Kilema - Week 2

The gang hanging out one night at dinner. I have never had so much indian food in my life!

All of us and the doctor after completing my first c-section!

The baby boy I assisted in delivering.

Ramy and I posing in front of the "It's Kili Time" sign!

Ramy, Aliya and I outside the wards!

Hi Everyone,

I am here at an internet cafe in town, as the internet at the house in Moshi was not working this weekend. I thought I would post a few more pictures from my last week in Kilema, before I head off for the week climbing Mt. Kilimanjaro. Hopefully it works!

Our last week in Kilema was great. It was filled with visiting the wards, getting to know some of the patients more, scrubbing in on a c-section, suturing a large wound, and learning more about tropical medicine. We also had one day off this week, as Wednesday was public holiday in Tanzania. We decided to take the opportunity to travel to Marangu, a town about 30 minutes (by daladala) from Kilema. We basically got to the town, walked around for a bit, bought a chocolate bar and soda, and just relaxed. It was great! The ride back on the daladala was hilarious - we were the last to get on, and there were already about 30 people on the bus. We had to stand, packed in a small area, with no room whatsoever. I though my arm was going to completely collapse under the pressure of all the people leaning on me. It was definitely loads of fun though!

On Thursday I assisted my first c-section! I did not do much, or anything out of the realm of my training, but it was great! I got to hold the retractors, some tools, and cut the suture when needed. The baby came out screaming and crying which a great feeling! At first I was nervous about it all, worried I may feel faint. But once it got started all those feelings left me, and I was just super excited! Maybe I should be a surgeon? Who knows!

This week we also visited the women whose babies we delivered last week. We must have seen then five or more times, just popping in their room here and there, seeing how they were doing. We need a translator to actually talk to them, so we find someone in the hospital who can speak english. Two of the moms decided they wanted us to suggest names for their babies. The mother of the twins especially wanted suggestions from us, and asked us to create a list of names that we liked. We gave her about 20 boys names and 20 girls names, including both western and african names. She ended up picking George and Karen! These names are actually two people from Pamoja Tunaweza - George is the driver, and Karen is the physician who started the centre. It was funny that she picked both of their names out of all the names we gave! Of course we suggested our names, but apparently Whitney is just too hard to pronounce! The "t" sound just doesn't come out easily for people here, and I have had names ranging from White, Whitely, Witness, and essentially anything you can imagine. The other mother named her son Jonathan which was very sweet as well. It was so nice to be involved in these women's lives, and be a part of this happy time!

Other than that, we head out for Mt. Kilimanjaro tomorrow morning! The climb will occur over 7 days, ending next sunday. We bought lots of snacks in town today, as they said we will need boosts of energy here and there throughout the trek. Please think of us during this time when will we be away! I hope we can all make it to the top, as long we do not suffer from altitude sickness. We are looking forward to it so much, and can't wait to get started! Thanks everyone for your support, and I will update again once we get back next week!

Miss you all!

Medical Caravan, Chekereni

Me after a long day at the caravan. I am using my scarf to protect my hair from all the dust on the road!

Some kids outside the caravan who just wanted to play! They loved having their picture taken and seeing themselves on the camera.

Aliya and I waiting for our next patient.

Patients lined up to see the medical students and doctors. They formed the line after having their weight and blood pressure taken by some volunteers. At the back right of this picture, a woman is collecting her medication from the temporary pharmacy that we set up. All of the medication was given free of charge.

This is the building that we used for the caravan. There were a few seperate rooms that we could use as examination rooms, a pharmacy, and a counselling room. The space worked great for what we needed.

Everyone chatting outside of our bus in Chekereni.

This is the bus full of all the volunteers on our way to Chekereni, where the caravan was located.

Hi Again!

I wanted to post another update from our weekend in Moshi. This past weekend we headed back to Moshi from Kilema, in order to take part in a Medical Caravan organized by Pamoja Tunaweza and Dr. Yeates (the physician from Kingston). Dr. Yeates was here for the caravan (and about one week before that), and her goal for organizing this was for all of the medical students to get exposed to what a Medical Caravan is, and provide medical care to a remote community with limited access. In total, there were about 20 volunteers, and each of us had a different role during the day. All of the medical students (in total there were 6 of us), were responsible for meeting the patients with a translator, and taking a full medical history of their problems. Most of the patients did not complain of a single problem, rather there were multiple problems intertwined with each other that were difficult to sort out. Other volunteers were responsible for taking weight and blood pressure, triaging the patients as they arrived, and ensuring the line kept in order. In total, between all of the medical students, we saw about 55 patients throughout the day.

After taking a full history, we called Dr. Yeates over to discuss the case, the likely diagnosis, and decide on what medication to prescribe for their problems. Patients issues ranged from joint problems, to malaria, to asthma, to complicated patients with both HIV and TB who had an entire different set of problems. We were able to see really interesting medical issues - things we will likely never see again for many years to come (if ever). Dr. Yeates really took the opportunity to teach us about the different cases, so that we can use that knowledge in our later careers. It was so interesting to see how they used their available resources. For instance, one boy who we diagnosed with asthma was given the appropriate puffer medication, however they did not have any aerochambers to use with the puffers. Instead, they fashioned up the aerochamber with a small water bottle, so that he could inhale the medication through that. It was amazing how they could make that contraption out of nothing!

Overall, the caravan was such an awesome experience. We saw great medicine, worked together as a team, and helped a group of people who would otherwise not receive medication or care. They have many caravans planned throughout the year, and they are able to follow-up with these patients after the caravan is complete. They also refer patients to their clinic and the local hospital if their medical needs exceed that of the care provided. Despite the weekend being hectic and crazy (and thus explaining why I was not able to update in Moshi), we all had an awesome time, and were very appreciative of the experience. Enjoy the pictures!

Kilema - Week 1

This is the second baby that we watched being delivered. He was the exact weight of the previous two babies combined, 4.7 kg.

Helping warm the twins after their delivery.

The first babies we saw being born. Twins! One boy (2.3 kg) and one girl (2.4kg). Very tiny.

This is one of the medical wards at the hospital where we spend our mornings doing rounds.

Ramy and I after climbing the hill near near our house. There are such beautiful views of the surrounding villages and all rolling hills in the distance.

This is a view of the hospital on our way up the hill by our house. The white building in the centre is on the hospital grounds, and our house is to the left side of this picture.

Ramy took this photo of us climbing directly up the side of the hill/moutain near our house. It is something to do around our house, and is our "training" for Mt. Kilimanjoro.

This is a photo from the market about 2km from our house. Lots of bright coloured dresses, and many different fruits and vegetables for sale.

Ramy, Aliya and I doing our laundry one day on the porch of our house.

Our first view of Mt. Kilimanjaro while here in Kilema. Apparently we are climbing that in less than a week!

The entrance to Kilema Hospital, where we will be spending 2 weeks in total shadowing different doctors in different wards.

Hi Everyone!

Sorry it has been so long since I updated. We have not had reliable access to internet, so I have not been able to send many messages since we arrived. I have been working on updating this blog for the past three days, and finally have been able to get some pictures up! We have been here in Kilema for about one week now, shadowing different doctors throughout the hospital. Kilema is about one hour and thirty minutes east of Moshi, and the hospital is hidden away in the slopes of the hills. There is not too much to do here, as there is not really a town with shops or anything like that. There is a market on Mondays and Thursdays, which sells lots of delicious fruits and vegetables which is nice. I really like that it is so quiet and peaceful here - it is a nice change from living in the city. Ramy, Aliya, and I have had lots of opportunities to chat, do laundry, read, and watch movies. Our days are usually busier in the mornings, followed by more relaxed afternoons. Morning report starts at 8am, and rounds begin at 9:30am. We have seen lots of interesting medicine while on rounds - things we would be unlikely to see at home in Canada. We take lots of opportunities to ask questions, and try to learn about the different issues that are faced here.

The hospital here tends to slow down a lot in the afternoon, so some days we have found it difficult to find work. We have gone to clinics and the lab, and also to the Operating Theatre to watch different minor and major procedures. Minor procedures can range from cleaning and dressing a wound, to removal of different growths on the body, to casting. Major procedures are things like caesarean sections. While here, we have already seen two c-sections, one of which was the delivery of twins. Things here are so different from that in Canada, but it has been great to see how things are done. All of the doctors are so welcoming, inviting us to different clinics or surgeries so that we can get as much experience as possible. Hopefully over the next week we are able to continue to see lots of interesting things, and learn more about medicine here in Tanzania. I will try to update about Kilema again, likely near the end of the week. Next week Ramy and I will be climbing Mt. Kilimanjaro, so keep us in your thoughts for that!