Habari ako?

Erik, Bernice, Nashesha, and Erik Mdogo

I had a fun weekend with Erik, Bernice, and Nashesha and I’m nearly adjusted to the time change. On Sunday, we went to Erik Mdogo’s house, which is way out of town, past all the flower farms. For those of you who don’t know him, Erik Mdogo is my uncle’s friend from Minnesota who lives in Tanzania and because they are both named Erik, one must have a nickname. Mdogo means little as Erik Mdogo is both younger and shorter than my uncle. He has a cute red mud house in the middle of nowhere with a great garden. He has many fruit trees including peach, mango, papaya, banana, avocado, and tomato. He also has many chickens and rabbits. He does all this with no electricity and his water comes piped in to a spigot in the yard. It’s beautiful though and he’s got a view of both Mt. Meru and Mt. Kilimanjaro. We had a huge meal that went on for hours with great conversation too.

Erik's "bread-maker"

Erik's veiw of Mt. Maru

Although this is supposed to be the dry season, it has been raining more days than not and when it rains it really pours for an hour or more. It has made everything lush and green and it also washes out the roads and gives rise to a malaria season due to stagnant pools of water.
Monday was my first day at the hospital and I began on the medicine ward. I will spend roughly 2 weeks on each ward: medicine, pediatrics, OB/Gyn, and surgery, taking away from some areas for rural experiences. We begin the morning with chapel, followed by a morning report where we hear about any deaths, serious patients, and interesting new admissions, and then have either x-ray rounds or didactic teaching before we begin our ward rounds. Africa has its own time and it is a much more relaxed setting than in the US. We haven’t finished rounding before noon, but we have a very busy service right now. We are seeing a lot of malaria, acute and chronic lung disease, HIV, TB, peptic ulcer disease, and infectious gastrointestinal problems on the adult ward. Each lab test is ordered individually rather than in a battery like a chem 12 or LFTs or even a CBC. We order only a hemoglobin or a WBC count or creatinine, although everyone seems to get a blood smear for malaria.
Rounds are conducted in English with someone speaking to the patient and translating for the group. There are no hospital employed interpreters and for the Maasai patients who don’t speak Kiswahili, we have to find a relative or hospital employee or someone who can speak both Kiswahili and Kimaasai to help us out. There isn’t the same push here to get patients out the door as in the US because the hospital bed is much cheaper than tests we order. Meals for the patient are the responsibility of the family and that keeps costs down, but also makes it difficult to control the diet of a diabetic.
I spent my second afternoon in the town clinic with a more affluent patient population. I was able to see patients on my own and they spoke English so I didn’t even need an interpreter. There is a lab, pharmacy, and x-ray in the town clinic, just like the hospital. There is a CT scanner in Moshi, about an hour’s drive from Arusha and there are different lab tests that are temporarily unavailable at times due to lack of reagents so a good history and physical are very important here.

My roommate returned on Tuesday after 2 days on Kilimanjaro. He wasn’t feeling well when he left for the climb and found himself very ill on the 2nd day. His guide thought he may have malaria because he was feeling sick so early in the trip and so he came back to town and into the clinic. It turned out to be altitude sickness rather than malaria and he was feeling fine after a short time off the mountain.
There are now way too many Erik/cs I’m associated with as my roommate is Eric with a “C.” He’s an Australian 4th year medical student who will be here into February. It’s nice to have someone else in the house and our 3rd roommate is still on the mountain until Saturday.