Thursday, May 26, 2011

Last post from Zanzibar

I am logging onto the internet for the last time here. I doubt I will be posting until after I return. Today was our last day at the hospital. It was a good last day. Our doctor who oversaw us was so sad to see us go.  Even sadder though was as I was gathering my bag I realized the baby on the cot next to it was dead. It was a week old infant that likely died from sepsis. Death here is so common. We saw two infants in the NICU yesterday that both died. I am so thankful for all I have and the medical care I can offer to my patients back home Anyhow, life goes on. On a happier note, we are going up north tomorrow to Nungwi and will snorkel the beautiful Mnemba Atoll. Then return early on Saturday morning to head to the airport. I fly from Zanzibar to Dar then Dubai then JFK then Dulles. Excited to sleep in my own bed and take a hot shower at the end of the trip! Still hoping I don't develop malaria from all the mosquito bites I have gotten. That is all for now!

Tuesday, May 24, 2011

Safari

This is the start of my last week here in Zanzibar.

We just returned from at three day safari in Northern Tanzania (Lake Manyara, Ngorongoro Crater and Tangeire). It was beyond amazing. The lions and their cubs were awesome and so up close that there were about to come through our jeep window! The zebras and elephants were everywhere and more than you could even attempt to take pictures of. The giraffes were so tall and graceful. The flamingos where endless and created a blur of pink on all the lakes.We saw two black rhinos. We saw many, many more but I won't bore you with that. It didn't even seem real to see everything up close. I kept thinking I was on the scene of the Lion King. Of course, I took a ton of pictures which I can't wait to get back and upload.

Things have been going really well otherwise. I will be sad to leave. I also am proud to report that we have consistent water and power! We are finishing our last week at the hospital. Today we saw the older kids with some very interesting diseases. I must say being here as sure made me realize a lot of thing but especially how lucky I am for the excellent education I have gotten during residency. We had another child die last week and one over the weekend while we were gone. Still sad but the norm here.

Just before I fly back this weekend, we are going to go up north to another beach called Nungwi. There is another volunteer who lives up there we will get to visit and have show us around. Anyhow,  I will try to write more about the safari and other things later as the internet speed and access aren't great.

Monday, May 16, 2011

Picture Perfect Beaches

On Friday, we went to Prison Island. It had been built as a quarantine station back in the 1800s. This island is famous for tortoises. We got to feed them and they are massive. The beach was gorgeous but sadly I couldn't go swimming. On our way to meet our friends to get on the boat, I cut my toes open. I hit my foot on a metal roof and thought I just stubbed it. I looked down and my flip flop was filled with a puddle of blood. I managed to cut my two little toes. I think it definitely could have used a suture or two. Needless to say I was glad to have the hemostat gauze my mother suggested I bring. I wrapped up my toes after cleaning with some "local water" and went off to the beach. Thankfully now it is healing and I have avoided infection. First thought was thank god my Tetanus shot is up to date.

Then on Saturday we left for a little town on the east coast called Paje. It was very relaxing. It was on the Indian Ocean. The water was warm and crystal clear and sand as white as in FWB. There were hardly any people out there just locals who make their living off of collecting seaweed. The tides are very dramatic. Normally when the tide varies by about 1 kilometer. When we where there it was much less as it is a full moon I think but it was shallow as far as we could see at low tide. Locals were walking out and it was only about knee deep as far as you could see. The cabanas we stayed in only had two beds with mosquito nets a fan and sand floors. It was perfect. The place is run by Germans and only has 8 cabanas. The ride there was quite the experience as are most things here. It took about 2 hours (51 kilometers) and we rode in what is called the dahladalaha. These are basically a truck bed with a metal roof on top with rows of wooden seats inside. It gets jam packed with people and just when you think it is full they throw someone else in. I counted 32 at one point. I am thankful that I am not claustrophobic.  Luckily, we got a ride back into town in a friend of our roommates.

The hospital continues to be very interesting and frustrating at the same time. We came in for rounds on Friday morning and the room we store our bags in while working is supposed to be the ICU but it isn't really used as this since they have no resources for it. We saw this little kid about 2 years old lying on the bed. He was grunting and appeared to be very ill. I assessed him and then we went to ask our attending what was going on with him and if anyone had seen him. Nope. He was admitted about midnight for "asthma" and treated with oxygen and bronchodilator. He was never given more or reassessed. We (me, Kiron and the med student) started to attempt to put an IV in this kid but had nothing to do it. Apparently they have to buy the materials from the pharmacy and then use them and the pharm was closed overnight. Long, long story short. He died later that afternoon. He is the second one of our patients to pass during rounds. The other was a 21 day old with severe dehydration who wasn't even on IVF when we saw him on rounds. We have initiated taking vitals on rounds starting today. They don't do them at all here. Sad that that is something you can easily do with few resources and they don't even make use of it. Makes me so thankful for what we have. God help me if I get sick here....

We just booked a Safari trip for the weekend. We will be going to Ngorongoro Crater and Lake Manyara. I am super excited and can't wait! Things at the apartment are good. Our water situation seems to have stabilized the last few days as well as the power. Just thankful for the little things. I am writing this from the hospital library which does have internet.

Wednesday, May 11, 2011

Oh the adventures!

Got water but then the power went out...

We got running water today! This is great. I took a real shower a few minutes ago. Before that we cleaned and washed almost everything as it had actually been more like 3.5 weeks that there hadn't been water.  It will be nice to actually cook our own food, flush toilets and wash hands!  We found a market yesterday to buy some things and have so far been eating PB&J sandwiches for lunch and dinner out. Well now that I think about it, we have no power since this afternoon so guess we have to wait for that to cook. 

Our roommates are both from Germany. They have been very sweet and invited us to go with them this weekend to a beach on the east coast. Most things are closed for the season because it is the low season (aka the rainy season). We will stay at Teddy's Place. The pictures look amazing. I can't wait! 

So far I haven't gotten but one mosquito bite. We are sleeping under mosquito nets though. Definitely don't need any covers as we only have a ceiling fan. It is quite comfortable though. Our room is really spacious and we have even set up a little sitting area. We are trying to do board studying for at least an hour a day.  See how long that lasts!  

The hospital has been interesting. We have been two days so far. The first day we rounded on the "cot ward" for children under three. Mostly they had been admitted for respiratory issues (pneumonia, bronchiolitis) and others with UTIs, neonatal sepsis, diarrhea and seizures. One kid today was likely infected with TB. I definitely didn't have my N-95 mask.  Sure  there are likely others with TB. Everyone gets a blood smear for malaria and treated for malaria if they have a fever. We also walk on rounds with a open container with paracetamol (Tylenol) and hand them out to the mothers to crush and feed to their child. There is also an isolated ward for those with measles. We didn't see them but I think there are about three patients in there currently.  I would like to see them before I leave as we are likely to never see this in the US. This morning when we arrived, we saw a kitten sleeping on the shelf right next to the injectable antibiotics that they leave sitting out on an open shelf in the hallway. All the families are required to go and buy the medication the doctor orders so it can be given. 

After rounds today, we were told to go to cardiac clinic. This took place on a porch outside. The doctor we were told to work with we come to find out is a GP who is doing his intern year and has only been in pediatrics for two weeks.  We listened to a ton of murmurs and thrills too. I am weak in cards stuff and thought this was pretty neat. A lot of the children haven't had surgery and those that have, went to Israel. The doctors we worked with didn't even listen to or examine the patients. As a matter of fact, he didn't even have a stethoscope.  

That is all for now!

Sunday, May 08, 2011

Buckets

It only took 15 minutes to fly from Dar to Zanzibar. The water around the island was a gorgeous turquoise and you could see the reefs and other tiny islands on the outskirts.  We saw the hospital from the air and actually looked like one of the nicest places on the island. 

We were met at the airport by Amed who works for the travel company that World Unite uses. He told us things were not ready at the house that we had been told we were gonna be staying at. He said one of us would stay at that house about 7km from town and the other in Stone Town. I said I don't think so. 

Lots of phone calls were made and the person who was in charge and supposed to have picked us up was notified. After about three hours, we finally solidified things and we are both sharing an apartment in Stone Town with 2 or 3 other girls. It is a decent set up. 

Our apartment is nestled in the labyrinth of the town. Might have to leave bread crumbs to figure our way in and out! The catch is that there has been no running water for two and half weeks due to someone sabotaging the water well. So for us, it is buckets to flush and shower. This isn't a new thing for me as I had to do this after Hurricane Ivan and in St. Vincent during the dry season. 

The upside to all the initial chaos was we got a wonderful tour from Amed. He took us to the water front area  where all the food vendors set up. They had shish kabobs of every fish and seafood imaginable. We opted for a pizza. This isn't pizza as we know it. It is really a dough base filled with meat, veggies, cheese, mayo and egg all stirred up together. It is then cooked up on both sides like a pancake. 

So today, Sunday we are getting acquainted with the rest of the town and then tomorrow will be our first day at the hospital. 

Happy Mothers Day Mom. It was great to chat with you yesterday and I will try to talk with you on FaceTime. We have no internet in our place and I an typing this all off line to upload when we find an Internet cafe. 

Thats all for now.....

Sand Surfing

It was a great time  in Dubai! First, we hit up the shopping after arriving early in the morning.  We went to the Mall of Dubai that has the world tallest building, the Burj Khalif. Didn't go up to the top since it was so hazy and you wouldn't see much plus it was sold out. Saw the very tall indoor ski resort in the Emirates Mall.  Getting there was an adventure. We rode on the metro. There are separate men and women/children sections.  We of course didn't realize this  for a little while till we wondered why there were so many men. It worked out well though once  we figured this out as there was more room in our section! 

Later our first night, we attempted to venture out for dinner but that was a bust. We wanted to go down to the market to eat near the water. Well, we couldn't find any place. When  we attempted to get out of the area but about 15 taxis went by and refused to pick us up. Finally, one was kind enough to and we went back and ate some awesome Italian food in our hotel over looking the water. 
 
The second day we met up with Kiron's cousin Radha. She was so sweet to give us the insiders tour of the city.  We went out to the famous Palm island. It is manmade islands in the shape of palm trees. People have houses on the fronds. We got to see them. Wow, that is quite the life!

That night we took the much anticipated Desert Safari. It was awesome. By far the best part of the trip. We were in a convoy of about 20 Toyota Land Cruisers. Each one held about 6 passengers. After a long drive out to the middle of nowhere, we finally got to the dunes. It was a wild ride. It was like surfing in car! I have no idea how our driver did it. We were sitting in the back which gets flung around the most.  I did start to feel a little sick towards the end. I took some video that I will post at some point. If this was the US there would have been a massive waiver to sign. We then went to ride camels before the traditional Arabic dinner where we sat on pillows and watched dancers. I got henna on my arm. I think it looks really nice. Does surprise me every now and then when I look down and forget I did it.  Then afterwards we hit up the Madinat Jumeriah for some dancing. We hads a great time and thankfully no problem waking felt our flight.

The flight to Dar Es Salaam in Emirate airlines was nice but not as nice as the one coming from the US. We arrived and got ourVisas without too much  hassle. But boy I now understand the term "Africa hot" as there was no air flow and sweat dripping off of me. I know this is just the beginning.  We are now sitting waiting for our hopper flight to Zanzibar. 

Thursday, May 05, 2011

Half way around the world

I have arrived in Dubai. Our hotel let us check in early (9am)! Emirate airlines was awesome! Definitely would fly them again. Hardly got any sleep because I was watching a bunch of movies during the 12.5 hr flight.  Our hotel window faces the creek and has  incredible views of all the boats. We are off to explore Dubai now.  

Tuesday, May 03, 2011

Leaving on a jet plane!

I am about to embark on my away month to Zanzibar. I am thrilled that my residency program allows me a month to get away and practice medicine in another country. I am going with a company called World Unite . I will be traveling with my friend Kiron from medical school. She and I met when we both did an elective in England fourth year of medical school. I am excited to travel with her again. The first stop will be Dubai for three days before heading to Zanzibar. As you can see in the picture below, I am all packed and ready to go. I will try to keep my blog up to date as I travel around.

Trying to travel light!