Sunday night thoughts

My Home in Arusha, Tanzania

"Exempla House"

Sun-dried laundry

Tea on the front porch with my brother Brenden, who spent 2 weeks volunteering in Arusha

Dinner with my housemates Sharon (Indiana Univ MSIV), my brother Brenden, me, Jennie (OT student from Australia and Lena (Germany MSIII)

I've been in Arusha for two weeks now and am proud to have finally gotten this blog up and running. It has been a busy 2 weeks. I have been a member of the pediatrics team at Selian Lutheran Hospital in a little town called Ngaramtoni, which is sort of like a suburb of Arusha. I live in a lovely little house with 3 other international volunteers, who hail from Australia, Indiana University med school and Germany. We have a beautiful lawn and an outdoor pet tortoise, who never seems to want to chat when i see him him. To the right is a photo of my bedroom, complete with giant mosquito net. It's actually quite cozy.

The street which we live on is narrow and bumpy and absolutely filled with people walking up and down it all day and much of the night. There are no sidewalks, so you walk along the street. It only takes one or two brushes with a speeding taxi to learn how to stay "safe" on the Tanzanian streets. As our tourguide Frank would say, "it's all part of the adventure."

This is not a picture of my street, but of the road that we take when we walk to Selian, which is about a 4 1/2 mile walk. Mount Meru can be seen in the background most of the way.

These are pictures of two of the most memorable patients that I've seen so far. The little boy on the left with the sly smile is a Maasai boy with hepatomegaly of unknown etiology. We have limited resources to evaluate for liver and heart problems and no Mantoux testing available. We are currently treating him for extra-pulmonary tuberculosis and so far he's doing well. The boy on the right came to us terribly edematous, as you see here. He had nephrotic syndrome. Tragically, he did not survive.

Both boys come from backgrounds completely different from my own and due to the language barrier, I cannot communicate with either of them directly. But one thing is consistent with kids all over the world: they love toys and they love attention, 2 things that go a long way here.

This is another patient and his mom just before discharge. He was treated for malaria.

At night we drink tea (chai is very popular here, which took a little getting used to as a dedicated coffee-lover) and share our thoughts about what happened during the day...sounds quaint, right? It is, in some ways. It's very easy to live here - life is much slower and simpler than it is in the states. It has to be, when you may or may not have simple luxuries like running water and electricity at any given time. (95% of the time we have both - but i will say that today i chose to swim in a nearby hotel pool because my last shower was 3 days ago and since we haven't had running water all weekend, chlorinated pool water was just the solution to my bathing woes...) But life here is also challenging - especially the work part. We have very few options for lab tests, and even those that we do get are sometimes questionable. Kids are very sick, often with malaria, pneumonia, HIV or a combination of all of them. I'm learning to expect to have less diagnoses handed to me on paper and try harder to make do with physical exams and local epidemiology. I teach the interns and the interns and patients teach me. It is together the most rewarding, interesting and frustrating experience of my career as a medical trainee.

This little girl had severe pneumonia and did very well with just IV antibiotics. I gave her a sticker on this particular day and she immediately stuck it to her forehead.

The boy below was also very sweet. He had malaria and did well. His mom was exceptionally appreciative and showed it with lots of smiles.

Being here - being part of healthcare team - is an unbelievable privilege. There is an intense need for health care delivery and a tragic lack of access. The economic problems of the world are reflected here now - there are fewer tourists than usual, which negatively impacts the tourism industry, and the drought is causing an even bigger problem with agriculture - the other major money maker for the area. And on top of that, there are people who need help but simply live too remotely to receive it. Several outreach organizations fly or drive out to help them when they can, but there is just so much to do...
It is not uncommon for me to be walking down the street at any given time of day and turn around to see several kids trailing behind me. They like to ask me, in English, how I am and LOVE to have their pictures taken. This photo was taken on the walk home from Selian.

I am extremely grateful to have the opportunity to learn and practice medicine in Tanzania. The people that make up the missionary community of Arusha - volunteers and missionaries from all over the world, every denomination and multiple disciplines - are some of the most inspiring and optimistic people that I have ever met. I hope to introduce you to many of them via this blog throughout the rest of my stay. It is clearer to me now than ever before that what brings us happiness in life has very little to do with money.

Photo of new friend Jennie, Cecily (you know her!) and I at a wedding in Arusha