First day at work!

This morning was our first day at St. Elizabeth's hospital, and I was so excited and ready to start working. After a 35 minute walk, we arrived and started our orientation and tour of the hospital. Tesha, a nurse, showed us around, which was quite frustrating at times as she spoke very quietly and I missed a lot of what she was saying. But the following are the parts that I was able to pick up on.

We first met with Dr. Kwai, who seemed to be the head doctor at the hospital. He asked us what area we wanted to work in, and upon hearing that we had been trained in HIV testing and counseling, he was very excited. He told us that the HIV/AIDS ward at this hospital was the only one treating patients in Arusha, and that it was only 1 of 7 in all of Tanzania. Even more shocking was to hear that it had only been in existence for 4 years. It shocks me to hear that the only place to be treated for HIV in a city of 2 million has only been around for such a short period of time, especially since the disease has been around for 30 years. It just goes to show that things progress so much slower hear, than back home.

We then went around to meet many of the other doctors, nurses, and midwives that work at the hospital, and I have never felt so welcomed by so many people. Everyone hear is so polite and inviting and they all told us that we should just pop in if we want to see what they do. Our first stop was the Ultrasound room where we got to watch a pregnant woman find out that her baby was healthy, but I couldn't understand anything because the doctor only talked to her in Swahili (another incentive to learn the language). We also met Graeme, a Scot who is also volunteering at our hospital.

Tesha then took us to the pharmacies, the first of which was the infectious disease pharmacy, where they house all of the medications and testing supplies for HIV, TB, and malaria. I could not believe the array of medications that they had; there were numerous pills of many different families of medicines, they had liquid forms for children and patients who had trouble swallowing, and they had medications in shot form. Dr. Mack, who ran this pharmacy, showed us the three HIV tests that they use: a Unigold rapid, an SD rapid, and a third that I couldn't see the name of. The resources they had were amazing considering the how short-lived this clinic was, but it also goes to show how much money is being poured into infectious diseases by outside contributors. Mr. Mack also showed us the record keeping system they use for the medications they dispense, all in paper, and each patient is given a number through the government and that number is the only ID that the hospital records. This is very helpful for these patients who are terribly concerned with stigma. This pharmacy was a wonderful surprise and I feel confident that Whitney's and my skills will be well utilized in this department. I am also so excited to be able to test patients and then treat them. All the work that we have done so far has only been on the testing side, and now we will get a very comprehensive look at infectious diseases.

We stopped in the other walk-up pharmacy that they had for their other medications, and it was a complete 180 to the first pharmacy. The shelves were nearly bare and many of the slots were empty. So much concentration seems to have been put into the infectious diseases that the medicine people need for other ailments are terribly overlooked.

We walked through the rest of the hospital, which included the X-ray station, part-time dentist office, surgical ward, maternity ward, opthamologist, the ward for HIV patients, wards for other patients, and the outpatient clinic. Although the safety and sanitary standards seemed much lower than I have ever known, I was greatly impressed with the many different services that they provide their patients. Privacy in Africa is very different, and quite frankly non-existent. As we toured the hospital, we interrupted several patients during their visits, and many other people did as well. With a system like this, it is easy to see how people are scared to visit the doctor for various reasons because there is such little privacy.

There were 2 waiting areas, both outside, and they were full of people seeking medical attention. This hospital sees a lot of people, which was evident after seeing their filing system. There were two adjacent rooms that were stacked floor to ceiling with charts that didn't have any numbering or labeling tabs. There were also boxes on the floor with files in them, and Whitney joked to me that it looked a lot like some of the systems you would see back home. A lady was in there looking for a chart when we went in, and 5 minutes later when we left, she was still looking.

All in all, I was very impressed with our placement and am looking forward to our first actual day of work. We couldn't stay to visit with the doctors because we didn't have our lab coats.

The picture is of the Maasai woman that we bought a bracelet from during the "Amazing Race". She was funny and we had a good conversation with her.

Written by Zach

12 October 2009

Mambo! Today was our first day at placement. We left the house early and got to the hospital a little before 8am. The walk isn’t bad because it is down hill most of the way, but on the way home is tiring. We walk past Selian Hospital everyday to get to ours’, so that is pretty cool.

The hospital was pretty nice. There were a surprisingly high number of doctors there (around 10-12 probably) and the hospital has many different wards and services. It has pediatrics, gynecology, surgery, opthamology, HIV/AIDS, TB, malaria, dental and a general medical, plus a few more that I may have forgotten. The hospital also seemed pretty organized, as far as Africa goes. I think it is definitely one of the nicer ones in Arusha, but in a Westernized country, it would be considered a condemned building probably. Everyone was very nice and welcoming, and they were excited to hear that we will be there for 6 months. I think most volunteers they get stay for 3 months max, so they were pumped. We also visited the lab where they analyze the samples and they were pretty excited that I had a chemistry degree J I will do what I can there with them, too. I think one of the things that was most strange there was how much they are going to let us do. In the states we are considered amateurs and is cut throat to get to work in a hospital, where here, we are considered highly educated and will pretty much have free reign to do what we want.

We got to into all the different areas, but I was obviously most interested in seeing the HIV/AIDS patients. There were three rooms for the patients, separated by males and females. The rooms weren’t full, but there were many beds per room. I was nervous to see the patients at first, thinking I might get a little emotional, but I did good and kept it together. There were two doctors with the patients, which made me feel better and think that they were being taken good care of. I was also really impressed with the pharmacy for the HIV and TB patients, which was separate from the regular pharmacy. It was well stocked and was clean and organized. They had 1^st, 2^nd and I think even 3^rd line drugs for HIV and three different kinds of tests, including UniGold tests, which we are familiar with. They also had a finger prick rapid test, but not by a company that we recognized. The pharmacist there was specialized for the HIV patients, also, which is awesome. It is nice to see a program so well established. Even though we might have been more help somewhere with less resources, this will be a great place for us to learn a TON and get a feel for medicine in Africa. When we have a good knowledge of that, and are better at our Swahili, we should be able to go to places more rural and be able to help.

The hospital administrator said that St. Elizabeth’s was the first hospital to have an HIV/AIDS ward in Arusha, and only the 7^th in all of Tanzania. The amazing thing is, though, that the program is only 4 years old. Before that, I guess it was hit and miss if you had HIV and needed treatment in Arusha, and sadly, it is still like that for most of the country.

Tonight we are having “Thanksgiving” dinner because it is Canadian Thanksgiving today. We are hoping to celebrate the “real Thanksgiving” in November J, since there is one other American in the house with us.

Yesterday was Sunday and we got up early to go to church. We planned to go to the Arusha Community Church, which is where most of the white people go here, so the service would be in English and we would be able to understand the service. We walked around town for two hours, but couldn’t find it! When we got home, we checked the directions again, and it was just where we thought and had been looking. We must have walked around it over and over, and just never saw it. I will e-mail the Simonson’s probably this week and ask for more precise directions so we can go next week.

Well, you’ll be hearing more from us soon, after we get a little more time in the HIV ward of the hospital. Love and miss you all.

Written by Whitney