Back to Tanzania

Its been a while since I last blogged!! I almost forgot the joy in waiting forever for my images to get uploaded:)

Well I returned safely back to Tanzania yesterday. As most of you know I had been in the U.S. for the last 3 weeks. I had a wonderful time at my sister Ellen's wedding. Congratulations to Ellen and David who are probably sipping Mai Tai's in Maui right now:)

I am so happy for my sister and I'm so happy to have been able to make it to the wedding to see family and friends and to meet most of the people who actually read this blog!! Great to see my cousins Jeff and David! And to see my parents friends after such a long time and meet new ones who work at Channel Nine or who flew into DC from Boca to go to the wedding. It was great to share some stories with you! And most importantly to know that you are still reading my blog. Its heartwarming to know that even people I had met for the first time actually really appreciate the work that's being done.

The entire wedding weekend was great. Loved seeing family and friends again and meeting many new people including David Levin's (my new brother-in-law) family. But especially enjoyed two golf games (thank you Stan Levin for setting up golf at Westwood). I'm sorry I didn't bring my A game. And thank you Rob Ades!! for the golf game at Woodmont! I played a little bit better at Woodmont but sadly my short game had suffered while I was away. Who would have guessed!

Things here in Tanzania started off a little bit shaky. Had a bit of a scare yesterday as my checked luggage did not arrive, but fortunately everything arrived today as I just returned from the airport (again). The flights were comfortable. 13 hours to Dubai and then 5 hours to Dar Es Salaam. I'm staying in the same hotel - Econo Lodge, which is located in the city center and has affordable prices (although they did hike up the price by 10% since the last time I stayed).

My program manager in Dar Es Salaam confirmed that I will begin working at Sokoine Hospital in Lindi probably beginning the first week in September. I am still waiting for accomodations to be finalized and because I have switched placements and now working in a different 'region' I am awaiting a new working permit - which should not take too long. The accomodation is the limiting factor - timewise.

As far as the work goes I will again be working as one of very few doctors in the hospital, with focus on strengthening the ob/gyn departments, reducing neonatal and maternal morbidity and mortality, as well as part time teaching of clinical officers.

My work probably won't start again for another three weeks, but I 'm glad to be back in Tanzania and looking forward to traveling around a bit before starting work again. Considering a small trip up north to Arusha or else south to Cape Town, South Africa.

I will still be using the same emails (nhorlic@aol.com) and neil@ndanda.net so please email and stay in touch!

The pictures were taken in Lindi (a larger city compared to my previous home in Ndanda), located right on the Indian Ocean. The first picture was taken right on the coast and the bottom picture of one of the side streets in town.

Goodbye Ndanda

So much has happened in the last month (since I last "blogged").....many good and some "interesting" experiences. Because of the interesting experiences I've decided I want to change my placement location here in Tanzania. To make a long story short, a couple of things didn't work out as I'd liked, so I've had discussions with my program manager in Dar and in process of making arrangements to move to a different hospital, relatively close to Ndanda.

And I've been finalizing travel plans.....Will be arriving in the States on July 17th and staying for 3 weeks. My sister Ellen is getting married to her fiance David, August 3rd! Looking forward to the wedding! Also will be in NYC for one weekend to visit friends and in Chicago for a couple of days as well.....

And then I return to Tanzania August 7th...... and if all goes according to plan, I would start work in a different hospital when I return.......

So, I will be changing email addresses and likely changing the website address (no longer travelingneil.blogspot.com...... I'll make a new post and inform of the website name change)......

In the meantime I'll still be using the same email address.

The other day I enjoyed a very heartwarming goodbye party hosted by the nursing staff at Maternity department. See above picture. The nurses sang me a song (7 minutes) which I was lucky to capture on video to show you and save for memories...... The video is worth more than a thousand words so I'll have to show to you in person for full effect. (Song is sung in Kiswahili but I can translate). I think if you listen to the song now, the only word you might recognize is Horlick :)

Time seems to have flown by. Its now July 1st. I have to start packing and will move out of my house by July 11th........will be in Mtwara for a couple of days, then Dar es Salaam a couple of days and then my flight leaves for the states on July 16th! I'm definitely looking forward to coming back home for a short vacation and seeing family and friends! And to eat a little (or a lot) of sushi!

Until next time, hope all is well back home and I'll inform of my new email address and website blog name. But in the meantime can you help me think of a new website name??

Goodbye Sheena

Sheena, our labarotory technologist from Colorado left to go back home to the States today. After living in Ndanda for 20 months, she packed her bags and boarded the Precision Air flight to Dar Es Salaam this afternoon.

Its a sad day for me - not only is our most reliable source of accurate lab tests gone, but now I'm the lone American living in Ndanda!

Immediately after returning from the airport to drop off Sheena, the hospital administrator approached me with a bottle of Heinz 57 Ketchup (maybe in an effort to appease me after all the joking about the dutch and their mayonaisse).....

Soon enough a replacement lab technologist will arrive (end of July) from the Phillipines.

We arrived in Mtwara Friday night about a quarter past 6 just in time to take this photo of the sunset on the Indian Ocean. 2nd picture taken this afternoon on a lazy sunday afternoon watching sailboats and dhows pass by the guest house. Below is a picture from Saturday night farewell dinner for Sheena at the Old Boma Hotel. About 12 of us sat poolside and had buffet dinner and wine. Now I'm back in Ndanda and going to head to the guest house for dinner soon. Hope all is well back home!

Name That Movie

OK I'm offering 500 Tanzanian Schillings to the first person who can name this movie....I watched last night.

As you can see, the white wall in the house makes for a nice movie screen from which its possible to project movies.

Wednesday is teaching day.....another lecture for the nursing students - today I gave a lecture on "Obstetric Hemorrhage". It is the first time the students have received any "clinical" lectures so sometimes I find it difficult to gauge their level of knowledge. But with an average test score of 50% either teacher or students are not doing so well!

Tuesdays and Fridays are now "operating days" - so any gyn cases that need to go to the OR go on Tues or Fri. Yesterday we had two laparotomies for adnexal masses - first was a 40 year old with large adnexal mass probably mucinous cystadenoma. Second was a postmenopausal female with large adnexal mass - turned out to be a dermoid cyst - probably she had for a few decades.....

Weather here has been beautiful last few days with lower humidity. Seems like the rainy season is behind us. Need to spend more time outside and back to the mini lake (Chemchemi) here for swimming.

Hope you are having more seasonable weather back home!

The Market

Almost all prices for goods in Tanzania are negotiable. There are exceptions like business products sold in Dar Es Salaam, however, almost anywhere else, you are expected to negotiate. Nowhere else is this more true that at the market. Today was no exception.
I just returned from the market to buy a few things, some fruits and vegetables, cooking oil and flour.....and just as always, I have to negotiate with the same vendors I see everyday.
But things are getting worse. I mean each time I go to the market more peoople approach me with items to buy and each is looking to sell me something for an inflated price.
Today the same thing happened. I rode my bike down the street to the market. The first person who saw me began shouting "Doctor, Doctor" and ran up to me with a handful of oranges. The greeting was heard by a bunch of other people who took it as a sign to draw near as well, and within minutes I was surrounded by at least a dozen people with fruits and vegetables, toilet paper, tooth picks, watches, shoes, etc. all yelling and screaming to buy their items.....
Today was a little bit different, there were more people, maybe 15 total, all urging me to buy something. Being a white guy in the market here, the locals know that they can inflate the prices on everything. And as much as I know it is a higher price there is no way to bargain! So I get all of my essentials and give the loudest person money. Next time I need to buy something I'm going to make a list and give to one of the nurses.......

I gave my nursing students a quiz today - just a simple 12 question test on anatomy/physiology of reproductive system. I asked the students after, what they though of the questions and most said that the questions were easy......The average score was a 50%, the highest score was 10 correct and the lowest was 2 correct. It was the first quiz I've written, so I tried to balance hard, medium, and easy questions! I included questions like name the largest artery in the body to questions differentiating between hormones involved in HPO axis......interestingly enough, one of the students who scored the highest, missed the answer to largest artery in the body!

At night its been quiet as usual. It helps having the projector that I bought in Dar es Salaam - the last few nights my neighbors have come over for a movie, popcorn and wine; we have been watching Godfather (part II last night)......

That's it from here. If you can think of any suggestions on how to improve test scores in Tanzanian nursing students let me know!!

Mother's day

Happy Mother's day!

Today was "Nurses day" - so all of the nurses are scheduled to work their normal duty hours but find time to ask all of the doctors for gifts! or money.....
It was busy today..... Started the day with an elective repeat c-section for twins at term with one previous c/section. Both male babies with good outcomes. Then another c/section for twins due to prolapse of the cervix and obstructed labor. Both male babies with good outcomes. Then had a ruptured ectopic. Tomorrow should be another busy day with a scheduled repeat c/section and TAH.

Hope you are doing well back home. Sorry to hear about the unseasonably cold weather in DC and Chicago! Its been in the 30s all week here....but in Celcius, so I can't complain!

Teaching

Started teaching the nursing school students yesterday! From 12pm to 2pm I gave my first lecture - "Anatomy of female reproductive system".

When I walked into the classroom it was difficult to keep a straight face because all of the students (twenty) stood up and greeted me as I made my way into the classroom.....something perhaps American students should do too? :)

Every lecture is preceded by a prayer and then greetings between teacher and students.

Luckily I prepared enough information to teach for 2 hours though this was difficult.

I took before and after pictures of my class to see if you can identify how many students were sleeping after the lecture, but I was happy to see only one student nodding off at the end :) So I agreed with the principal to give lectures to the second year students once a week for 2 hours.......it is a little bit of work to prepare the lectures but a great review for me and fun to teach these students!