The interntet's been down for the past few days. When we arrived back in Ndanda, a bad storm passed. Thunder and lightning struck one of the computer lines. IT department seems to have it fixed.
Work was busy the last couple days - went to theatre for another ruptured ectopic pregnancy, and a couple of c-sections. One molar pregnancy presented and had uterus evacuated.
Tonight's agenda - Party at the abbey - told to bring instruments?? Expect to be singing (or at least listening to music).
We are planning a new years eve dinner here, everyone's pitching in to make some pasta, i'm bringing the alcohol.
The pictures from Zanzibar should be up in a few days...
Hope everyone is doing well. Happy New Year!!
All the best for 2008!
Best wishes,
Neil
Sunday, December 30, 2007
Tuesday, December 25, 2007
Zanzibar
Zanzibar is awesome! Friday morning took an early morning ferry from Dar Es Salaam to Zanzibar. Disembarked from the boat and walked across the street to find myself surrounded by what seemed like thousands of people buying/selling items in the markets that fill the maze of narrow winding streets that make up Stone Town. After a little shopping i checked into Maruhubi hotel a short distance down the road and spent the afternoon swimming in the pool with a few of the other VSO "volunteers". More of the same on Saturday and then went for dinner at a little more upscale hotel Mtoni Marine's to celebrate on of the vol's 50th birthday. About 12 of us sat out on the beach under the stars listening to a few Tanzanian's play local music and then sung happy birthday to Corrie. The next day I took a taxi across the island due west to the town of Uroa to meet Sheena, Francijn and Diane, my next door neighbors in Ndanda who were staying at a little cheaper hotel on the east coast (Santa Maria Coral Park). This hotel is very quiet, secluded hotel with little cabanas scattered about the beach. There is a beautiful beachfront view of the Indian Ocean. We spent one afternoon snorkeling and the other days swimming in the ocean during high tide and relaxing out on the beach.
I was feeling a little ambitious with my photography and decided to take the camera out into the ocean with me to capture the amazing blue colors of ocean against the horizon. I was in the midst of telling myself to be careful not to drop my camera because there are many hidden rocks covered in sand which are not visible under the water. The next moment I tripped over the rock and found myself searching the ocean floor for the camera! Unfortunately with high tide, and sand covering the ground it was impossible to find.
There is a village on the coast and a couple of locals were out on the shore. I mentioned that I dropped my camera into the water. One man told me to wait until low tide and then look. I searched a little more without luck, and when I looked back on shore, more people in the village had come out of their homes and into the water to look for the camera. I offered 50,000 shillings to the person who could find the camera. I told the people of the village I would return just before sundown. I walked back to the hotel and saw about 50 people(men, women and children) in the water on a hunt for my camera! I returned to the village just before sundown and a little boy told me a little girl had found the camera. I walked into the village and met the girl who gave me the camera. I was surrounded by the people in the village and then I gave the girl the money. The next moment it seemed like the whole village began shouting and cheering - Of course the camera was broken but I felt that giving the money to this girl and seeing the joy on her face was worth it - I thought it would make a nice christmas present to many people. I lost a lot of pictures of the hotels and beach but I bought a new digital camera today in Stone town and have taken plenty of photos of stone town. I will download the pictures from stone town and my friends' pictures from the resort when I'm back in Ndanda. Happy Holidays!!
I was feeling a little ambitious with my photography and decided to take the camera out into the ocean with me to capture the amazing blue colors of ocean against the horizon. I was in the midst of telling myself to be careful not to drop my camera because there are many hidden rocks covered in sand which are not visible under the water. The next moment I tripped over the rock and found myself searching the ocean floor for the camera! Unfortunately with high tide, and sand covering the ground it was impossible to find.
There is a village on the coast and a couple of locals were out on the shore. I mentioned that I dropped my camera into the water. One man told me to wait until low tide and then look. I searched a little more without luck, and when I looked back on shore, more people in the village had come out of their homes and into the water to look for the camera. I offered 50,000 shillings to the person who could find the camera. I told the people of the village I would return just before sundown. I walked back to the hotel and saw about 50 people(men, women and children) in the water on a hunt for my camera! I returned to the village just before sundown and a little boy told me a little girl had found the camera. I walked into the village and met the girl who gave me the camera. I was surrounded by the people in the village and then I gave the girl the money. The next moment it seemed like the whole village began shouting and cheering - Of course the camera was broken but I felt that giving the money to this girl and seeing the joy on her face was worth it - I thought it would make a nice christmas present to many people. I lost a lot of pictures of the hotels and beach but I bought a new digital camera today in Stone town and have taken plenty of photos of stone town. I will download the pictures from stone town and my friends' pictures from the resort when I'm back in Ndanda. Happy Holidays!!
Wednesday, December 19, 2007
Post AVC
Returned from "AVC" (Annual Volunteer Conference) this afternoon, very interesting meetings... See Photo Gallery for some new pictures.
Tomorrow is a bank holiday here, most of the shops are closed. Luckily made it back in time to go to the medical supplier to buy doppler ultrasounds. Tomorrow going to buy ferry tickets for Zanzibar and then probably wander around a bit. Hope everyone's doing well.
Tomorrow is a bank holiday here, most of the shops are closed. Luckily made it back in time to go to the medical supplier to buy doppler ultrasounds. Tomorrow going to buy ferry tickets for Zanzibar and then probably wander around a bit. Hope everyone's doing well.
Monday, December 17, 2007
Dar
Back in Dar Es Salaam for AVC (Annual volunteer conference), a 3 day conference for meetings and sharing placement experiences. The Beachcomber Hotel is host to this years VSO Tanzania conference, attendance of ~ 70 people. Located right on the Indian Ocean with spectacular views, nice pool and conference room. Just finished dinner buffet. Entertainment tonight - "African night" theme.....instructions are to wear traditional African attire (for me that means polo and kackis:). More meetings on the agenda for tomorrow and Wednesday. Thursday is a free day so i'm hoping to buy some doppler ultrasounds for the hospital and do a little more shopping in Dar. Leaving for Zanzibar on Friday to celebrate Sikuku (Christmas holiday). Expect to have plenty of pictures to share when I get back to Ndanda, maybe I can post while in Zanzibar, but not on this computer - connection is too slow.
Hope everyone is well back home.
Hope everyone is well back home.
Monday, December 10, 2007
Internet
This post has to be very short and to the point. Partner hospital in Ndanda provides 100MB/ month free internet. Surprise phone call from the hospital administrator informed me that I have used 750MB the first week of December (1/3 of entire hospital MB). The extra internet equals my month's salary!
Aside from internet, have been busy with work. Was on call last Thursday and had another ruptured ectopic. She came around 9pm, with classic signs - acute abdomen, CMT, and free fluid in the pelvis. Went to the OR for salpingectomy. I'm surprised how many ectopics I see here, although not quite as surprising considering prevalence of PID is high.
Today was another busy day - TAH/possible Myomectomy on the schedule. The patient was thirty four, never pregnant and desired fertility, she had symptomatic fibroids, so I told her I will try to do a myomectomy - she had a large pedunculated 18 week size uterus, and a few smaller intramural fibroids; removed large pedunculated fibroid. Hopefully she can become pregnant. I saw a couple outpatients after that then the word from maternity came that there was a c-section for obstructed labor. I was told she came in labor and made it to complete but could not push. I did the c-section, unfortunately the baby had apgars of 0,0! probably chronic hypoxemia! I have to review the chart and see what the problem was.
Heading to Dar Es Salaam on Sunday and then to Zanzibar for holiday next week. Will take lots of pictures. Hope everyone is doing well back home.
Aside from internet, have been busy with work. Was on call last Thursday and had another ruptured ectopic. She came around 9pm, with classic signs - acute abdomen, CMT, and free fluid in the pelvis. Went to the OR for salpingectomy. I'm surprised how many ectopics I see here, although not quite as surprising considering prevalence of PID is high.
Today was another busy day - TAH/possible Myomectomy on the schedule. The patient was thirty four, never pregnant and desired fertility, she had symptomatic fibroids, so I told her I will try to do a myomectomy - she had a large pedunculated 18 week size uterus, and a few smaller intramural fibroids; removed large pedunculated fibroid. Hopefully she can become pregnant. I saw a couple outpatients after that then the word from maternity came that there was a c-section for obstructed labor. I was told she came in labor and made it to complete but could not push. I did the c-section, unfortunately the baby had apgars of 0,0! probably chronic hypoxemia! I have to review the chart and see what the problem was.
Heading to Dar Es Salaam on Sunday and then to Zanzibar for holiday next week. Will take lots of pictures. Hope everyone is doing well back home.
Wednesday, December 5, 2007
Tuesday, December 4, 2007
Karosho
Call night on Sunday was not too bad. I had one c-section for CPD. The mother was a G6P5 (5 children - all born by normal vaginal delivery). But this baby did not want to deliver - suspected asynclitism. The night was quiet after that. Only a couple of patients before. Got called around 10am to pronounce the death of a man in the male surgical ward. 63 year old s/p motorcycle accident.
Today it was not too busy, apparently December is a light month for surgeries and deliveries, I guess partly because many patients don't have the money this time of year and just don't deliver now. Almost all of the patients rely on their farming of cashew nuts (karosho) to earn a living. One of the nurses asked me to buy some, so I bought a bag for $5,000 schillings (a little less than $5). They taste pretty good, very fresh.
Yesterday, I was post call. After morning conference went to round on the patients in maternity. Then one patient sent to W8 for evaluation. First trimester pain and a little bleeding. Tried to take her by wheelchair to the theatre to do an ultrasound but en route her head fell backwards and eyes shut, so we rushed back to W8, took vitals, placed a line and did a bedside ultrasound there. Was pretty confident by the exam/ultrasound she had an ectopic pregnancy. Went to OR for laparotomy and found ruptured ectopic (two this week). Again ~ one liter of blood in the pelvis...
One of the volunteers working in Mtwara is here visiting for a few days. She is from the Phillipines and is a lab tech, actually has a masters in blood transfusion services (?). She is working in a gov't hospital in Mtwara - where staff, support, supplies are not as good as Ndanda. She is leaving to go back home early (in April). Just came to visit the lab here. We had dinner last night with her, Mr. Piet the hospital administrator and two of the volunteers here - Sheena and Diane. Gnochi, and salad, one of the first good meals I've had in a long time. I asked Sheena for the recipe, maybe I can add some variety to my meals.
Received the first package from the states the other day - what an ordeal. I went to the post office about half a dozen times because they are very specific about documentation. First the package had not arrived, and when it finally did, I needed to get a key from the hospital warehouse and an "authority card" from the hospital administrator..... The post office was reluctant to give me my package, but I insisted that I have received authority and work for the hospital and need to get back to my duties......(it took about 3 weeks to arrive - about a week to get to Tanzania and then about two weeks from Dar Es Salaam).
Hope everyone is doing well at home. Remember you can visit me in Tanzania whenever you want......except for August - Ellen is getting married! Scary to write let alone think about (Congratulations David and Ellen).
Another couple of weeks in Ndanda before my 10 day holiday in Dar and then Zanzibar - which I'm definitely looking forward to....
Today it was not too busy, apparently December is a light month for surgeries and deliveries, I guess partly because many patients don't have the money this time of year and just don't deliver now. Almost all of the patients rely on their farming of cashew nuts (karosho) to earn a living. One of the nurses asked me to buy some, so I bought a bag for $5,000 schillings (a little less than $5). They taste pretty good, very fresh.
Yesterday, I was post call. After morning conference went to round on the patients in maternity. Then one patient sent to W8 for evaluation. First trimester pain and a little bleeding. Tried to take her by wheelchair to the theatre to do an ultrasound but en route her head fell backwards and eyes shut, so we rushed back to W8, took vitals, placed a line and did a bedside ultrasound there. Was pretty confident by the exam/ultrasound she had an ectopic pregnancy. Went to OR for laparotomy and found ruptured ectopic (two this week). Again ~ one liter of blood in the pelvis...
One of the volunteers working in Mtwara is here visiting for a few days. She is from the Phillipines and is a lab tech, actually has a masters in blood transfusion services (?). She is working in a gov't hospital in Mtwara - where staff, support, supplies are not as good as Ndanda. She is leaving to go back home early (in April). Just came to visit the lab here. We had dinner last night with her, Mr. Piet the hospital administrator and two of the volunteers here - Sheena and Diane. Gnochi, and salad, one of the first good meals I've had in a long time. I asked Sheena for the recipe, maybe I can add some variety to my meals.
Received the first package from the states the other day - what an ordeal. I went to the post office about half a dozen times because they are very specific about documentation. First the package had not arrived, and when it finally did, I needed to get a key from the hospital warehouse and an "authority card" from the hospital administrator..... The post office was reluctant to give me my package, but I insisted that I have received authority and work for the hospital and need to get back to my duties......(it took about 3 weeks to arrive - about a week to get to Tanzania and then about two weeks from Dar Es Salaam).
Hope everyone is doing well at home. Remember you can visit me in Tanzania whenever you want......except for August - Ellen is getting married! Scary to write let alone think about (Congratulations David and Ellen).
Another couple of weeks in Ndanda before my 10 day holiday in Dar and then Zanzibar - which I'm definitely looking forward to....
Saturday, December 1, 2007
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