Let’s do a quick walk through the departments I interned in:
First Anaesthesia. The head of the department is an entire story itself. His name is Liundi and he is always joking around with everyone. He took us to his cashew farm the other day and accompanied us to a dancehall once in his ‘shamba car’. That car makes more sounds then any moving vehicle should ever produce. Any second you expect it to simply surrender to it’s many leaks. There are two football teams here from Tanzania whom are always competing and you are either a Younga (short for ‘Young Africans’) or a Simba (swahili for ‘lion’) fan. Liundi is taking his love for Younga to a different level. He is always wearing a scarf with their colours when he is not in scrubs. He works calm and efficient always quick with his tongue to make everyone chuckle in the theatre (OP in german). I’ve learned more about intubation and lumbal punction but I was a little shocked how random the dosages for the muscle relaxants, opiates and sleeping drugs are. Here the anaesthesists are not doctors as they are in Germany. The ones that work here did a two year training for it exept Liundi who studied longer in the capital city. In addition to that the machines for ventilation etc sometimes seize to work. I think it was one of the most interesting but also challenging parts I’ve seen here. Unfortunately I don’t yet have the expertise to help them really change routines, which sometimes proved to be a bit frustrating.
Surgery: They have two different surgical departments here: General and orthopedic. I was mostly in the orthopedic theatre because I came to highly respect the surgeon there very quickly. Erasto doesn’t talk much and is often mistaken for being shy. He is not yet a learned specialist but a ‘general practitioner’ as they call it here, which is why every two weeks a different orthopedic specialist comes from the big hospital Moi in Dar Es Salaam. I learned how exhausting surgery could be when we fixed a distal fractured fibula wearing an entire armor of lead underneath the operation overalls for two hours. I was soaked through aftwewards since they put the air-conditioning on 28 degrees in there. Erasto told me that he favored orthopedics because usually the people aren’t in acute danger and most of them will recover after surgery. When he had rotated through the gynaecology department he had to do many C-Sections and he said that he’d never want to become a Gynaecologist since if something goes wrong – and it’s more likely to since the women only come to the hospital the very first time when they are in labor if at all – you might have the woman and or the child dying under your hands. We don’t really have it in Germany either and I think it’s a very crucial thing that is missing: psychological after care for doctors. No one teaches us how to deal with death and we wonder why doctors tend to become numb. With the culture of endurance being expected here in Tanzania it makes the issue even more severe.
Gynaecology: The department is way to small for how desperately it’s needed. The ward is old and in comparison to the newer ones uncomfortable. I have beem lucky enough to see a few mothers giving birth and the doctor here Mbimbi is extremely good as I’ve mentioned in a previous blog post. There was a hospital architect here who is helping to build a new mother and child ward and give the topic a place congruent to it’s inportance.
Physiotherapy: I spend a day there to compare it to how it is practiced in Germany. From the physically hard farm work most people have problems with their lumbal spine and there were many cases of disc prolapses. The physiotherapist works on a clump foot camp together with german surgeons and has a really cute son who always greets me in the street since I’ve been at there home once and even comes to sit next to me in church.
Internal Medicine: That inculdes sonography and echo, endoscopy, the intensive care unit and the dialysis. The doctor from endoscopy loves what he calls ‘the german efficiency’. He told me us germans are great to have around in an emergency since we act fast. He is a memorable character with his enormous glasses and growing belly always making jokes. Every day I took a moment to visit the ICU because the nurses really grew on me. Dr. Saad who is in charge of the ICU impressed me as Ersato did in orthopedics with his quite confidence and accuracy. We had long talks about religion etc when we were done with work. It’s a very good organised department.
The time in the hospital and Ndanda itself with Chemchem, it’s people and the best food I’ve ever had the fortune of it being prepared for us was amazing. As you can see more then the departments and equipment I am describing the people. I have learned that they are what I value over everything else.
PS: we had a volleyball match the other day against a team from another hospital. I played too and we won all three rounds 🙂