Last post for a few days....

This will be my last post for the next 6 days. We are going on a 5 day camping safari to 4 of the national parks here. Keep your fingers crossed that we get to see all of the "big five" plus many others! I will try and take plenty of pictures and will post them when I can.

Aside from that, I have finished my 1st rotation at the hospital in the MCH (Maternal Child Health) department and will be heading to the OR when we return from safari. Today I tried to help the organization of the clinic by organizing the work space and making small "in" boxes for some of the things they are always misplacing under a stack of papers and books. They seemed to be very thankful for the help and the idea. They are also sad to see me go, as I can do a complete visit start to finish at this point. I was told I was very quick! and that they would miss me. So while I might not have felt too helpful, it appears I did make a difference which feels good! I will likely return there once Cassie leaves (she is only here for 4 weeks).

I also found that when we are not busy at MCH, I can go to the pharmacy and help count pills for prepackaging of prescriptions. I know this helps them greatly and I even have previous experience in this area from when I worked in the pharmacy at the Free Clinic in Christiansburg VA during college. :) The pharmacy is a small walk-in closet in size, and has two of the three walls covered with shelving. The medications are the organized by what they do. Ex: Anti-fungal, Antibiotics, Anti-malarials etc.... Very easy and to the point. It is also important to note they only have about 3 types of medications per category! I also learned they very rarely ask about allergies, as most people don't know if they have any or not!

I will post about my safari experience when I return!

Trip to Moshi

Mount Kilimanjaro


Yesterday Cassie and I took a day trip to Moshi. It is a smaller city about an hour from Arusha by bus. There we met with John, Dr Hoon's guide from his Mt Kilimanjaro hike in 2006. He picked us up from the bus station and lead us to the taxi stand where we met with our taxi driver for the day. We drove towards Mt Kili and took many pictures along the way.

When the roads finially got even more remote than the previous 10 miles of dirt roads we had traveled, we parked the car on the side and walked to the waterfall. The hike to and from the waterfall was beautiful. Everything was so green and edible plants were everywhere (as this was the farm land of the locals but looks nothing like the organized farms we are used to). We saw corn, mangos, avacodos, passionfruit, coffee, and bananas, bananas, and even more bananas!!!!



Before reaching the waterfall's all non-locals have to pay an entry fee which may or may not go to the government?!?! I'm not very clear on this. But while we were there our guide John asked for a banana liquor. This is a local brew, that is mashed bananas some sort of millet and water. They serve it in a large plastic cup that is meant to be shared by all. So Cassie and I shared. It was not too bad. A little yeasty and with some sediment, but overall nice to try!


The waterfall was wonderful. It is the talest falls in Moshi (that's what we think at least, but is hard sometimes to understand the answers to our questions). It was cooler by about 20 degrees than the surrounding area and had a nice mist coming off. We ate lunch there and then headed back towards the car.


The place where we had parked was actually next to a local Chugga tribe family's hut. We we invited for fresh coffee and to see their house. While I am not a coffee drinker I did have a taste of Cassie's and it was WONDERFUL! They even showed us the entire process of taking the red coffee beans and making them into ground coffee. Below is a picture of the mother grinding coffee!


We then were taken back to town and John excitedly showed us his life and all that he has accomplished! Which is a privelige to have had the opportunity to have the amount of education he has had in his life. He is very thankful for this.

After that we took the bus back home to Arusha!

*Also, I have received many e-mails stating that people are having troubles posting comments. I have tried to make this problem disappear so let me know if it is better!

A day away from the hospital

Cassie and I in the back of the pick up, before we left for the primary school


Today we were asked to help pass out items that have been sent as donations from a past volunteer at the school where she worked. It was an adventure to say the least. I likely won't be able to capture it all but will try to do so in the order that they occurred.

It started with a planned meeting time of 9am at one of the coordinator's house. We arrived late but that didn't matter as he was not there anyway. It is "African time" ...get used to it. He finally arrived and we hit the road at 10:45. We had a hired truck which only fit 6 people and we were traveling with 9 including the driver, so I sat in the back of the truck with the donations and two of the other guides. It was great, except I was COVERED with fine dust/dirt when we arrived. I have pictures but don't know when I will be able to get them on here unfortunately. Anyway, we made a slight detour and visited the driver's family (his two wives and his 5 children between the ages of 3-1.5 years old) They offered use tea and it is rude to say no, but we all wished we could have. It was mostly cow's milk with maybe a touch of tea that had been cooked over a fire and smelled and tasted like smoke. We also watched the men drink warm/fresh cows milk from long goard's. Then back in the car to the school....





We arrived at the school and all this children ran outside and just starred at us. We are getting more used to the celebrity status we have here as "white people". They even touched our skin, I guess to see if it was real. We met with the head master and the teachers and then had the children line up my class and we handed out the donations. Most of which was clothing, and it didn't even have to fit the children we were giving it to. No one cared! The teachers just kept saying it is ok they will give it to their family for other children. So every child got at least one thing and many were sneaky and would hide their gift and return for a second or third (in one or two cases a forth I'm pretty sure





After we passed out the goodies we noticed our driver was gone. We were told we would be walking to the market (Please note on the 1.5 hour drive in we saw NO market) He assured us it was close. And it actually was. This market was for the natives ONLY! They were selling livestock, mainly goats and cows, both dead and alive. We were escorted to the goat section and welcomed inside one of the many corn stalk huts where we had a room temperature soda and "fresh" goat's meat. It was not bad! But we will see how all of our stomach's handle the tea and the goat's meat!



Then it was time to go home, and still no driver. So we got on a "dalla dalla" (van/mini bus) and headed back to town. This was an adventure as it was raining and the roads are all dirt with many big holes, driving is mud is much like snow I guess. We only got stuck twice and only feared for our lives for about 20 minutes! But we made it back to town in one piece and celebrated with some ice cream in the shopping area very near to our host family's house.

Now to go home and wash up! I almost blend in with the locals after the very dirty car ride!

3rd day...

I have learned how to hear a fetal heart rate with the fundascope! In fact, I unfortunately trusted myself enough to know that I was not able to hear a 36 weeker....I handed the fundascope to the "nurse midwife" (a male nurse) who also couldn't hear it. We had the doctor, who happened to be in the room, listen and he, too, could not find it. So we sent her to ultrasound. She returned an hour later with a slip of paper with the letters IUFD. This was easy for even me to understand. (Intrauterine fetal death) The mother was a 40 year old with HIV and only had one leg. She walked with a large stick for support. It was sad, and clearly is not handled with "kid gloves" but instead is told matter of factly to the mother and she is send on her way. She is to report back for induction when possible.

Otherwise today was good. No baby's hit the ground! And I'm becoming much better at fundal height measuring with my hands as well as with a measuring tape. I can typically estimate the fetal age with my hand measurement as close as 2-3 weeks (assuming their dates are correct in the first place). So I am learning as well as being able to help. Today we must have seen 50 pregnant women, you see there are no appointments they just arrive and are seen in the order that they arrived. So some days there are very few patients and others there are a lot.

I believe we have worked out our plans for the weekend. We will be taking a "dalla dalla" (not sure of the spelling in swahili but it means a small bus of sorts) to Moshi which is an hour drive. There we will meet with Dr Hoon's friend John, and will have a tour of the waterfalls at the base of Mt Kilimanjaro. John is the hiking guide Dr Hoon hiked Mt Kili with. We might spend the night at a friend of a friend of a friend of mine's house. But that has not been worked out yet. We might also just return that same night.

So far my only loss is 300 US dollars, due to an ATM not giving me money! But it is posted to my bank account as removed! No longer just pending, so it is truly gone! Fingers crossed that will be the biggest loss during my trip! And yes I have tried to contact SunTrust, but they wrote me back and stated that they could look into it but my card would have to be canceled...which is not an option.

2nd day at the hospital

Things were a bit more my speed today. I worked in the outpatient MCH department (maternal and child health). The day was spent getting weights on children under the age of 5. They are to return monthly for wt checks when they are under a year old. But that is all that is done on that visit, just a weight. They do not see a doctor or have a physical. Their growth is plotted on a card and given back to the mother to keep for the next visit, there is no second copy of this recorded medical information. The most horrifying thing was when the strap broke that was holding the child being weighed and he fell to the ground hitting his side and his head on the cement from about 4 ft. If that wasn't bad enough, nothing is done exept to let the mother sooth the child and put him back in a new sling and try again! It was very hard to watch!

Several children were underweight or had lost significant weight since their last visit, I tried to show my concern but was told that is was only because the mother had been sick a week or two prior! (This was not a good enough answer for me, but for now it has to be!)

I also preformed maternal checks. At each visit (also monthly until the 8th month when it becomes weekly) a Blood pressure, weight, fundal measurement, and listening for fetal heart rate is preformed. Some mothers have labs drawn and receive malaria medications (depends on how far along they are) Also HIV tests are preformed 3 times during the 9 month pregnancy. The most difficult task is trying to hear the fetal heart rate through a wooden fundoscope. This is a skill that requires a bit more practice, especailly on the 20-30 weekers!

I am feeling more confortable and even a bit helpful, the hardest part is not being able to communicate in Swahili. I know some basic phrases "Thank you" "Thank you very much" " You are welcome" "Enjoy" "How are you?" "Whats up?"

Our 10 minute walk to the hospital is all on dirt roads and passes by a primary and secondary school. On the way home the children are out of class and tag along behind us chanting different english phrases like "hello" "morning" "good morning" and "how are you?" Today we cut through the middle of a small soccer game (taking place on the dirt road) and the ball was passed to a young boy near me, so I joined the game! Took the ball and proceded to go and shoot on the child in goal. He saved it but all the little boys thought this was great. After missing my goal, I continued walking to the house! I have a feeling these kids might become part of my after work activities at some point, even if it is just playing soccer a few times a week. :)

First day at St Elizabeth's Hospital in Arusha

I spent my first day at the hospital. It was mostly walking around meeting all the staff, doctors, nurses etc. After we met EVERYONE! We went to the surgical theater ( Operating room) and watch an eye doctor preform 3 surgeries and start a 4th but the woman decided not to have her cataract removed after she had been given a needle to the eye to numb and had a 10 pound weight on her eye to "reduce the pressure so that when they start not everything pops out" (that is a direct quote from the doctor) So you can see it was an interesting day.

Bottom line it is so different and so rural that it is difficult to fit in everything I experienced today. But will put some "highlights" to give you guys an idea.

1) The smell (mom you would die!!!!) Everything from plain BO, to bowel movement, to vomit, to rotting flesh!

2) The shear number of people in one area. And the limited doctors and nurses.

3) The constant wet floors that are being cleaned, yet drip from the steps of the floor above because the water is never actually dried, but instead is left to dry by mother nature.

Now about the OR..... WOW

4) Sterile is not really a known word.....I mean of course it is but a very different attitude about how sterile one must be. Examples, the doctor used the same scrub gown for all the surgeries, they re-used instruments between patients.

5) The patients are FULLY awake with no meds! other than lidocaine locally!

6) A nurse even almost caught on fire from the caughtery system! Need I say more....

ok my time is up at the internet cafe and it is about to start POURING so I better go...more later this week.

The first real post!

So I arrived without any problems, all my bags made it, I was able to pick up my VISA in the airport without any hassle and my ride was even there to take me to the host family's house. The only down side was it was night time so I was unable to see the area until the next morning.

I am sharing a small bedroom with another nurse from the US. Her name is Cassie (so if I use the term we I am generally refering to Cassie and I). It has two twin beds and nothing else. It is a bit crampped but works just fine. Fingers crossed we have seen no Mosquitos yet, so have begun to assess the situation each night to decide on whether or not to use our net while we sleep. But don't worry I am taking my medications religously!

The house is a 4 bedroom 1.5 bath. The 60 year old host is called "Mama" and she has a live in maid who is roughly 14-16 years old, named Jennifer. The other 2 bedrooms have volunteers as well. Although 3 of them are on a Safari this weekend so I have not met them yet.

Food is good thus far, different but good. Last night we had stewed green bananas in a light tomato sauce with spinach. Tonight is curried rice and goat (so I have been told)

We were given a tour of the town by someone "A Broader View" hired. He was excellent. Very friendly spoke good english and was always watching our back. So now that I have said that, it isn't that Arusha is unsafe! But pick pocketers, especailly with a focus on the white people are on the streets! Also we have been told that we must be back at our host family house by 6:30 pm and no later if we are walking. We also can take cabs if it is after those times. This is not merely a suggestion but something even the locals live by. So this will all take a little of time to get used to but sure will be fine in the end.

Dinner is generally at 8pm, so the first full day was very long getting adjusted. But this morning was a touch better even though we got up extra early go to Roman Catholic church with Mama. The entire service was in Swahili, but the music was very enjoyable! Mama tells us the 3rd mass of the day is in English, Cassie and I agreed we would try and make that one sunday, just to see how it is.

We are working on getting our weekend trip figured out but at this point are set on doing a 5 day camping safari. With an unknown date at this point. I will keep you updated as I start working on Monday. I think our day is from 9am- 3pm (must be nice)

Thats all for now....hope all is well at home!

I'm here

eMore to follow....30 sec left at internet cafe

Down to the Wire....

Well, it is officially 2 days before I jet off to Africa. Am I ready??? No! Am I still running around doing last minute things??? Yes, of course! I'm sure it will come together by Wednesday evening but until then I have plenty to do.

This will likely be my last post before I leave, I just wanted to say Goodbye to everyone and thanks for all of your encouraging words. I will be thinking of you all, often. I will try to keep this going once I'm in Tanzania. If it won't be possible for what ever reason I will find a way to let you all know, but fingers crossed you should be able to receive regular updates on here.

Also here are pictures of my new hair cut that everyone has been asking for. I donated the rest and now have a fabulous short Africa friendly hairdo.