Halfway

I can't grasp that I have been there for a month already and that I only have less than 4 weeks left.
Every day here brings new surprises.
But for this blog post I will focus on my working experience thus far in greater detail.

As I have mentioned before, I am assigned a weekly rotation that says I should be "working" in a certain ward each week. It also says a doctors name that is suppose to be supervising me. This, however, is not true. I have met only 1 of my supervising doctors since I have been here, in five different wards. The wards I have been assigned to so far were surgical, labor, and pediatrics. I learned very early on that there is no one to check in with or to report to at any of the wards. So if I go to a different ward, it doesn't matter. This might sound odd, why wouldn't I want to go to a certain ward? Well read my post about the labor ward...I have yet to return to it and was suppose to stay there for 2 weeks. The other thing effected by the lack of authority is how the nurses view the volunteers. They seem to see us as annoyances that are in the way of them doing their work. However, most of the time the nurses are sitting at a desk shouting out to the student nurses to be doing the things they should be doing. Basically, in order to be of any help or learn anything I have to walk up to a student nurse in the ward, introduce myself and tell them about projects abroad and why I am there. Then I follow them around for a little bit, asking questions and reading files to fill in the unknowns. If I am lucky, they are super excited to show me stuff and have me assist in whatever they are doing. If I am unlucky, they speak no english. The doctors are, in general, willing to take the time to show us what we should do, but only after we ask and assert ourselves.

Though I have only been assigned to spend time in three wards, I have spent a good amount of time in the mens and womens internal medical wards. As I have mentioned a few times before, these wards are mainly patients suffering from malaria, TB, and other infectious diseases. The days spent in these wards I was shadowing my friend Ben, a nurse volunteering from sweden. Since Ben is already a registered nurse he knows so much more than the student nurses here and sometimes even the registered nurses. He is so great! He has showed me and talked me through placing IVs and giving medications, reading patient files, and placing catheters. I am scheduled to spend a week in internal medicine at the end of my stay but this is Ben's last week here so I will spend this week in internal medicine instead.

Another ward I have spent a few days in, is the minor theatre. This is where people come as outpatients to get wounds dressed or redressed and cleaned, stitches, and the most shocking, circumcision. This is where I did my first stitches as I described previously. This ward is usually where you feel like you are actually doing the most. TO explain the conditions of this small room would never paint the right picture. Patients have to bring all of their own supplies, the only supply the hospital provides is the stitches and the iodine solution. So patients come in with unsterilized gauze and cotton and it is placed in a sterilizer for less than a few minutes, so its not actually sterile. Its just very overwhelming to wrap my head around the inability for a hospital to provide proper supplies for something so simple as cleaning and wrapping a burn wound.

Regardless of which ward I am assigned to, each wednesday I have gone to major theatre (surgery). This week, I watched a man's last three toes get amputated down to his tarsal bones. It was absolutely horrendous. They don't have bone cutters so they were literally using surgical blades that kept breaking inside his foot. The man has gangrene from diabetes and as we left the surgery, the surgeon explained that they would most likely have to come back and amputate his entire foot....so then why didn't they just do that this time...I have no clue. The same day I got to assist in a removal of a hernia. Assisting means I got to hold the tools that were clamped to the skin and to cut the sutures. Afterwards the head surgeon dictated as I wrote in the patient file what happened in the surgery. I came to Tanzania with a few goals, and one of them was to figure out what I might want to specialize in. I think it has become more and more clear that I thoroughly enjoy surgery.

I wish I could explain things much better, but words don't explain the smell, or the constant film of dirt on everything, the yellow of the patients eyes that are dying from cerebral malaria, or the sound of a mother crying for her child.