Escargot?

I had to work the OPD (outpatient department) today because my coworker unexpectedly announced that he has meetings this entire week in Masasi (neighboring region) for the secondary school here. There is something fishy about this sudden revelation....

I don't particulary like working in the OPD because all patients are seen here (sort of a triage spot) - everything from orthopedics to peds/medicine, etc. and I don't particulary gain any experience in triaging ortho cases. So I send all of the male patients that are not straightforward to the theatre for the gen. surgeon to give a final disposition. I think I saw 50-60 patients. They are sometimes quick triage visits othertimes a full exam. The toughest part is trying to pretend I understannd the entire history in Kiswahili......I still believe that the people in southern Tanzania speak with an accent that is difficult to understand - sort of like southernerns in the states? I did not think I would get a break from the continuous stream of patients; however, I stepped out around noon for some tea and bagia (fried okra I think) and peanuts. I was back in the OPD until 2:30.

At 2:30 we had a meeting to discuss the 2nd maternal death of the year. This death was in a 28 year old mother about 23 weeks pregnant with HIV who was admitted with palpitations, fevers, and dyspnea. She died about 4 days after her admission. The CD4 count was 354, which is generally above the level at which ART is started. I found out about her death while I was on call on Saturday right after leaving the theatre for splenectomy in a 8 year old boy who fell down from a mango tree. (When there is an emergency trauma case, the gen. surgeon gets called and then i assist). I saw another kid up in a tree as we were taking this boy to the theatre. Don't know if he made it down safely or not.

BTW the first maternal death was a transfer with postpartum sepsis, severe malaria and severe anemia after delivering IUFD (intrauterine fetal demise) at an another hospital. She was only about 22 years old but had multiorgan failure. Very sad case.

Aside from the splenectomy, Saturday's call was relatively quiet. I was hoping to be in Mtwara for a weekend free, but was not given permission by the gen. surgeon because I was told I had the previous weekend free and we are supposed to only have one weekend a month free. Don't ask me how my colleague can unexpectedly get a week off to go to a meeting in Masasi but I could not switch calls to get a weekend free.

Anyone like escargot? Referring to the picture above. I have to explain. When I'm on call I have to hope that I don't get called to see patients around 6:30 becuase that is when dinner is served in the Abbey guest house. Murphy's Law was the case this past weekend. Twenty minutes beforfe dinner, I got a call from the male surgical ward to see two patients - a ruptured spleen and a ? inguinal hernia. So of course I was running to see the patients so that I could make it to dinner on time when I stepped on my slow-moving friend above - a crack of the shell and a pile of yellow sludge later, I was down in Ward 2. It seems that its snail season nowadays with snails/slugs all over the place. Add some garlic butter and chicken broth and call it escargot? Actually I would have preferred to scoop up the pile of sludge and cook to add some variety to my meals because lately my diet has consisted of mystery meat, tomatoes and rice.

If you sense a cynical tone in this post, I think you are right, I do too. Its because I'm still frustrated by my banking issue. Its now been 2 months since I deposited my predeparture check from VSO but still hasn't cleared. I say "hi" to my "friends" in the bank almost every day to ask if my check has cleared. "Bado" they say = "not yet" I was expecting this response again today so I refused to leave the bank until they gave me the telephone number of the boss in charge. I have emailed Canada to ask them too. Hopefully somehow the check will turn up and clear. Right below good food and family/friends I think efficiency of banking systems ranks #3 on my list of things I miss from the US :)