Happenings this week

there always seems like a decent amount of things to blog about, considering this country is totally different for us. Everything is going fairly well, hope it stays that way. In my spare time besides exploring and eating or doing laundry haha I have been planning our South Africa trip- such a popular time and thus a lot of things have to be booked far in advance leading to a few disappointments. There is so much to see and drink and eat there. It is going to be a totally different experience than this one starting with a big bed ( I've noticed mattresses here are just pieces of foam) and a stand up shower. Oh and wine. Obviously one wants to be more comfortable but I am glad to experience "real living" here and actually somewhat jive into the community. That is always the best way to experience a country. These people flying in for the pre planned safari circuit are having a totally different time than us. Which is fine as we are here for a reason and their money helps this country ( an all inclusive night in the ngorongoro lodge is like 1500$!) . We do hope to come back as more of tourists and already have an itinery set ( climb mt kili as that is on my bucket list, Serengeti safari, then Zanzibar island) and would love our families to experience this amazing country.

Meanwhile in the hospital: I've gotten into my groove of working w two other physicians. The way of medicine here is just different ( like learning Italian after already speaking French) but I'm picking up on it. They use so many different antibiotics that we "retired" in the US. Some of the things I don't agree with ( using an old antipsychotic that requires close blood monitoring but then not doing the blood monitoring) so it is hard sometimes but overall they work w what they have (still marveling on how limited it is) and for the most part the patients get better at least from what I can see so something is working. It would be interesting to see the bigger university hospital as we have to refer some complicated patients there ( I'm used to being the best hospital as IU is the last stop for people from around a decent chunk of the Midwest). I've seen some more "cool" cases such as toxoplasmosis of the brain , "tropical spleen", Brucella (had to look this one up as I haven't heard of it since Med school basically bacteria found in raw beef and unpasteurized milk and only found in US in certain areas in the NW), typhoid,and a lot more malaria. Tb, and  HIV. Sad case of a 29 yr old who came in short of breath , whole left lung whited out w fluid, tried to tap but grossly bloody. Has ascites (belly fluid) tapped some off bloody too. This suggests malignancy - lung? Pt so young! But family is wanting her discharged bc they need to find money for a CT scan (150$ here which is a lot even for Americans). I don't know how they would afford treatment even though my gut tells me it is pointless, but I hope they are able to at least take her to the big hospital to evaluate further. Another pt died, it seems to happen so suddenly here and I never see it coming. Another sad case of a 13 yr old boy w HIV ( I guess they consider anyone at that age "adult") who came in basically unresponsive - diagnosis cryptococcal meningitis and malaria. I thought he was done for. He was so underweight and just looked so angelic. I brushed the flies off his face bc he couldn't and I wanted him to at least die w some dignity as it was unsettling. Mom ( well aunt as his parents died of the disease) was trying to find money to pay for the Iv meds ( I was thinking of some way to slip her money if she couldn't bc it was just all so sad but she got some from relatives). Anyways, the meds took hold and worked! Kids are fighters. Every day he looked better and better ( even went nuts when we had to draw his blood) and was discharged! Happy ending for at least now ( the sad reality is he probably won't live long w HIV and apparently not really taking his meds- in the US the adult would be reported and taken to court I'm sure). Another pt today keeps spitting out her meds and is not getting much better ( we suspect she has some mental illness as she keeps mumbling to herself but for me I would want to investigate further to make sure that is not just an effect of the bacterial infection but docs just give her meds to be quiet ) and now her family wants to take her home so she can get prayed over. In the US we would then question the sanity of the relative but here this is definitely cultural. Witch doctors are also common here and definitely for the Maasai most have seen the witch doctor before coming to the hospital ( some of the remedies make sense like how they found the quinine tree which can cure malaria but most is not going to cure these illnesses)

I told Matt he should blog at least once a week haha so he can tell you more but basically still dividing his time between the orphanage and the villages. They acted quickly w some of the money our family donated and bought all that food and meds and delivered them to the village. A village elder made a speech about how grateful they were and 30 families ( a family is a pretty large unit here bc it doesn't just mean immediate relation) that had kids deemed to be high risk for starvation  were given the food ( if they don't have food they not only starve but don't take their HIV meds). And the antibiotics were given to 100 kids as well. Each family rep thanked Matt individually. I bet that meant a lot. The goal is to one day be Able to give families means to be more independent like a chicken coop so they can sell eggs ( tried giving each a rooster and chicken before but some families just ate them right away!) but this planning takes time and hopefully something we can help w in the future.


Kind of like intertwining reality shows, Matt and a little girl showed up at my hospital yesterday! He takes the kids for their HIV check ups. They said she would know what to do but she didn't really and I couldn't help too much bc I'm not working in that clinic. But luckily a "mama" saw our situation and pointed her the right way. It was a lot of waiting and of course our machine was broken so she will have to come back and get her counts checked. A lot of inefficiency for sure . Matt had come at one time before and the doctor was "busy" . He also took a little girl to the dentist to consult for pulling her teeth, so then she had to come back, but had a fever so they couldn't pull it. She missed two days of school and so much time due to this. Such is life here I guess.

In other experiences this week I went to the Tamzanite museum. Tamzanite is only found here by Kilimanjaro so it is 1000x more rare than diamonds. And apparently limited supply so it will disappear soon. I heard about the mining process and they say it's ethical but would have to look into it more if ever bought one. They are beautiful blue, violet, and burgundy stones but obviously $$. Maybe one day.

And the other cool thing: I had a dress made for me. ( to matts chagrin- " why do you need to buy more clothes??" Maybe after another few years of marriage he will stop asking this haha) I partly wanted the dress and partly wanted the experience. It was definitely that. I went into a section of town w fabrics near the central market. Of course they were on me likes sharks to chum in two seconds. I was a bit nervous the whole time, w my bag and being taken around in a crowded place. But went to a shop and spent time picking out the perfect fabric and bargaining a lot. Then talking to the seamstress and picking out a dress from a catalogue ( hard to tell as all the ladies in it were definitely not models nor were the photos taken professionally) and picked one for her to make w a matching bag. And I have enough material left over for a headscarf if I wanted. The dress is beautiful but a little hard to get in and out of as it has a side zipper. The whole process was fun but somewhat tarnished  as everyone wanted a piece of the pie- as soon as I showed up back to the shop instantly the 3 men that had been leading me around showed up out of the woodwork ( one who brought me to the shop, one who brought me to the fabric store and tried to get me to another market one that showed me his souvenir shop- shoddy goods he was trying to sell for an insane amount of money) . I firmly told the one I didn't want to go back to his shop and pay 20$ for a smal wood giraffe, I told the other I didn't want to go to the market (he's like well give me a tip like you promised. I did? And for what?) and the other wanted a tip too and was like demanding it ( I was like I just gave your shop business! And they probably charged me more ). So I basically brushed them off and the other randoms in the street. Seriously the hustling is the most annoying part. I get it, they see a Mzungu and  think they are an atm but it gets tiring as someone who likes to walk and not be bothered . My first day wandering one guy followed me into the museum and literally would not leave for an hour. Blech. So now I'm kind of rude ( I'm sure some people say hi and ask how I am to be nice and it is sad I have to ignore them ) but it cuts down on the following and hustling.

Tonight we are getting dinner, tomorrow Kilimanjaro I think just to go to the park, and Sunday our first day of "nothing". Change wait