The Rhythm of Life

There is a rhythm to life here in Tanzania that we are beginning to understand.  There is the usual chaos of getting plugged into our work here coupled with a daily dose of uncertainty of when and if things will actually happen: when will rounds start, what medicines and lab tests are available, etc.,.  Fortunately, we are learning to adjust. Even the unpredictable has a degree of predictability to it.  It will rain, we just don't know when.  And, we know the rain will stop…eventually.   Dr John Kvasnicka arrived in Iringa on Saturday and will get to Ilula,; we just don’t know exactly how.  We may meet Dr Ken Olson on his drive past Ilula to Iringa—or we may not.

We did abbreviated ward rounds on Saturday morning to check on several patients.  A small group went on home hospice visits and we received an orientation to the lab.  Surprisingly, they can do rapid hepatitis B, hepatitis C and rapid malaria tests here in addition to rapid HIV tests and VDRLs for syphilis..  They are able to do CD4 counts when reagents are in stock—we just don’t know when supplies will be available.

We have two confirmed cases of syphilis on the ward.  We really never see this back in Minnesota.  Syphilis has protean manifestations that can affect every body system.   Now we think we see syphilis everywhere: the macules on the soles of a patient’s feet;  a tongue lesion could be a classic mucus patch. Maybe one patient’s condyloma accuminata is actually condyloma lata.  We just don’t know for sure.

For we at Shoulder to Shoulder, there has been 8 years of uncertainty about the status of the nursing school: when will construction be completed; will it pass inspection and be certified by the government; what will the quality of instruction be?  But, delightfully, the school is now open and classes are in session. The nurses in our group have observed classes and think the quality of instruction is excellent.  The King Family Foundation, Dr Gary Moody, Lamont Koerner and everyone involved with STS should take pride in this accomplishment: an exercise in hope, persistence and uncertainty spanning all of those years.  We have made friends with the nursing students and have had several didactic discussions with them.  We distributed the quilts made by church groups in the St Paul area to the students and instructors today.  Last night Caity, one of our Pharmacy students, and Sara, a nurse organized a game night with the nursing students where we played charades and had a Glee-style “sing-off.” (I think we lost!)

Last week we were asked if we had a song to sing: I had neglected to warn our group that this might be requested of us so we had to punt.  But now we are prepared: we have organized a song for today (Sunday): an old Three Dog Night song, “Joy to the World” (“…Jeramiah was a bull frog…”!).  Our group members in my age demographic take comfort in knowing all of the words to a song that our younger group members have chosen to perform.  So, there will be singing today. We just can’t guarantee  the singing will be any good.

Randy