure I failed to express to them how much I feel like the pleasure was all mine.  They encouraged me to return and I truly do hope that someday I will be able to help this hospital as much as it has helped me. (Mom, by the way, I volunteered your services so you might have to come with me next time!) I felt so incredibly special tonight and I feel lucky to be a part of this amazing group. I am so sad to leave, but know that I have made some lifelong colleagues, so I hope this blog serves to show how big their hearts of gold are. 

Vero (mama joyce's right hand girl) and I "being cool"

Mama Joyce and Mama Msemo love

Wrapping me in my new kitenge

The whole crew