Karibu

I apologize for the post date posting…I’ve just been able to access internet and only because  apparently the network is only functional at 3 am (I was woken up for a cesarean section at 1 am so I was up J). The way I’m using phone and internet here is so far removed from iMessaging that even dial up seems like advanced technology right now. I currently have to use the SIM card from my 1997 TECNO phone (which I have to buy scratch off cards to load more data on every other day), put the SIM card into  a USB modem, plug it into my computer, then cross my fingers, pray a lot and then patiently wait to see if maybe I can download an HTML formatted webpage.  Aside from being internet silent (which has not really been all that bad I must say), my stay in Tanzania has continued to be peaceful and full of warm, welcoming people. “Karibu” meaning “You are welcome” is said to me everywhere I go and all these villagers continue to do whatever they can to make me feel at home.

My week at the hospital was somewhat eventful, but definitely not as crazy as I was used to at Mulago. Every morning I report for morning report/prayers at 7:45 am (this is of course after my delicious Spanish omelet, chapatti and African tea breakfast). After the entire hospital has been filled with the Swahili hymns, we start morning rounds. First, we go to the two antenatal rooms that are filled with approximately 20 mothers waiting to go into labor (as I said before they come early so that they don’t have to climb the mountain when they go into labor and risk having a baby under an ant infested tree). We do our Leopold’s maneuvers and find baby’s heart beat with the fetoscope; after doing this on so many women here in Africa, I’m so surprised at how much my manual diagnostic skills are improving. I even was able to tell a mom that she was carrying twins on Friday-just by feeling her stomach!

Gonja Lutheran Hospital Docs, Nurses and Midwives

Gonja Lutheran Hospital

Theatre

After antenatal, we head to the rest of the wards. Each ward is filled with approximately 15 cots with a few wooden benches scattered in between for family members to sit. The first two rooms are for women (many postpartum women and some there for general reasons), the next two for men and then then last is the pediatric room, where thankfully usually has the last amount of sick patients. The patients in the ward usually have to stay anywhere from 2-30 days and in general patients stay in the hospital a lot longer than they would in the US. Whereas most patients in the US would be sent home 2 days after a cesarean section or appendectomy (barring any very serious complications), people here stay for at least 7 days due to their worry about going too far away from the hospital lest any infection or complications occur. While I admire the patience of the patients themselves for staying in the hospital that long, I am blown away by the dedication and endurance of the family members. Family members have one wooden bench to sit on (if they are lucky), no television, no magazines, no cafeteria, no lounge, essentially nothing to do but sit and tend to their family members. I have seen several family members every day at the hospital and judging by the fact that they haven’t changed clothes, some of them haven’t left their family member’s bedside at all. The hospital does not provide food for patients or family members (they don’t have the staff or the funds), so family members have to go outside to a little hut that serves as a kitchen and make the food themselves. Every day there are approximately 30-40 women around this hut cooking over a wood burning fire. Not only are they on 24/7 bedside vigil, but family members mostly serve as the nursing staff for their patient as well (again, hospital does not have the nursing power or the budget to hire more staff). I’ve seen family members run to get a doctor when their family member wasn’t responding, I’ve seen them get urinals, I’ve seen them prop beds up so their family member in heart failure can breathe better. It really is amazing to see how much their elders, mothers, fathers, friends, cousins and children mean to them. This also makes me really appreciative of the US nursing staff, because I have realized how much they function as patients’ family members while patients are in the hospital.

I think the head doctor has picked up on my interests because usually after (or actually, most times during) rounds he sends me to the OR to help out with a C section or appendectomy. Here, I usually work with an amazing grab bag of nurse midwives, nurses, nursing assistants, nursing students and two physicians, Apenda (which means to love everyone) and Mama Msewo. Mama Msewo is status post 5 children of her own and is now serving as the general surgeon/OBGYN for Gonja. I really struggle to look at her as an intimidating attending because she acts, talks, walks and jokes more like my beloved Great Aunt Mali than my normally gruff surgical attendings. She is so patient with me and has let me be her one and only assist on many surgeries. While she definitely is using some old school (I mean really old school) surgical techniques, she also gets the job done and does a darn good job at it. She is an amazingly dedicated, smart, humble and compassionate physician and I feel so lucky to have her as a mentor here.

I also gave away the rest of my donations last Thursday, and as soon as I get the pictures I will post them. While my reception in Uganda was very thank-full, my reception in Tanzania was made for a movie. The entire staff got up, sang a song, clapped for me, took pictures and shouted “oo’s and aa’s” like they were watching fireworks every time I pulled out another nasal cannula or box of gloves. The ophthalmoscope and otoscope were again huge hits and I honestly thought they were going to make me crowd surf when I brought them out. At the end, Sister Dora said to me, “Thank you so much, this just shows us that no matter if we are black or white, or rich or poor, we all belong to Jesus and are here to serve him and his people in love and unity.” Thank you again to all you wonderful donors, your impact has been astounding and you deserve a special spot in heaven!