Week Four

This week was the first time I felt settled into a routine; I spent a lot of time with my host family. I bought a soccer ball to pass around when I get home from work and am learning a few new Tanzanian card games and yard games. The weather has been cold by African standards since it is wet season. So we have spent more time inside the house watching movies and soccer matches most nights. At the hospital this week, I got to work with several recovering stroke patients along with my regular appointments. A kind tourist who’s a social worker back in America donated lots of toys and games for the children at the foundation. It is much easier to get the children to agree to treatment and stretching with the promise of soccer or playing in the sand afterward.

This weekend a new volunteer moved into the room, and we spent Saturday out shopping and exploring more of the Arusha city center and spent Sunday resting and watching movies between playing outside, and practicing Swahili.

This week I wanted to highlight the hospital since the remodel of the pediatric ICU is almost complete. By the end of next week, the physiotherapy/ occupational therapy wing should be returning to normal. A normal for them, but it has been a shared space since I arrived at Selian Lutheran Hospital.

Most of the work my department completes is outpatient, meaning patients travel to the hospital for an appointment and go home afterward. Once a day, we make rounds through the medical and surgical wards to check on post-surgery patients and those in the intensive care unit.

Pictured is Nikas, an occupational therapy student close to graduating from a college here in Arusha, checking nerve and muscle function in a post-orthopedic surgery patient with an external fixture securing his multiple broken bones after a motorcycle accident. Our most common post-surgery patients are those with nails and cages keeping the leg in place, and we continue to see them as outpatient clients after the external fixture is removed as they practice putting weight on the freshly healed bone.

While Arusha has near a dozen hospitals, Salian is one of the biggest, boasting a smaller in-city location and the sizeable multi-building compound I travel to daily. It is also, according to unsolicited information I get from locals after telling them where I work, one of the more expensive hospitals. For context, a single occupational therapy session that has no real-time limit, we work with the patient until fatigue or the treatment is complete for that session costs 10,000 Tanzanian Shillings or $5 United States Dollars, and that is without insurance. The hospital is fully staffed with intelligent doctors ranging from general medicine to anesthesiologists but still struggles with supplies and materials. At the Wednesday meeting, it was announced the order for dopamine and anesthesia was delayed so there would be no major surgeries until it arrived. It is incredibly rare that they actually put a patient entirely to sleep, even an amputation. I got the opportunity to sit in on the patient was awake and not hooked up to any vital monitors the entire procedure, so this announcement did not have too much effect on daily operations.

My daily routine at the hospital starts with catching the staff bus at 7 am, just a 10-minute walk from my house on the main road.

After arriving, morning devotion and service starts around 7:45 and go until 8:15. After most of the general staff leaves, doctors and specialists stay, and the interns present on current patients and weekend or previous day admissions. Departments take turns presenting research or teaching on a subject, often until 9:30 or later. After the doctors follow the interns to the presented patients, they presented and hear more specifics. Sometimes I tag along on the rounds if I don’t have a patient of my own and get to learn a lot from the interns and surgeons. I see my patients the rest of the day or assist in cases with the other occupational or physiotherapists and staff until lunch, around 2 pm. Then the hospital bus starts to leave close to 3:30, and I take that home. Sometimes I grab a snack or drink with my coworkers and some friendly nurses after work. This has been one of my favorite past times in Tanzania as it makes me feel like an actual member of the staff and not just the white volunteer that needs most things translated to English. I also get to hear firsthand about the difficulties of health care here and learn about their lives and families, creating friendships I hope last past my 100 days here.

The hospital is wildly different than any I have been in back home, but the care they give and the effort the medical professionals put in are the same. Similarly, doctors here and back home face the same dilemma of how to help those who they know cannot afford the bill they are accruing. Perhaps the most unfortunate universal I’ve witnessed so far.

Next week the medical volunteers will travel for an outreach project in a rural village, and I am very excited to share that process with you all. I also get to take another Swahili class and welcome new volunteers and say goodbye to some that have been here since I arrived.

Sincerely Yours,

Mary Kate Parmer