Days 13-14: Observing Procedures!

I shadowed Dr. Jones in clinic this week and observed both diagnostic interviews and 2 surgical procedures. The clinic can only accommodate local anesthesia, so I stood in on an adult circumcision and a simple suturing procedure for a boy with a deep upper lip injury. Watching the surgeon perform the procedures and simultaneously train the clinic staff was fascinating. It really brought home the importance of good lighting and hygiene even in a small suburban/ rural clinic. One stitch in poor lighting can make a huge difference in a person's life.

Feral Dogs, Cats, and Butterflies

The wildlife here is almost overwhelming. The most entertaining "neighbors" have been this feline family. They're wild but not shy about strolling by just after breakfast to see if you might leave some food out. Paula and Denny are not fans of these cats because they hunt the birds and of course likely have fleas. I caught one napping by the screen door near the kitchen. This is the mama-cat. Possibly pregnant...

I also saw this pack of wild dogs just across from the clinic on my way from work. They are a good example of the Tanzania Terrier, as the locals call them. I don't know if the breed is named officially but this is what all dogs here look like. I think I'm lucky these didn't eat me...

On the walk from the bungalow to the clinic, there is a spot where I always see the same butterfly. Here it is...

Days 11-12: Busy Clinic

Monday was crazy. The main registration/ billing person was out sick so I had to learn pretty fast and assist the head nurse as we managed the influx of people. Not only did we have a lot of walk-ins, but 2 local schools decided to bus in their students for check-ups. The school pays for the students' consultation fee.

Here I am with Miriam (to my right) the head nurse who knows everything there is to know about the clinic and who paaatiently taught me reg. and billing procedures (as well as some Swahili) on Monday and Victoria, a physician here at the clinic, to my left.

Tuesday was a little lighter in terms of patient flow but I was still busy as I pushed to finish my patient records project. This is a shot of me and Mariam, the Queen of Registration and Billing (she does more work in a day than most of us in a week) after I FINALLY finished re-alphabetizing the old charts. The charts themselves are to our right in the boxes; what you see is about a third of them. The clinic opened in 2006 and so far there are 24,500+ patient records on file.

To our right at the top is a picture of current President Kikwete and to the left, the older gentleman, is Julius Nyerere - the first leader of Tanzania after the country gained independence. Many offices in TZ display both photos as Nyerere is on their currency as well. The interesting thing about him is that, as President, Nyerere was outspoken about trying to make sure his family did NOT follow him into politics and pretty much prevented his son from running for national office. This was in order to protect Tanzania from "big man" politics that has infected so many other newly independent African states.

Next I worked a little in the diagnostic lab (the clinic runs HIV, pregnancy, urinalysis, stool, and blood sugar tests, among others plus pelvic and abdominal ultrasound exams) and called it a day. Not many people seem to get HIV tests (a small handful a day, at most)... may have something to do with the fact that they have to announce they want the HIV test done and pay for it in front of all the other patients. The clinic is too small for private conversations with the patients and written forms are not the norm because of the high illiteracy rate among patients in low-cost healthcare settings. So, the norm is loud - and very public conversation.

Day 10 - Sunday Dinner at Dr. Bon's

Dr. Bon (as in Boniface) invited the volunteers for dinner at his home in Mwanza. He lives up on a hill that would be a hiker's dream. His brother drove us. We had the local fare (beef stew, fried fish, rice, cabbage, cucumber salad) plus the best drink I've tasted EVER. A fresh pineapple + avocado smoothie. We polished off two jugs of it in the first 10 minutes. His wife is gorgeous and the kids charming. I was definitely not that good as a teenager. Dr. Bon is an avid soccer fan and (apparently) like most of the men in Tanzania is waiting for FIFA World Cup 2010 (in South Africa) with the game calendar neatly folded behind his TV. His wife is not an avid a fan, shockingly.

On our drive to Dr. Bon's, we saw the ONLY jogger in Mwanza making his way up the road. Poor guy...everyone seems to know him and everyone kind of laughs. :/

Day 9 - Saturday Trips to Lake Vic and Dancing Rock

Clinic is open half day on Saturdays so we put in the hours; it was busy! Afterward, however, Mboto and Dr. M took us out for some sightseeing in Mwanza! Here is a view of the lake from the road:







1) The pier (like a fisherman's wharf type of thingy) at Lake Victoria. Smelly smelly but amazing birds and views.













2) Park overlooking the lake It was peppered with some cow patties but otherwise beautiful. You can see some locals behind me doing their laundry on the right. We try to not take pictures of the local people unless it's unavoidable (i.e. they walk into the shot) or they give their permission. Not only is it rude to objectify them like that but you may get yelled at or cursed by a Maasai. Not cursed AT, mind you...cursed as in "abracadabra." So, anyway..this is me at the park.

Some likely schistosomiasis vectors at the beach (3 feet from swimming locals)








3) Dancing Rock!

The drive up to "Dancing Rock" in Mwanza was so scary I had to look away. Below is a picture of the road to give you an idea of the drive. You have to hold on because otherwise you will whack your head on the window or fellow passenger's noggin. Saw many goats and even piglets in the homes we passed. The horse is a dashboard bobblehead. I have no idea either...





The Dancing Rock itself is a complex constellation of enormous boulders that peak to a vista overlooking Mwanza as well as the Lake. My picture with Yelena really doesn't do it justice, the view was so so vast. I will upload other pics when I get them from the fellow volunteers.
On the other side of the vista there is a HUUUUGE boulder. The only person with ballz to climb it was a teenage girl (WIN). It's difficult because there are no footholds and you kind of have to scamble like a gecko. We cheered her on and she was shaking with giggles the whole way up. Here she is at the top. Good job!!
After the trip we were hungry and tired and decided to go to a highly highly recommended local restaurant. Well, it sucked. We sat for 3 hrs looking at this:
Tai Five restaurant is ass, don't go there. I never got my Ughali either. >:/ Separate Eugi from her food and she shall FLAME you!

The Party Scene is so NOT off the hook... :) Pool Bar and Rockman Pub

Went to Rockman Pub with the 3 fellow volunteers, a new and relatively spiffy local establishment. We were served Vladimir Vodka (distilled in Tanzania) and Fanta. They don't pre-mix your cocktails, just bring the ingredients. I mostly chatted with Mboto, who is the IHP driver extraordinaire and was so patient for hauling us there and back. FYI, I am NOT drunk, I'm just squawking directions for the person taking the shot on where the "big button" is. :D

That is a carrier pigeon on my shirt, if you're curious.


A few days earlier, we had stopped by the Pool Bar here in the village (I don't think it's an official name - just that the little lodge has a pool table and a clean quiet bar) where Y and I were pretty entertained by the very correctly dressed woman on the Toilet sign.

Note the covered up knees and shoulders! (Jeanhee, I can hear you laughing from here...I couldn't help myself, okay?!)

Day 8 - Family Planning Clinic and Village Market

Instead of work today I joined Paula on a trip to Mwanza.

We visited the city Family Planning Center where the Nyakato clinic and others like it receive their contraceptive supplies. In order to receive a batch, the clinic must supply a report of how the previously-received batch was used. I'm assuming this is to prevent overpurchase and resale of supplies...









After that, we had to drop my housemate and fellow volunteer R at the airport but before we let her go we had lunch at one of the outdoor spots just by the airport building.

We each got a HUGE plate of (local) rice, plus beans, tomato sauce, spinach, and I ordered fish.They served tilapia from Lake Victoria. Even though you can't swim there, the tilapia is too good to pass up. Don't ask me why I'm making my rabbit face. I confuse "hungry" with "rabbit" for some reason...