TGIF

Thank g-d its Friday! Its been a busy week, not only at work but at my new home.
At home, I like to think I was pretty productive. I managed to get internet access, a plumber and new furnishings to make the place more homely. I still don't have running water, but the plumber promises by next week, the pump and water will be functioning. I like his optimism but I won't be holding my breath; I take what most people say around here with a grain of salt.

At work its been really busy. Which is good. I've been enjoying the work! I feel lucky to be working at a hospital which had two European gynecologists working in it for the past 4 years. There is a real Ob/Gyn Department. Now we are three, but the nurses are well trained as are the Assistant medical officers. There is equipment which is functional and staff who are capable of using the equipment. Unlike the previous hospital I was working at, there is a cervical cancer screening room as well as a radiology department which hopes to begin mammography soon.

The Assistant medical officers have been trained to do gynecologic surgeries and I think they are have more surgical skill than alot of graduating residents in US. That is not to say as a generalization that US trained gynecologists are undertrained by any means.

This week I spent the majority of the time in the clinic (outpatient department). Typically seeing about fifteen to twenty patients a day. The patients are a mix between obstetric and gyne patients, with all of the same complaints I'd seen during training - infertility, gynecologic malignancy, general gynecologic diseases, STD's, pregnancy related complications, etc.

When I'm not in the clinic I'm in the ward or operating room. This week I had two hysterectomies for symptomatic fibroids. The first was a very difficult case! The woman had a large fixed mass the size of a twenty week pregnancy. Probably complicated by pelvic inflammatory disease, the mass was fixed to the bladder and peritoneum with thick adhesions. She lost a lot of blood required two units of transfusion but had an unremarkable post-op course.
The second patient for hysterectomy also had symptomatic fibroids, but a smaller, much more mobile uterus, which was much easier to remove without any complications.

The language barrier is slowly breaking down, I mean its becoming much easier to communicate with patients in Kiswahili. Although much of what I say is the same to every patient, I think listening and communicating with people in Kiswahili makes it easier.

The doctor-in-charge of the hospital is the only functioning "radiologist" in the hospital, and he's been away at a meeting for the past few days so I've been doing a ton of ultrasound. I enjoy this because I never had a chance to perform much gyn ultrasound during residency, aside from first trimester family planning ultrasounds.

Oh, I almost forgot, I have another dog. Now that makes three. Her name is Bush. She is two months old and much bigger than my other two dogs - Obama and McCain (who are slowly getting bigger). Bush came to me about a week ago. She ran away by sneaking under the front gate the first day. She found her way back home about a few miles away. The owner brought her back a couple of days later. She snuck under another fence the next day and went back home. I was thinking of naming her Houdini for her disappearing acts but I like Bush better. She is very well received by Obama and McCain who are very happy to have a new friend.

Its going to be a relaxing weekend here in Lindi. Plan to go to the beach and swim tomorrow. Next weekend I'm going back to Mtwara for another going away party.
Hope everyone at home has a nice, relaxing, enjoyable and fun-filled weekend!:)