The mobile medical clinic team
The day after we arrived in Karatu we were chucked right in a the deep end and set off on the mobile medical clinic. There were twenty of us all together, mostly tanzanians who work with Dr Frank. The had two other practising doctors with us - Ivan who is a medical officer (similar to a nursing practioner in the UK) and Dr Mugass a medical student. There was also Siana a nurse and acting pharmacist, josephat our lab technician and Deana and Marie who were occupational therapists from the US who were working at a local orphanage. The mobile clinic was the first of 24 monthly clinics which were planned for the area of Mon'gola, in particular the village of Laganghereri. FAME had recieved a grant from the Netherland malaria no more trust to fund the project. Three hours on the red bumpy roads we arrived in Laganghereri and the locals were waiting. Some people had walked for hours or even days to get to the clinic as the word had spread that there was free health care available. We set up in some school buildings and got through as many patients as we could. In total we manage to see around 500 people in 4 days.
I worked with Mary, FAME's HIV outreach co-ordinator and expert translator. It took a while for me to find my feet, when I asked a patient what the problem was in my best swahili Mary would reply they have pain in their head, ears, chest, stomach and backbone, as well as some diarrhoea and coughing up a bit of blood
Chilling on the mobile clinic
! She was brilliant at helping me figure out the main problems and explaining the diagnosis. Most of the patients were from the local tribes and had only previously seen a traditional healer/witch doctor. Some had scars on their faces and bodies - the aftermath of traditional healing. Being the only female doctor the majority of patients I saw were young women with likely STI's and pelvic infammatory disease. Gynaecology isn't my best subject but it was just a case of going by symptoms and whipping the patient into the back of the bus for a quick injection and handing out a few condoms. We saw loads of Malaria as no one uses mosquito nets, and brucellosis - from slaughtering cattle and the unpasteurised milk. The mind set was just to do the best we could, pick out the sick patients, do a bit of health education and de-worm everyone! We came back to Karatu knackered, dusty and completely sick of rice and beans. All in all a pretty amazing week.Sye
Right, Kirsty's filled you in on the first part of our wee trip so i'll try not repeat the details or bore/annoy you with countless teary-eyed cliches but let me jsut say this: I've been lucky enough to have done some travelling in my time and while Africa was somewhere I definitely wanted to visit and travel in at some point, it was never somewhere I was hugely drawn to or knew that much about
The journey to Mang'ola
. I'm not sure of any particular reason, but it was just a bit further down my list. Sitting writing this after only a few weeks i realise that was a big mistake. I've never had three weeks like this before - it's already been absolute quality.The mobile clinic was amazing - happy, sad, rewarding and at times frustrating. The people here just get on with things - they're tough as fuck. There was the woman who walked several hours with 4 small kids strapped to her and as it turned out had malaria, a chest infection and an STD that she'd had for 3 years and which gave her constant pain but did she complain? no, just got on with it. Another guy who was really sick had become paralysed from the waist down 2 years ago and had been nursed all that time on the floor of his tiny mud hut by his wife on her own. He had some of the worst pressure sores i've seen on his hip and back - nearly down to the bone and infected. He barely flinched when we had to do a bush style wound debridement on him with no anaesthetic and very little pain killer to limit the infection. He had HIV and his paralysis was most likely due to an infection he picked up and couldn't fight off. It turned out his wife was sick too and also had HIV - we had to tell her, it was so difficult but she was incredibly brave, her attitude was that this was just how it was and she just wanted to make sure her family would be OK - very humbling. There was a fair bit of gutting stuff like that that we couldn't do that much about like people with undiagnosed cancers but there was also some great medicine where people had been miserable for ages with things that for us are easily to treat and when you got them sorted out it was really rewarding - thats what it's all about
Laganghereri
.The setting for all this, despite much of the area being very run down, was pretty stunning too. I've not seen scenery like it anywhere i've been before, there's something striking about how red the earth is and how different it is depending how close to the water you are, you can see it change in front of your eyes over relatively short distances. Some of it's very green which surprised me - i thought of it as dry and barren (don't get me wrong a lot of it is - and very dusty) but theres patches of thick rainforest, savannah grassland and marshy green bits by the water teaming with wildlife - beautiful.
Right that's enough of that. To carry on where Kirsty left off, after the mobile clinic we spent the week back at the clinic base in Karatu. As they'd told us before we arrived they've got the place pretty well staffed with Tanzanian doctors and don't have a massive patient load yet so there weren't a huge number of cases for us to see. As i'd said to them i liked orthopaedics, i was considered an expert and was consulted on all the joint pains and did the odd steroid injection and Kirsty was consulted on the medical stuff. When we weren't seeing patients there was a lot of behind the scenes stuff to get on with because they're planning to build a 14 bed hospital on the site with theatres for major and minor surgery. We helped with the some of the aspects of planning it and the organisation of the clinic itself
Patients waiting to be seen
. It was pretty good cos it's not the kind of stuff you generally think much about as a doctor but it was interesting to see how they deal with the problem of being in such a remote area and getting the supplies they need, things that aren't an issue at home.While in Karatu we stayed with the volunteer coordinator for the clinic, Caroline, who's a very switched on very organised German girl who likes a bit of a drink. Her place had a pub in the compound literally 50 feet from the door: 1 pound beers - Joy! Most, if not all nights were spent there so it was a good laugh.
We arranged a couple of wee trips during the week too. The first was to visit a hunter gatherer tribe that live in the bush called the Hadzabe. These guys are mental, they're really excitable and talk in a fairly in your face language that has clicks in it (bit like Marvin from southpark) it sounds like they're always raging but they're really smiley and friendly. When we went to see them they were going out hunting and we went with them - brilliant!. They gave us all bows and arrows and ran out into the scub with us following. They manage to pick off little birds with their arrows which they then strap to their belts/ loincloths and then every so often they'd stop, light a fire and cook them up (cook is a loose term: they hold them over the fire for a minute or so then munch them - bones, heads and all, no wastage)
Trying to firgure out what the hell is wrong
. They also had a bit of a penchant for weed and would all have a wee smoke out of a stone pipe before they went out hunting - i think they reckoned it made them one with nature or somthing. Great day.The next trip was out on safari in the Ngorongoro Crater which apparently has the highest concentration of wildlife in it of any of the African wildlife parks. This Place was incredible, it's a volcanic crater 17km across filled with animals. You drive up to the top of the rim through dense rainforest then down the other side into the crater itself. From the top of the rim there an incredible view down to the grassland below and you can see that its perfectly circular completly enclosed by what looks like a massive wall all the way round. When we got in it started off pretty slow and we saw zebras and wildebeast, which is all well and good but the novelty soon wears off and you want the lions and elephants. I was not to be dissapointed - pretty soon they all started coming out the woodwork, lions coming within 4 or 5 feet of the car, elephants bathing, hippos chilling, water buffalo etc all in immense numbers everywhere you looked. Couldn't have imagined seeing that much - highly recommended.
While the week at the clinic was a bit lighter on hardcore medicine compared to the one before it was still definitely worthwhile. The team there are a pretty special lot, they work for a fraction of the wage of their opposite numbers in the uk but theres no slacking and no bitching and moaning like you get so much at home, everyones always got a smile on. Frank and Susan especially are two of the nicest folk you'll meet and have always got a joke or a story no matter how busy they are. Come the end of the week though we were starting to get itchy feet and were ready to get on with the next leg of the trip.
No comments:
Post a Comment