Farewell Lindi, TZ and final blog:(

I said goodbye to my colleagues and friends of the hospital last night at my 'farewell party'. Hosted by the Doctor-in-charge and coordinated by one of the head Maternity nurses and medical staff, the party was held at one of the hotels on the beach. About forty people turned out to help me say goodbye.
Speeches were made, followed by drinks and food, and then a little bit of dancing to end the night.
Up on stage with the Doctor-in-charge and Regional Administrative Secretary.



Our local DJ on the job.


Cheers to everyone

Dancing at the end of the night!
Tomorrow I'm flying north to Kilimanjaro for the start of my safari in the Serengetti!

Hospital Pictures

This is our Maternity Ward. There are about 14 beds and usually about 20-30 patients in the ward! Maybe you can see in the back of the ward, most of the beds are shared by two, sometimes three patients! We are lucky to have received brand new beds with mosquito nets from Mama Salma Kikwete, the first Lady of Tanzania, who recently came to Lindi to donate beds and equipment. Its a full ward round day, meaning we see and examine all of the patients in Maternity Department. Farther back in the ward, through the double doors is "Labor and Delivery" where patients are brought for triage and for delivery. There are 3 delivery "beds". In our hospital we are doing on average about 140 deliveries per month so those 3 delivery beds are usually always full!



This young girl is 16. She just delivered twins by cesarian section. I think she is actually lucky. There are so many teenage girls who come very late to the hospital or get referred from a dispensary after having been in labor for 2 to 3 days. They often end up with an IUFD (Intrauterine Fetal Demise) and unfortunately a VVF (Vesicovaginal fistula). While this girl managed to deliver healthy twins, she will need alot of social support being only 16 and a new mother!



Here you see our "sterile speculums" and other "sterile equipment". The equipment has in fact been "sterilized" in an autoclave but certainly you would not be able to guess by the look of these! Our patients don't complain nor do they even seem to notice!


I only have 7 days left in Lindi. A lot of mixed emotions! There are many things I'll miss and many I will be happy to leave behind. In fact I only have 5 working days left, but who is counting!

What I'm really going to miss most is the people I've met here in Africa - some very extraordinarily genuine people. There is one particular author, Kuki Gallmann, who describes Africans as "People for whom tradition is important and to whom family values still matter; people who protect the young and respect the old, care for the sick and feed the hungry, even if it means sharing the little that they have; generous people, ready to smile and to forgive; people with a song in their heart and a dance in their step; enduring, compassionate and infintely patient." (From the novel 'African Nights'). I think this is a very accurate description.

Remembering Chitanda

Chitanda was one of the two x-ray technicians working in the hospital. He died early this morning in the hospital due to severe Malaria and pneumonia.

Chitanda was probably in his mid fifties and had worked at the hospital for over twenty years! Since I started work in September I saw him every day working as usual. He was an integral part of the x-ray department! I come to x-ray to scan patients for ultrasound and perform HSG's (Hysterosalpingograms) - a study used to evaluate patients with infertility and other gynecologic disorders. I could always tell if the HSG showed some significant finding by the look on Chitanda's face when he came out of the developing room with the film. If there was a smile on his face, the patient either had some evidence of tubal disease or a uterine filling defect. If his face was expressionless, the study was probably normal:)

I spent much of the day today in the x-ray department and I couldn't help but spend most my time feeling sorry for Chitanda's family and for his long time friend and co-worker, Juma, who like Chitanda has worked in the x-ray department for over twenty years, and spent almost everyday working together with his friend and co-worker.

Chitanda was admitted to the hospital with Malaria last week, then discharged home after about five to seven days of treatment; then he was re-admitted a few days ago. His condition deteriorated and he passed away this morning. I stopped by his room in the hospital to check on him and give him my condolensces last week, and was expecting he would bounce back in no time! But unfortunately he did not make it.

Chitanda's funeral service will be tomorrow morning. I am really hoping to attend, but these days a number of the clinical officers are away from the hospital and as we're short staffed already, I'm afraid I'm probably going to be spending the day in the hospital and clinic.

My condolensces to all of Chitanda's family and friends who will be at the funeral tomorrow!

The patients

There are some patients I meet that I will remember for a long time. Their names will escape me but their stories I'll remember. Sometimes the patients who make lasting impressions on me have good outcomes with happy endings but more often than not the patients who I remember are the sad cases with very unfortunate outcomes.
I met the patient above in the ultrasound room today. She is a 60 year old woman who came with increasing abdominal pain and early satiety. By the looks of her abdomen you would think she's about to deliver! But unfortunately this patient has an advanced stage cancer probably of ovarian origin. The ultrasound showed a ton of ascites and a large pelvic mass. I wanted to admit this patient to the gyn ward for exploratory laparotomy for diagnostic/therapeutic purposes, but the patient declined. Her relative explained that her family has no money and can't afford an operation. I told her that she would have to pay Tsh 6,000 (about $6 US dollars). She said she has to go home first to collect her belongings and discuss with her other relatives. I had to agree with her plan and I let her go home. (Unfortunately) I am not allowed to waive the fee for surgery or personally help patients pay for surgery. I'm sure the financial issue was one of the reasons for presenting to the hospital at such a late stage!!

Here we are preparing a patient for a cesarian section.

This young girl is only 22. She has a full term pregnancy, one previous cesarian section (when she was 16 years old) and she is HIV +. She came to the hospital alone, without any relatives! Although she does say that she has a husband, he wasn't around. The cesarian section went well but she had a ton of adhesions in the abdomen/pelvis. The baby had good apgars but we won't know if the baby is HIV+ for another couple of weeks.

I took this picture in the operating "theatre" just before the cesarian section. I'm lucky to use this operating theatre which was just constructed last year and opened about a couple of months ago. There is plenty of space and much better light source compared to the small, dark, operating theatre we had been temporarily using when I arrived in September!!