In the telling and hearing of stories, the context is important. What constitutes a context? Why is it important? In my case the context is all new and includes geography, culture, politics and history. My anthropology friends(Can you believe I have more than one?) caution me that my understanding of illness and treatment are different from my patient's understanding and in this culture the differences are more pronounced. I am limited by language and perspective in understanding them.
Politics and history I can read about and my son Luke gave me a depressing but informative book entitled "The State of Africa" which reviews the last 50 years of post-colonial African history. We all make judgments on the basis of our experiences and context is important as it informs your judgment. I have shared with you a number of experiences but I wanted you to know that my context is limited for now.
The Touch Foundation for whom I work has as its objective to address the shortage of health care workers in Tanzania and I refer you to their website for more information. www.touchfoundation.org. Let me share with you one "statistic" that has informed my judgment. I attend 0730 morning surgical rounds and the surgery interns report on their previous day. There are 4 interns. One is on call for the wards and one for the casualty department. On average the intern on the wards reports that there are 300 patients on the surgery service in the hospital. The interns scrub in on theatre cases and attend outpatient clinics. Those of you with a medical background know the relative impossibility facing these young Tanzanian physicians as they perform their daily duties. The overwhelming responsibility of this patient load is but a microcosm of what the country as a whole faces.
Speaking of new experiences I will end with a list of firsts:
To feed a monkey my breakfast buscuit as he jumped beside the hospital walkway on my way to surgery morning report.
To observe a 13 year old girl barely flinch as she sat on a stool having her blood drawn. Her regal bearing was all the more amazing because her hemoglobin returned 2.8(should be 4 times higher)
To watch a mother carry her limp 5 year old son who 2 days earlier had been bitten by a snake on the right foot. His leg was swollen twice its size up to the thigh.
To walk home for a superbly prepared vegetarian lunch every day. Alfan is the cook of my food(that's the way it is expressed in swahili which I prefer to "my cook")
To be left on the side of the city street as my taxi driver negotiated a "fine" with police for pulling out in front of another vehicle.
To sleep inside a mosquito netting every night. Something is a bit more unsettling here about being awakened by the high pitched buzz of a mosquito around your ear.
To watch the sunset over Lake Victoria in the evening.
To discuss with a nurse in Australia about the transfer of a patient to Johannesburg or Nairobi or Sydney
3 comments:
Steve, we just found your blog, so I've got a lot of catching up to do. It sounds like a fasinating journey, even though it is filled with experiences that are so "different" for lack of a better word. We're praying for you and the people you are serving. Dulce is in Cuba, so if you have time for reading, her blog is dulcemange.blogspot.com. Take care and we'll see you upon your return. Peace, Pam Mange
you have written about the patients that you encounter. can you give us any insite into the medical students, residents, attendings at the hospital? i am interested in your mission to teach them. don
Don
I am trying to figure out how to provide this insight in a balanced way when I cannot be fully anonymous. Knowing the hospital in which I am working would not make it too difficult to determine the person about whom I am providing an opinion. I haven't determined how to responsibly do that on a public blog.
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