June 28, 2012
First day in the clinic!
Rounds begin at 7:30 am at the small in-patient Kammed Clinic. I was a little nervous about what to expect but I shouldn’t have been. Dr. Baraka, the main doctor who’s been working with us, is young and soft spoken. He treats the patients (and us) gently and with respect. On rounds, he asks us to jump in and help with the physical exams, as well as asking us questions about what investigations we’d like to order next and what our management would be. Not going to lie, at first this seemed a bit challenging to me- I know what I might suggest in Canada, but is that appropriate here? Are those investigations/resources available? Again, I quickly learned that resources may be limited but the basics of management remain the same. And, it’s very interesting learning how much more they attempt to discern from the history first. Infections are certainly much higher up on the differential diagnosis, but diabetes, hypertension and heart disease are still also very common.
After rounds, we essentially had a mini “continuing medical education” (CME) discussion with our group, Drs. Mhando and Baraka as well as the nurses in the clinic. Dr. Baraka, I learned, had been hosting discussions all week about various conditions that are more common in Tanzania to get our group up to speed. Today’s topic was malaria and I certainly much more than we had in Canada. For tomorrow, our group was asked to prepare a talk about tuberculosis- more on that below!
In the afternoon, I met Dr. Mhando (absolutely wonderful man) and we did echocardiograms for the afternoon. I actually hadn’t even seen one of these in Canada yet, so again, great learning experience.
Also, I learned that engineers are the same all over the world. One patient, an elderly man, had travelled by bus early that morning to make it to the afternoon clinic. A retired civil engineer, he was being treated for hypertension and diabetes. Upon being asked how things were going, he dutifully pulled a little notebook, where blood glucose levels and blood pressure measurements had been meticulously tracked and recorded over the last 3 months. I couldn’t help but chuckle. With a family (and soon to be in-law family) full of engineers, how many times had I seen similar graphs of blood pressures done by them? I can remember retired engineers I’d seen in family medicine clinics in Canada with similar charts and notebooks. Amazing, haha. I told my patient this and he gave me a chuckle in return. Love it!
In the evening was my first experience at Via Via café! A local “mzungu” (white person) café/bar, it was an amazing venue. Composed of numerous interconnected round huts on a hill, it has a giant screen in the valley with seating cut into the hill for viewing all important Euro Cup matches (and the Olympics soon!). A local regae type band was playing the place was packed with mzungus and locals a like.
Last week when the group had visited, the place was hosting an African dance team as well as Miss Arusha! Definitely looking forward to more nights relaxing at Via Via!
Much love y’all,