Week 3 + 4: Frustrations

Being in a development country means that things just aren't the way you are used to. Power can go out for an entire day after heavy rainfall, a hospital doesn't have the necessary resources to treat a patient properly or due to said heavy rainfall there is nobody in the hospital because the roads were not fit for travel.
Of course I expected that things would be different, I watch the news.
What I wasn't prepared for was how much it would frustrate me.
Starting with my work on the Minor theatre, one of the most interesting yet frustrating parts of the hospital. Minor is a department of the hospital where everybody who has had an accident, be that they cut in their own fingers, were stabbed during a robbery or were hit by a car whilst riding a motorcycle.
In Minor they stitch the people up and asses the situation. It is manned by interns (they are completing their medical studies and doing internships all over the hospital) and a nurse (who is abolutely amazing at his work and knows so much I thought he was one of the head doctors first). Here is a short selection of things I've seen in Minor:
- somebody who had an motorcycle accident and had a big wound on his head which needed stitching.
- A girl who had burned herself on some boiling water and needed dressing of her wounds.
- A guy who had had a motorcycle accident (seeing a trend here?) and who's toe was completely skinned. No seriously, it was like he had two of the same toe: one made of skin with the nail still on it and one made just of bone and muscle.
- An old man who had his prostate removed and needed his catheter changed
- A women who had just had a c-section and needed dressing of the stitches.
- A guy who had just fallen down off a building.
Now I am not a doctor yet (hopefully in three years I'll be able to call myself one) but I do know that falling down 4 stories is not good for you. In fact it's very dangerous (feel free to either confirm or deny this statement). In Holland people like that would be under constant monitoring and would be wheeled straight to a CT-scan to asses the damage.
Not in Mwananyamala. Here people go to Minor Theatre first to get stitched up (because if you're not bleeding from the outside, you can't be bleeding from the inside right?!). Then you get an x-Ray of the skull and you are send on your way. No testing of vital functions or a neurological examination. This just amazed me. Now I understand that they have a huge lack of resources. As an government hospital they don't have a lot of funding and often have to wait a long tome for supplies (it once lasted three days before Minor and Labour had latex gloves again). But what I don't understand is why somebody who's had such a serious accident is not referred to the national hospital immediately. Or why somebody who ,at least, has a very heavy concussion is being send on his way without any advice.
Sometimes I feel that the doctors give up without even trying. But I also wonder: what if they have tried before? And found that the gloves where all gone? Or there was no stitching thread? Or found nobody to teach them how to stitch as the interns have no supervisor and are expected to learn as they do without guidance. Would I also lose hope and just kind of stop trying? I like to think I wouldn't but even I must admit that it's a pretty sucky situation for everybody.
Being a mzungu in Tanzania means that it's actually possible for you to afford good health care when you are ill. I was feeling a bit off and was coughing quite a lot. Anybody knows me that I would probably let my finger fall of first before I would go to the doctor in Holland but me being my slightly paranoid self was afraid that I had contracted some funky tropical disease. What I encountered was just what I was used to: a health clinic like one of a GP in Holland. I was assessed by a very friendly Mexican doctor who comforted me and gave me some interesting medicine (I took it and felt worse then before so in the trash it went). It was striking to see the difference and also kind of unsettling. What if those people I see being wheeled into the morgue daily had that kind of care? It's something quite awful and makes me very sad (for those interested, it was just a light viral infection and I think I'll continue just letting my finger fall off).
To end this blog on a bit of a positive note: We went on a safari to Selous Game Reserve. It was an awesome group of people for a weekend of animal watching. Selous is a national park in the south of Tanzania, about a seven hour drive from Dar.
We saw loads of animals like giraffes, hippos and even a pooping elephant (proof of that on my Facebook). Next to a game drive, we also took a walking safari. Not many animals to see but it was certainly interesting all because of our guide. He came out in a proper jungle persons attire: painted white and with nothing but some leaves to hide his bum and dingalong. He explained a lot of the traditions of his tribe, of the medicinal use of plants and trees and of the sedating effect of elephant dunk. yes you read that right: you can get high of elephant poop. He showed us how it was done and smoked about three times in the two and a half hours it took him to guide us around the Forrest. It was a good (and kind of funny) ending to two heavy weeks of working in the hospital.