Nkoaranga – Week 1

Hello Canadian friends and family,

 

Just checking in after our week in Nkoranga, a rural hospital just outside Arusha. We were not sure what to expect at the beginning of the week, but found ourselves wishing we had more time at the end. It was a great experience with many opportunities for independent learning and awareness of everyday health issues within a developing country. We got to attend morning mass with all the hospital staff, go on rounds, scrub in on some surgeries, help out with deliveries, accompany the palliative care nursing team on home visits and even sent some time in the pharmacy and lab. Fortunately for us, we were living right beside the hospital orphanage, home to 17 children of varying ages, some just 3 months old. We spent a few evenings there playing with the kids, helping out the mama’s with their everyday routines. Most of the time it was chaotic with all the kids, and we often wondered how the mama’s were able to manage all the work themselves after the volunteers had left for the day.

 

We each had memorable moments that we would like to share from this week. I guess I will start!

 

My most memorable moment this past week was the last patient we saw while on the home visits with the palliative care nurses. We drove about 20 minutes up a really bumpy road and came to this small hut. Walking inside, we saw an elderly man lying in a bed wrapped in kangas (the traditional African cloth), and his wife, who greeted us warmly. We learned that this man has been blind for 5 years because of uncontrolled blood sugars from his Diabetes. The nurse informed us that they were not able to afford medication continuously, and that while metformin is the medication of choice (or even insulin), he was not able to continue payments and so his blood sugars had been left uncontrolled for many years. I remember feeling helpless at that moment. A medication that would cost them 10,000 shillings a month (just around 7 dollars) was still not even feasible. We thought of offering to pay for a few months of treatment, but that would just be a temporary measure and inevitably he would wind up off treatment again. It’s frustrating to feel like you cannot help. The other distinct memory from this visit was walking into their home and glancing up at the ceiling. From years and years of indoor cooking with no ventilation, there was a thick tar-like black substance coating the entire hut. We all found it difficult to breathe just for the 20 minutes we were in there. I can’t imagine how they ever would be able to live in such an environment. Apart from the home visits, I also really enjoyed seeing how the deliveries are managed here, and how strong the women are. I think Odion will speak to this more below!

-Much love, Bethany

 

Similar to Bethany’s experience with the palliative home care visits, joining on this experience was one of the most memorable parts of my (Cindy’s) week.  We ventured out onto road conditions that most North American drivers would never attempt.  The team included a driver, a social worker and a nurse who were responsible for approximately 900 patients in the surrounding area, with the majority being HIV patients followed by diabetes, TB, and a number of different types of cancers.  As you can imagine the palliative health care team is faced with an enormous up hill battle of trying to provide sufficient care to their large list of patients.  Joining on the visits, we were exposed to the limited resources that are available for the patients suffering at home.  For example, one of the patients had large tumors that have left him unable to walk and have significantly decreased his quality of life.  As I sat in the bedroom where this man had spent the last 2 years of his life laying in bed, I couldn’t help but think that this would have never happened in Canada.  Not only would the cancer have been treated but a simple topical cream such as Polysporine was not even available to help with the raw skin that was exposed to the dusty environment. Sadly this experience is only one of many patients that I have met along my journey this far that due to the resources available, will have a decreased quality of life.  It has been inspiring to see the strength of the families involved, and the innovative ways that the health care workers come up with providing the best care to patients with the limited resources that we have.  There is much to learn from the health care system here, and I look forward to spending more time in the clinics, here in Arusha this week!  

 

The one thing we are constantly reminded of as men is the difficulty of the birthing process women have to endure. And nowhere is this more true than in rural communities in countries such as Tanzania. Spending time at the Nkoaranga Regional Hospital, I had the opportunity to help out in some deliveries. My first one was an accidental walk-in while exploring the maternity ward. An ante-natal woman was in what appeared to be broken stir-ups. I thought she was just undergoing a routine check-up by the nurse. I was wrong. This woman was about to deliver, and the only person there was the one nurse, and a first-year male medical student that accidentally stumbled upon the room. Without any medication, the woman was undergoing one of the most painful experiences in life, and she made it look easy. Much respect to the women in Tanzania, I don’t know how they are able to endure that experience without a peep. There was no one else there to take the baby following delivery. There was no doctor to oversee the process either. This one midwife was going to do it all. I helped out wherever I could, weighing the baby, trying to keep it warm and wrapped in blankets. Then the attention went back to the mom, as she required some stitches… without anesthetics. Strong indeed. I had a great week in Nkoaranga, learned much, especially about the differences between the two health care systems, and definitely looking forward to spending more time in Arusha.

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