Sounds of the Mountainside

I love the sounds of silence that we are experiencing here; however, we have become accustomed to the 5 AM ringing of the village bells that awaken everyone for their day.  The roosters crowing loudly then add to the wind section of this natural symphony.  Fellow colleagues add a 3^rd dimension exclaiming “hot water” which is the call to morning coffee & tea when our staff arrives with the heated water.  Tonight we are listening to the birds who add the flautist dimension while we gather on the deck before dinner enjoying the pastoral view of the green mountainside. Giant moths have added a bit of anxiety in the middle of the night when they visit our guest houses flapping their wings, but when we eventually crawl into our beds---the only “white noise” we hear is from the mountainside.

One other dimension that is becoming more obvious is the inter professional collaboration that is growing stronger each day as we visit medical, obstetric, adult and pediatric HIV, reproductive health, outpatient, and homebound palliative care patients. In addition, this medical group is quite well prepared to handle all minor medical issues that pop up as one of us certainly has an item that another of us needs. This should have been posted yesterday but we were out of power once again….such is life. posted for Friday, January 15, 2016

******* THIS POST WAS WRITTEN BY JEANNE PFEIFFER ********

Kindness is born of culture

Now that we have settled a bit, many of us have been reflecting on our experiences thus far. I cannot begin to explain how much for which we have to be thankful. In particular, I have noticed the wonderful nature of the local Tanzanians in every interaction I have had. This observation has me wondering how culture can play a large role into how people interact. Although many of us are from Minnesota which has a reputation for being cordial and respectful, nowhere in the American culture could one find people who are this gracious and caring for every person they encounter. One of the observations I have made is that, no matter the setting, each individual is acknowledged personally with a greeting. Moreover this exchange happens without fail and always includes positive vibes and a beaming smile. I found it particularly interesting that these interactions do not appear burdensome but rather second nature for the locals. Moreover, this trait appears to be born of generations of respect for others, elders, guests, and more. Although this doesn't seem to be too surprising, I promise that until you see the purity of it one cannot fully appreciate its beauty. I hope very much that the 20 or so of us on this trip can each take a piece of this culture back home as inspiration to lead some of the desperate changes our own culture needs.

I also wanted to write about some of the activities that have happened over the last day or so. Today I rounded for the first time and saw A LOT of neat things. I was able to observe patients ranging from 1 to 95 years old with a wide range of issues. During my time in the outpatient department, I even got to help as a nurse of sorts and Anne was able to help get a heart rate reading as well as assist in the removal of an abscess. The best part is we are administrators who were just there to see the operational flow and learn about the medical records yet our physician counterpart, Nixon, insisted that we learn about the clinical aspects of the hospital by giving it a try. Additionally, some of the medical students were able to observe in the operating room for multiple C-Sections, including one delivery of twins! However, here at Ilula the challenges are always present and because the power went out, Aaron found himself fetching his head lamp to complete suturing a patients forehead.

Finally, I wanted to add two personal events over the past 24 hours that I enjoyed immensely. First, Rishi and I were able to play soccer with the nursing students! It was very fun and everyone was so happy/excited by the camaraderie. I feel hopeful that we have already made some friends. Also, last night Kikoti, the hospital administrator, invited us to his home (which was beautiful) for a nice meal. My favorite part of the evening was when Kikoti told his children that Cindy was their second Bibi (grandmother). This was a special evening for me for which I will not soon forget. Well I'm done rambling now, hopefully our adventures have only just begun.

Zanzibar Revolution Day

Today is Zanzibar Revolution Day. While it is considered a national holiday, the celebrations occur mostly on the Zanzibar islands.  Most businesses, including the hospital, close for the holiday nationwide. I asked a few Tanzanians about its significance and they explained that it celebrates the day when the Sultan of Zanzibar and his Arab government were overthrown in 1964. Later on Zanzibar joined the State of Tanganyika to form what is now known as Tanzania. You can tell that the name is a hybrid of the two names.  

The hospital was closed, but retained minimal staff to care for hospitalized patients and the outpatient/urgent care (OPD) clinic. The team had the opportunity to round on patients in the general ward, the maternal ward, and OPD. We also had the opportunity to connect with nursing students at Ilula. As you may have heard, the Nursing School opened in November of 2015. It enrolled 6 male nursing students and 7 female nursing students. They are currently living in the student housing facilities. One of the student’s name is Sarah. She spent some time today teaching us some phrases in Swahili and telling us about what she is learning about in school. The Ilula nursing students are covering topics in nutrition and have a big test tomorrow. Their typical school day starts at 7:30 am and ends at around 3 pm. They then utilize the rest of the day to study for exams and complete assignments. One of the highlights of the day was the didactic session on Malaria. It was the first time that our team met with the nursing students to participate in a session together. We learned about the parasite, P. falciparum, the mosquito vector, the signs and symptoms of malaria, and its treatment.  I have included a photo for you to see. 

Malaria matters in Tanzania with our team and Ilula nursing students

Monday, January 11th Our first day at ILH

We are getting settled in to our housing and adjusting both to the time change and to life in Ilula. The faculty are housed in the largest guest house, with semi-private rooms and bathrooms, as well as the largest living room and veranda.  This is where the group meets for meetings and meals, which are all buffet-style. The food has been a highlight thanks to our delightful local cook, Anna, and her two daughters. Meals have generally included rice, curried peas and potatoes, various meat casseroles, and chapati. We are well-fed, if any families of travelers have been worried!

The students are housed in two separate guest houses, one for women and one for men. The women's guest house also has a generous living room, as well as two bunk rooms that each have western-style bathrooms with a private shower and toilet. Success with the showers has been mixed thus far, but several ladies had successful rain showers! After our long bus ride on Saturday, we were happy to find clean sheets and mosquito nets hung and ready to use.

Today was the group's first day to observe and participate in rounds throughout the hospital, clinics, and nursing school. We started the morning with devotions and morning meeting with the hospital staff, then split up into smaller groups. Some highlights included:

-Healthcare administration students learning about finishing construction on the private ward and its potential role in funding the larger hospital system

-Infection prevention team & nursing students observing a tooth extraction and infection control measures in the dental clinic

-Medical students delivering a baby

-Pharmacy students investigated the pharmaceutical supplies and joined in on rounds

-Resident physicians learned about the top 10 conditions affecting patients treated in the hospital and participated in rounds where they were able to see examples of patients with those conditions and their various treatments.
 

After the rain

We woke up to rain early in the morning, which continued through the morning but let up by lunch. The countryside we can see from the verandas of our housing is particularly beautiful in the mist and clouds. I will try to post a picture, but the internet is happier with text than graphics. That being said, we are very grateful to have enough internet to check in with all of our families and friends!

Much love from Ilula,

Sara Jennerjohn, on behalf of the team

Dar to Ilula

Yesterday we took our trip from Dar es Salaam to Ilula hospital. We got a late start, and there was a lot of traffic even though it was a Saturday. Lots of trucks and tankers and buses.

Along the way we stopped at Glonency's 88 for lunch. A great restaurant; a sort of oasis on our long journey. Mainly our lunch consisted of beef curry, chicken, rice and potatoes. Some of us tried some local beer, some had cokes, and a couple tried a local ginger ale. Everything was delicious.

Turns out we were enjoying luxury at Wista's in terms of toilets. Along our way we had to become good at using "squatty potties". At one gas station there weren't handles on the inside of the door and we had to let each other out from the outside. The group sure had good humor about it. 

Zebras at Mikumi By Leah Anderson

The best part of the trip was passing through Mikumi National Park. We saw baboons, a lot of baboons, and elephants, giraffes, zebras, warthogs and impalas.

We arrived safely at our destination around 6pm, and had great food for dinner. I post this on Sunday, so we look forward to starting our first day working in the hospital tomorrow. 

Kaitlin Keyworth

Leah's Dubai Tower

Here is the tower Leah mentions (I think) if you missed it on Face Book

Today was long but amazing!

We started the day with a journey to the US Embassy, where we were greeted by Grey Saga. He and his colleagues introduced us to the work they are doing with the USAID.

From there, we made our way to the Kampala International University in Tanzania. Dr. Hurley’s old friend from Ilula (whose name I do not know how to spell!) was our lovely tour guide. He is currently in his 2^nd year of medical school. We were joined by another individual and together they guided us around the university. But not before sitting down for a delicious lunch of rice, plantains, beans, and fish at the university cafeteria!

Throughout our tour, everyone was quite enthusiastic to have us and they were all very welcoming. This particular university campus is about 4 years old and is still undergoing more construction. The main campus, I’m told is in Kampala, Uganda. There are other what I will call branches or campuses in several other countries ( 5 in total), with the one in Tanzania being one of them. We were able to tour the classrooms, the anatomy and physiology labs, and many other departments.

After about a 2+ hour campus tour, we hopped on our bus and headed back to Wista’s. We are all looking forward to catching up and resting up for the evening before heading to Ilula tomorrow morning.