Same & Different - *karibu

 Post for Wed 1/10 (no internet last night so I'm a day behind)

After chapel & morning report, we rounded with the OB medical officers (MDs). This was a fun day for me because I felt like I was in my element. I could really follow what was happening and the doctors did a great job of including us in the patient discussion. They often asked how our US healthcare system compares to what they do in Tanzania. 

The most surprising thing about today was noticing how many things are the same. Many times we use the same (or very similar) medications for the same conditions. Some meds we (US) use more broadly - for example, vitamin K is given to all babies in the US, but in TZ they only administer vitamin K to small or preterm infants. In other situations, TZ uses meds more liberally such as continuing antibiotics after all c/sections - even if there was no sign of infection. Postpartum length of stay is the same, but antenatally most women come to the hospital 2-4 weeks before their delivery just to wait. They may be having contractions or need monitoring for another reason, but most often it's because they are from a remote village and they want to be at the hospital before labor starts.

Towards the end of the morning, we saw a new patient with pre-eclampsia with severe features. Just like at home, this patient was started on magnesium sulfate. But after the bolus, instead of a continuous infusion, she was getting 10g as an IM injection (5g/10 mL in each buttock). I have never seen such large IM injection doses in the US - for magnesium or any drug. Jaci and I stopped by later in the day to see how the patient was doing. Her BP was down from 163/120 to 118/80 - much improved! While I have known for some time that you can give Mg IM, now I have seen that it actually works.

Today was also filled with non-medical tasks. Jaci and I took morning & afternoon walks into Ilula. We saw many tuk-tuks - 3 wheeled scooters with enclosed cab used as taxis. The people were also super friendly- especially the children.

It was also laundry day for me. I was able to get about half of my clothes off the line before it rained this evening. The rest just gets an extra 'rinse cycle' I guess.

The highlight of the afternoon was our Swahili lesson from Joyce. She was a great teacher and really pushed us to create sentences that we can use. I already found myself recognizing more words during our afternoon walk. 

Thursday & Friday will be busy & long at the medical conference in Iringa. Then we head to safari camp for the weekend.  Asante** for reading along with my journey! 

*Karibu - you are welcome

**Asante - thank you

Tuk-tuks