Happy Feet

I know, I know, it’s been awhile since I’ve written. My apologies. Fortunately we’ve been busy with quite a few fun things in addition to our work at the hospital. Tuesday, following a sad start to the week, was much slower and offered me the opportunity to step into the OR and observe Dr Lee repairing a broken femur.

A brutal and somewhat less sophisticated procedure than what would happen in the states, it was still fascinating nonetheless. Dr Lee cleaned and prepped the upper half of the right leg and then began cutting into the flesh. I’ve started to get used to seeing the blood drip down the leg instead of the smelling burning flesh as I’m accustomed to in the states. He cut through the skin, fat and muscle layers, all the way down to the bone. Once down to the bone, he took a pair of large locking pliers and pulled on the bone until it was at an angle where he could clean up the break and insert a thin guide rod into the bone to make space for the rod that would stabilize and help the break heal. Once finished with the lower half, he moved on to do basically the same thing with the upper half. It’s pretty crazy to see half a bone sticking out of a man’s thigh. Oh yeah, and did I mention that he was awake? Apparently they hardly ever use anesthesia here. What they use instead is something that they call a spinal. From what I could tell, it sounded like it’s basically a nerve block at the level of the spinal cord where they’ll be operating. So for this patient, they likely gave the spinal somewhere around L4. The guy was awake during the entire procedure and all of the crazy, brutal manipulation that was going on, but he didn’t flinch or scream. Point for Mt Meru.

Once the two bone halves were prepped and cleaned, Dr Lee used the probe to go all the way through upper half of the femur until the probe broke the skin near his hip. They made an incision and poked the probe through. Once they were certain of a clean path, they used the probe as a guide for the rod that Dr Lee hammered in from the top, all the way down to the bottom of the femur. The entire procedure took maybe 90 minutes tops. Crazy.

We found out while we were there on Tuesday that Wednesday is a national holiday, something to the effect of a peasants’ day. Meaning that none of the doctors would be in. This worked out well since Lindsay’s friend who works teaching English in southern Tanzania got in really late on Tuesday night. It was great to have him around since he’s conversationally fluent in Swahili. We went to the craft market and had a pretty lazy day, which was nice.

Thursday was back to the hospital, and amazingly enough we were informed by the chief medical officer that Dr Lace, a pediatrician from Salem, was going to be there and he wanted to teach us. Now, in case you haven’t figured this out by now, communication is not a strong point for Tanzanians. So the fact that the chief medical officer was able to get us that message was either a total coincidence or she actually was keeping an eye out for us to let us know. My guess is the former.

We went up to the labor ward after looking around unsuccessfully for the tall mzungu. No one had seen him. Again the labor ward was fairly quiet. Lindsay’s friend also came along with us as he’s thinking about a career in medicine himself. T, Lindsay and I have all been pretty desensitized to the human body and had already had a chance to get used to all the naked women who lay around in the labor ward. It was a little overwhelming for Andrew and he stepped outside for a bit. It was also pretty quiet, so I decided to take the opportunity to try again to find Dr Lace.

We indeed found him just as they’d started rounding in the Pediatric ICU. Pretty sad to see so many sick kids. There was one child with pretty severe cerebral palsy that has pneumonia and it sounds like they’re trying to keep him as comfortable as possible, but he can’t speak, walk or feed himself and his life expectancy is not good. There was also a younger child with a similar diagnosis that seemed to be able to function a little better, but I thought to myself how difficult it would be to have a child with such a condition in a place like this. The life expectancy is not good even in the states with all of our resources and technology. So hard.

We saw several children with diarrhea, a couple with malaria, one small child that likely has down syndrome, one with diabetes that they were having difficulties controlling his blood sugar and lots of distended tummies. There was a pretty large crowd around the new face so it was difficult to hear a lot of what was going on, so after awhile, Andrew and I headed back up to the labor ward to find T and Lindsay. T had been with a woman for an hour or so, in a similar situation as Monday. T and Lindsay had been doing an excellent job of keeping her comforted and encouraging her as well as staying on the nurses like hawks to keep a close eye on this woman and encourage them to do the episiotomy early and get the baby out.

My stomach churned as the watched the final moments of her delivery, unsure of whether or not the baby was going to start crying. I was more than relieved to hear the cries of a healthy baby girl. I don’t think I could have handled a repeat of Monday. The labor ward was still pretty quiet, so after Lindsay learned how to start an IV, she and I headed back down to the pediatric unit to catch the end of rounds. It was so refreshing to have someone like Dr Lace that is actually interested in teaching. I just shook my head sometimes as he would ask the interns some of the most obvious questions such as, “Is the patient on any medications?” and then if they were instructing them to make sure that they stayed on those meds while in the hospital. Isn’t that common sense? But then again, this is Africa… a saying that we’ve come to embrace and seems to sum up many situations that just seem to make no sense.

So you may be wondering why I titled this blog “Happy Feet”. Well, my feet FINALLY got to play some soccer with the local kids. We took Friday off to go visit our Canadian friends in Nkoaranga where they were helping out at the local hospital. They were busy in surgery and pulling teeth. While we were dropping off some goodies for them at their house, one of the girls came running up looking for headlamps and flashlights. “They’re in the middle of a surgery and the power just went out!!!” Surprising? Maybe when we had first started at Mt Meru, but that’s a pretty common scenario. So no, we weren’t surprised.

We then took the opportunity to go for a hike and explore the area a bit. We found a gorgeous trail up a hillside past a few houses and some kids playing outside. On the way back down, Andrew grabbed the kids and started organizing them for a soccer match. YESSSSSSS. I’d been wanting to kick a ball around with the locals since we arrived. The kids are so good and it was hilarious watching and playing with them. Oops, watch out for the cow. Is the laundry line out of bounds? Nope, apparently not. Is that cow dung on the ball? Oh yeah, better wipe that off real quick. And beware of all the shoes lying in the middle of the “field”. Hilarious, but so much fun. A much needed break from the chaos and reality of the hospital.

Saturday we joined another one of our Canadian friends on a trip to Majiya Chai where there is a program called Children for Children’s Future (CCF) that takes children off the street and clothes them, feeds them, houses them and schools them. From what we could tell it seemed like there was a primary school there and then they fundraised to pay for them to go to secondary or other trade schools. One of the boys wanted to go to acrobatic school. I wasn’t entirely sure what that was until our friend DeePal asked him to show us his “talent”. He took off his flip flops and did a round-off, back tuck on the grass. Gymnastics. My kind of kid. =) We asked how he learned how to do that and his response was simply, “my muscles tell me what to do”. Amazing.

After a bit of a tour and chatting with the kids a bit, we broke out the soccer ball and started some juggling with whoever wanted to join in. For those of you who don’t know what juggling is, you keep the soccer ball in the air using your head, chest, knees and feet to keep it from touching the ground and pass it around to one another. For me, there is no better way to bond with kids than playing soccer. Especially in a place like this. They all spoke pretty good English, especially compared to our limited Swahili, but sports like soccer go beyond language barriers. There was also a dance party that broke out. Music is another great ice breaker we’ve discovered.

After some yummy ugali and greens for lunch, we headed out to the soccer field for a little scrimmage. So much fun, but I totally got put in my place by kids that were more than half my age and played without shoes. Incredible. I told DeePal that I wanted to send back a box full of soccer shoes for the kids. Sadly the administration is going through a rough time and would likely confiscate the shoes to make the kids look more desolate and get more money. A very sad truth.

Once we got back and showered, we headed over to one of our favorite local hangouts for some food and live music. A wonderfully relaxing evening after a fun-filled, jam packed last few days. Sunday we were hoping to head to Arusha National Park to get our first look at some of the animals, but after looking into it a bit, it was more expensive than we were anticipating. So Sunday became a day for taking care of all the little things like laundry, food, cleaning and relaxing to prepare for the week. We also headed to another favorite hang out to watch Spain beat Holland to win the World Cup. So fantastic.

And so the week begins again and we’ll be spending most of our time in Pediatrics while Dr Lace is here.

Hope that catches everyone up!