Jan 27, 2019

By week two, most of us have settled into our groove in Tanzania. Just in time to welcome the second half of our group to Ilula! After a long treacherous bus ride, complicated by a flat tire on the way, our new friends arrived yesterday evening. It’s been fun welcoming Ken, Birdie, Cari, Steve, Norm, Deb, the Dudeks, Leslie and Chandra (sorry if I butchered anybody’s name). I look forward to getting to know them all better in the coming weeks.

We had a very busy Sunday, including long church services and meetings with the King foundation and hospital administration. I think the highlight of my day was going to Dr. Saga’s house for dinner. He shared many stories with us about his family and upbringing in Tanzania. As one of 10 children of a farming family, prospects of getting a higher education looked grim when he was growing up. But Dr. Saga was determined and continued to pursue opportunities to go back to school. He started out as a clerk helping to Swedish missionaries treating patients in Ilula. At that time, only a few decades ago, Ilula was a very rural village with only 4 houses! Overtime he worked his way up to assistant medical officer. With some help from friends abroad he was able to help transform Ilula Hospital into what it is today. It was a good reminder for me to never take my education for granted. I am so lucky to have had the opportunities in my life to pursue a career in medicine. We truly have amazing jobs!

Volunteering at Ilula has been a wonderful and eye opening experience. Apart from all of the medicine I’ve learned on ward rounds, Witnessing the beautiful relationship that Ken, Randy and others have formed with our Tanzanian colleagues has been truly inspirational. It gives me hope that through hard work, collaboration and faith anything is possible.

January 26, 2019

Two weeks ago a group of strangers or near strangers gathered at MSP to begin a Tanzanian adventure.  For some a routine trip, done over many years, for others an adventure of a life time.

Within days folks from highly diverse backgrounds meddled into a warm, supportive family.
Different continents, levels of training, age, professions created a group motivated to learn, share and have fun.  I mention age because I’m really the outlier in the bunch. It turned out not to be a problem at least I don’t think so. Maybe others have a different opinion, hopefully they will keep it to themelves(kidding).

It has been extremely invigorating to be around young, enthusiastic, bright young people on thresholds of great futures.  People, whose lives will undoubtedly have been inriched by the time spent in Ilula.  I do remember my first overseas adventure after medical school in a country crushed by poverty and war.  Coming from the States it was easy to be critical of what was available and how things were done.  After a few days reality set in and time to get to work with what you had.

I did not sense that with our family here.  All got immediately into the rhythm of Ilula with joy and flexibility.  Flexibility—-the key to success in any new situation.

Our Tanzanian hosts have been more than welcoming graciously allowing us to participate in OB/GYN,   General wards and peds which has been very rewarding to the residents, pharmacy and meds students as well as seasoned physicians and pharmacists. In HIV clinic and OPD got to see what high volume care looks like.

Other highlights for me were the visits to the orphanage and palliative care rounds out in the village.
Patients with tough problems living with meager resources yet appreciative and accepting.

And finally, the spiritual component floods all of the care that happens here with daily devotions as well as prayer with palliative care patients.


AS

WE SPEND OUR DAYS IS HOW WE LIVE OUR LIVES

Road trip to Image and popcorn

Oh goodness, oh for cute, the whole kit-&-kaboodle!

Today started with a handful of us taking on the foggy dirt road for our usual morning run, which ended with my chatting with a group of local students who were interested in my running watch and my goofy dance moves.  I was eventually saved by a group of women who dispersed the kids off to theor school day.

My morning was spent in the OB ward where I helped the nurse place an IV line and Foley catheter (a great time to brush up on my old nursing assistant skills!). Afterwards a few of us went to the operating theater to watch a c-section — everything went smoothly!

We meandered back up to the house where we met up with a visiting group from Augustana Lutheran Church.  At first it seemed there wouldn’t be enough space on their bus for a few of us to join the visitors on an excursion to a nearby village, Image, but luck was on our side and Meghan, Michael, and myself were able to swipe the three available seats!

On the way to the village, we made a brief stop at a dispensary where the people from Augustana asked questions and took a look around while we dropped off a box of medicines.  We then continued our bumpy journey along the worn dirt road to Image.  After passing many fields and a few donkeys, we turned down a quite avenue towards a school.  As we passed through the gate, our bus was greeted by the whole student assembly who were in song and dance.  It was a warm and beautiful introduction of the school to the visitors!  The students then departed for lunch while we followed the headmaster on a tour and information meeting about the school.

Quick caveat: I’ve been living in Italy for the past 3-ish years for medical school so I’m a bit out of touch with the Minnesota culture.  It was a full-on teimmersion experience for me, ripe with idioms and colloquialisms that I haven’t heard in ages!!  Offda now don-cha know how delightful that sure was!!

Our return trip was somehow more rocky than the trip there but the panoramas of this area of the world are incredible.  The children of the area were also on their way home from school so there was lots of waving a hollering, exchanging greetings in Swahili and English.

We topped off the evening with a movie night with the nursing school students.  We brought them popcorn & a recently acquired bag of dum-dum lollipops. Due to technical difficulties we started the movie late and didn’t even make it through the whole film before calling it a night.

As we moseyed our way home, hopefully many took the opportunity to check out the clear and brilliant starry night sky!!

Baadae!
Kelsey

A day like any other (January 24th 2019)

This day started like any other day....woke up to the sound of clanging symbol
and like any other day...I rolled over and wondered how anyone could possibly wake up to ring bells. But this is a tradition like many things in Tanzania, and reverence to its complete adherence is key.

Like any other day, we lingered in our suite while morning church commenced... we are not apathetic to this event. We just like to enjoy our coffee and appreciate the splendorous Tanzanian hills and valleys. The air is crisp, while there is an overlay of mist as an afterthought of the past rain. It clothes us with a message of renewed hope. I too this morning feel renewed hope, as yesterday was a day that I felt stifled. As a self-diagnosed introverted extrovert, I am afflicted with an incurable need for solitude when faced with too much togetherness. I finally realized today that it important to take time to self reflect and each day I need to make it a top priority.

I was once again in the maternity ward. Three laboring patients today, one of whom had newly diagnosed HIV. I realized that unlike the US, there is no base viral load that this required for treatment. Breastfeeding is encouraged to women even if they are HIV positive. This practice strategy is unlike the US system. In the setting of low economic resources, unfiltered tap water, and severe malnutrition, it is likely that a child will die of diarrhea rather than any HIV complication. This sad reality is one that is faced by many of this disenfranchised and destitute nation. It saddens me to realize that many women have to choose between the lesser of two evils.

We completed our afternoon with a talk on anemia. While listening to this lecture, I looked over and saw a gentelman lowering the national flag. No one was watching him (well except me), but he took this job very seriously. He sounded his whistle and lowered the flag, folded the flag neatly and marched away like any ordinary sargeant in well formed army. Again, tradition to be respected.

Still, I am grateful to be here. I get to learn from my colleagues, get to find myself in an unfamiliar environment and get to enjoy the great splendor that is Tanzania.

Asante Sana!!

Gina

January 23, 2019

Jambo! It’s incredible to think that our group has been in Ilula for an entire week now! We have observed many interesting clinical cases, learned alongside our Tanzanian colleagues, and logged several kilometers on morning runs/evening walks.

Today, some of our group members had the opportunity to participate in palliative care rounds in the community where they visited patients’ homes with Dr. Nixon and Pastor Phillip. These home visits allowed the group to assess how the patients were doing, address medication needs, and provide spiritual support and prayer.

Before dinner, we were able to experience downtown Ilula with a cold beverage, an exciting hunt for popcorn and pineapple, and a round of pool with some locals. Whenever we are walking around town, it almost feels like we are celebrities when all the kids run up to the sides of the roads yelling “Mzungu!” (white person) and the vendors all welcome us to come back everyday.

We ended today’s festivities with a rousing game of Fishbowl (kind of like a combination of Catch Phrase and Charades). It’s great to see everyone’s creativity come alive during these games and have a little competitive fun. However, I think the group is starting to realize that Sarah and I should not be on the same team because we think a little too much alike.😜

Usiku mwema (good night),

-Deann

Jan 22

**I apologize for the formatting, our internet is spotty so I couldn’t quite get the pictures in the right order**

Hey Everyone, 

It’s Michaela & it’s my turn to blog! Today was a busy day... lots going on!

Today’s big news this morning was that the showers are working again! We’ve gone 3-4 days now without running water in the showers but we’re all feeling refreshed now! 

A few Tanzania’s were complaining how cold it was here in the morning and were shocked to hear how much colder it is in Minnesota. The weather is perfect here! 70’s during the day and 60’s at night, couldn’t be any better! 

During our morning huddle, Kikoti, the hospital administrator, called me to the front and said something in Swahili. Everyone clapped at the end and I had no idea what they were saying about me. We joked that they had hired me as the new permanent ultrasound tech without my knowledge. So we’re still unsure... maybe I got a promotion! 

(They really just said I’m here to do ultrasounds if anyone needs one since Dr. Sovelo is gone) 

Today was the first day that ultrasound wasn’t crazy busy so I actually got to eat lunch with everyone and have a lunch break! 

A group of 4, Kaylin, Deann, Gena, And Kelsey went on the outreach program today. They went out to a village where they provided family planning counseling, infant immunizations, and prenatal care. 

We got a tour of the lab in the evening and were able to learn more about what tests they have available here and what some of their struggles are. 

Megan lead a talk on antibiotics which I heard went well! 

We were invited to a small gathering in the church with the nursing students. Every night at 7:30pm they gather in the chapel, sing, and worship god. They have invited us to join them anytime and we enjoyed it very much! 

And then we ended the night with a lovely game of Headst up! 

“I bless the rains down in Africa”

I can’t recall exactly who it was, but it must have been either one of our three female pharmacy students (Deann, Sarah or Kaylin) or perhaps Michela (“the one who works with ultrasound”) since they seem to be the most musical in our group.  Anyway, one of them played a cover of the 1982 Toto song, “Africa” (remember, part of the chorus goes, “…I bless the rains down in Africa….”) while we were sitting around at Wista’s in Dar Es Salaam last week waiting for others to return with lost luggage.  The song now seems somehow prophet since it has been raining on and off every day since we arrived at Ilula.  Sometimes the rain is torrential resulting in small rivers coursing thru the drainage trenches around the hospital. Sometimes it is gentle and almost mist-like.  It can challenge the morning walkers/runners in our group, the afternoon strollers and anyone trying to hang laundry out to dry.

Monday 21Jan2019 was another good day at Ilula: we met two Swedish nurses/missionaries, Nora and Steena, at morning report. They are stationed long term in Iringa, working with the Iringa Diocese and come to Ilula twice per week to volunteer.  I, Dr. Seli and Kaylin spent some time in OPD assisting the clinical officer seeing patients. They have a new electronic medical record that seems relatively useful however the clinical officers are more than happy to have our students function as scribes since they are not familiar with using keyboards or typing. We saw a bunch of patients including a kid with amoebic dysentery, another with atopic dermatitis, a 15 yr old who had a recent miscarriage and a pregnant woman with two weeks of high fever.  It is inspiring to see how we all contribute ideas to evaluating these patients.

We have had some arrivals and departures as well as a small celebration: Dr. John Kvasnicka arrived Monday and will spend this week on the wards prior to next week’s medical conference. Dr. Yvonne Datta departs Tuesday for Arusha where she will be visiting the cancer center project there (www.tanzaniacancercare.org).  And…it was Katherine Zerbeic’s birthday today: she celebrated by making some water color paintings of the vista from the guest house; we serenaded her with a happy birthday song.  Kelsey arranged for a cake, complete with candles (the roman-candle kind!)

It is raining here in Africa, but everything is green! 

…and,…I think it is we who have been blessed.

Randy