Safari Weekend!!

We took a long weekend to spend on a safari! It was just incredible! There is too much to say! I will give a quick overview, then put up pictures!

Day 1:
- Drove from Arusha to Lake Manyara National Park.

- The roof of the safari vehicle pooped up, allowing us to stand. I got the front seat, and therefore the best view!

- First view of animals!

- Stopped at a lookout point which had the most incredible tree! Seriously obsessed!

- Bathrooms at campsite had toilet paper AND soap! Talk about 5 star service! No hot water though, and so many mosquitoes. Showering when mosquitos are everywhere makes me feel very vulnerable.

Day 2:

-  Drove through Ngorongoro Conservation Area.

-  1000’s of zebras

-  Gave candy to a local boy on the side of the road.

-  Stopped at a lookout overlooking the Ngorongoro Crater. Beautiful!

-  Stopped for a packed lunch. Chicken again?!

-  Went to a Maasai Village (a local tribe). We were welcomed with dancing and jumping, as well as got a tour of their huts that slept 6 people per hut. It was very interesting learning about their way of life.

- Spent the night at a campsite in the Serengetti. We were told not to keep food in the tent as hyenas often walk through the tents at night. My tentmate had to pee really bad at 4am, so we waited until we didn’t hear weird noises and went to pee outside the tent. We heard branches snapping and when I flashed my flashlight towards the sound, we saw eyes looking back at us. We ran back inside the tent. We later learned that buffalo was walking through the campsite, and the noises we heard were lions roaring, hyenas, as well as baboons.

Day 3

- My poor tent mate – I slept talked and apparently told her there was a snake in our tent.

- Had a 5:30am sunrise game drive. Again, so many animals!

- Went back to campsite for brunch. A herd of elephants walked through the campsite!

- On the way to the crater, we saw a cheetah resting in a tree. One of the safari vehicles broke down at this spot. Good timing. We suntanned as we waited, and made sure the cheetah stayed where it was!

- Arrived at our campsite on the rim of Ngorongoro Crater in the dark due to the breakdown.

- Ice cold showers and squat toilets. Thank goodness for baby wipes! My friend got travelers diarrhea here of all places. HAHA. So glad it wasn’t me!

- The stars were amazing!

Day 4

- Was an exceptionally cold night. I slept great!

-  Extremely foggy, got out of tent and could barely see 5 feet in front of you! We were 2800m (?) in elevation. 

- Drove down into the Ngorongoro Crater! One road in, and one road out!

- We were able to see a black rhino!! This is apparently rare as there are only 18 rhinos left in the crater.

- There were momma and baby lion cubs sleeping after a big breakfast. They were so close, and I got some great pictures! One of the female lions had a big wound on her head. Our guide guessed that she got into a fight with a wildebeest.

- Had lunch by a hippo lake where hippos were suntanning by the shore. There were birds across the lake and the guide warned us to be careful if they came over and to hide our meat. Sure enough, they come and would swoop down and try and grab our food. I was so scared I ate in the jeep.

- We got back to Arusha later that evening, and new volunteers were beginning to arrive. There is an RN from SASKATOON!?! What are the chances?!!!?!

Marry me, mzungu!

I spent the morning in the immunization/dressings area.  In the dressings area, there is a plastic bed with no cover or bedding of any kind.  A man had a wound on his buttcheek, and ++serosang/mucous drainage came from the site. Once the doctor was finished, the drainage was wiped up with gauze. Next!

There was a little boy with Asthma given Aminophylline IV. They inserted a needle into his vein, and pushed the drug over 15 minutes. The little guy was so brave! Milan (the pharmacist) found this odd as Aminophylline was usually used as a last resort. What about an inhaler? Even a nebulizer? We then realized we haven’t seen any inhalers.

Immunization Room

I watched a vaginal delivery back on the labour ward. Seriously, African ladies are so tough! No analgesics given, and only a small yelp at the end. The nurses delivered the baby, cut the cord, and immediately took him over to clean him up, and set him under a warmer. The mother wiped herself down with a scarf in which she brought, stood up and put a pad in her underwear, got dressed, and went back to the ward where she shared a bed with a woman currently in early labour. We weighed (and cuddled) the baby, and the baby was brought to its mother for her to hold for the first time, after about an hour.

We took part in a caesarian section later that afternoon. The reason for the c-section was fetal distress and uterine rupture.  There was absolutely no fetal monitoring, and we had no idea how the baby was doing. This really made me uncomfortable. The procedure was done very quickly as they had to get baby out as soon as possible. The baby was okay, thank goodness! Milan watched the procedure as well, and was very thankful to be a pharmacist, as well as a man.  Also, there was a gecko in the scrub sink where we washed prior to entering the theatre.

On the daladala on the way home as I was squished between large mommas, and under a sack full of onions, one of the daladala workers gave me a piece of paper with his phone number on it. “Sistah! Sistah! Take this! Oh sistah!” We get this a lot, as well as “I love you” or “marry me” when we pass a local.  White people are a sign of wealth, and marrying us is seen as a way out of poverty. Don’t worry, I never called him.

Here are some pictures of the dressing room::

Dressing Room

Privacy? You're kidding.

Yesterday Natalia gave us “homework”. We had to study the HIV medications that were given at the clinic. We sat down and she told us about the different drugs used for kids, elderly, pregnant/breastfeeding, and the importance of healthy lifestyle habits. She also explained what their CD4 count indicated. There was a patient with a CD4 of 6, and at that point, Natalia said all they can do is hope and pray. She told us that she can’t tell mothers not to breastfeed, as most are unable to afford formula.

At the labour ward, we assessed a new patient. Again, no lube. Maybe I should donate a box full of lubrication? I bet the patients would appreciate that! One of the ladies had genital mutilation, which I have never seen before. I wish I asked how common GM was in Tanzania.

Have I described the Labour Room? It is a room with 3 beds next to each other, with about 3 feet in between beds. There is often 3 women in the room at all times, all with their legs spread or their breasts out with no curtain or barrier in between. They are often naked, and the door is often left open. It is weird to see as women are so modest out in public. 

Watching women in labour is difficult as they aren't allowed to show pain. They are literally told to “be quiet” if they groan or moan. At my friend’s placement (again, so glad I never saw this at mine), there was a woman who tore during birth and had to be stitched up. The woman was begging not to be stitched up yet as the lidocaine hadn’t been effective. The nurse continued anyway, and when the lady’s legs started closing, the nurse stabbed her leg with scissors to open them up again. Again, we are so fortunate in Canada.

I helped take garbage out back to the incinerator. Everything was thrown in there – mostly plastic packaging, used catheters, etc. Their poor lungs! I guess I need to be thankful urinary catheters aren't reused?

Welcome, Ebola!

In morning meeting they told us that Levolosi hospital will be the ebola center for Arusha.  There is a ward behind the hospital in which they will use for quarantine. The building is beautiful, but currently unfinished.  The hospital had the funding to complete the building, but because the government is so corrupt, they didn’t get all the money given to them.
 

Unfinished ward

I am struggling with deciding what to spend my donation money on.  I have learned that I need to be careful, and not go through the government. I am also aware that I need to purchase things myself, as giving money won’t end up where I was told it would go. It is very overwhelming as EVERYTHING needs to be updated. I also need to take into consideration that the staff does very well on what they have, and donations must be something they will use. For example, someone donated wheelchairs, and they are currently being used as chairs in the waiting room. I also need to purchase something that requires no upkeep (I was debating hand sanitizer dispensers, but once the supply is out, there is a good chance they will not be refilled). At my friend’s placement, someone donated pillows (did I mention that no pillows are provided?), but the staff stole them and took them home. I also thought of a soap supply as there is no soap anywhere, including the staff bathrooms, but at my friend’s placement, those went missing too.

This afternoon we helped at the HIV clinic where we found patient files, weighed patients, and counted out pills. Natalia (the HIV clinic nurse) told us that HIV pills are free, however there is a cost for a consultation (I think, don’t quote me on this).  Natalia told us she wants to start a clinic for children where they can play, and be given information and facts in a way a child would understand. It makes me sad seeing how many children come to the clinic.

Tamara filing at HIV clinic

We love filing!

HIV consultation room

Lubrication, please!

14 babies were born last night.  During morning rounds I saw TWO women and TWO new babies to each small single bed.  No one complained. It was hard to believe, as at home people complain if they aren't in a private room. Seriously, people in Canada don’t understand how fortunate they are.

Three women were in the labour room getting assessed. The nurse asked me if I wanted to do the vaginal exam. I said no, as I have no idea what I am looking for, and that is just increased risk for infection.  No lubrication was used, and it looked very painful. At my hospital sterile gloves were used which was nice to see. I have a couple friends at a nearby birth clinic, and they said that the nurse at their placement put on sterile gloves and did a vaginal exam on a lady, then using the same gloves, went to the next lady. Yup, lets let that sink in.

I did measure fundal height, and did blood pressures. I also attempted to listen to the fetal heart rate, but they use a plastic cone, and I had difficulty hearing anything.

Their system for disinfecting equipment is as follows: wash with soap by hand, soak in powdered bleach, rinse, and then put in autoclave. The part I struggled with was that they reused the suction tubing from surgeries, as well as IV tubing.  I have no idea as to when they decide to throw out the IV tubing. When it springs a leak?

I also spent some time in the dressing area (which is my favourite place to be). There was a man who had a disgusting finger wound. I am not sure the last time he got the dressing changed, because his skin was healing over the dressing, and getting the dressing off was very time consuming.  I also changed a neck dressing. The only supplies available was gauze and masking tape. The gauze was “sterile” in a big can. So, it was pretty straight forward when you don't have hundreds of dressing to choose from.  I spoke with the nurse, and she said that it is difficult, but they can only use what they have. 

Post-op room (on a quiet day)