Walking in the New forest
seems like a good idea
until it starts to rain
Driving to the nearest pub
and eating yummy lunch
oh my, what a shame....
Saturday, 17 November 2007
Thursday, 15 November 2007
Welcome to the fouth year
Despite passing my exams and having the summer in africa, it still surprised me somewhat to find myself actually being in the 4th year of medicine. Good surprise or bad? I have still yet to find out... I've already had 2 weeks of placement, 1 GP session and about a month on and off of project work and I still don't much feel like I want to be here. On the other hand, I have no clue as to what on earth I would do if I weren't here so I shouldn't complain.
In my alternate reality, what would I be doing? I would not be writing a blog. I would not be apathetic towards medicine and life in general. I would maybe be working now....or I might be about to go on a ski season. I might be famous. I might be thin. I might feel good about myself. I probably wouldn't. The grass is always greener on the otherside don't you think? Medicine, to the outside eye, is bloody good thing to be doing with your life.
This afternoon I have my second GP session and I should probably do some work so that he doesn't think I am a complete failure/fraud. Then I need to get going with my project....which is actually pretty interesting when you think about it, and once it gets ethics approval (please God, please) then it will be be a worthwhile use of my time. More worthwhile than facebook and blogging anyway. Plus I get to hang out on NICU with the tiny babies which never fails to make you feel a little bit good. Last time I went on a ward round there, one of the babies was crying and I held their hand and they stopped. Feel-good factor or what?!
Get back to work slacker...
In my alternate reality, what would I be doing? I would not be writing a blog. I would not be apathetic towards medicine and life in general. I would maybe be working now....or I might be about to go on a ski season. I might be famous. I might be thin. I might feel good about myself. I probably wouldn't. The grass is always greener on the otherside don't you think? Medicine, to the outside eye, is bloody good thing to be doing with your life.
This afternoon I have my second GP session and I should probably do some work so that he doesn't think I am a complete failure/fraud. Then I need to get going with my project....which is actually pretty interesting when you think about it, and once it gets ethics approval (please God, please) then it will be be a worthwhile use of my time. More worthwhile than facebook and blogging anyway. Plus I get to hang out on NICU with the tiny babies which never fails to make you feel a little bit good. Last time I went on a ward round there, one of the babies was crying and I held their hand and they stopped. Feel-good factor or what?!
Get back to work slacker...
Monday, 24 September 2007
Tip for the day...
Tip for the day...
Avoid roads, in a car or near cars, in the late afternoon. Everyone is suffering from hypoglycaemia and dehydration and the driving has become noticably worse since Ramadan started.
We are on the home straight. Only a week left til we come home. I'm finding that I am torn between the desire to get home to normality and the feeling that it is going to be weird to be in England and not sleeping under a mosquito net.
This weekend we went to Nungwi on the North of the island. Its one of the more sociable resorts although not as classically beautiful. We still really liked it...its only downfall was the seaweed, of which there was an incredible quantity! On Saturday we went on a dhow round to mnemba island to do some snorkelling on the reef around it (you are not allowed to land on the island or you get arrested because it is a privately owned island). I think it was the best snorkelling that I've done since being in Zanzibar and we saw so many different fish (and an eel which scared me a little). Then we had barbequed fish for lunch on a beach on zanzibar opposite mnemba. It was yummy. I was a bit of a loser because I forgot to put any suncream on my arms and now I have pink arms and have to keep out of the sun for the next couple of days :( We sailed back round to Nungwi late afternoon...Having never been seasick in my entire life, coming to Tanzania this summer I have to say that whenever I get on a boat now I feel awful. I have been experimenting with if I feel better if I sit at watch the Horizon, watch the boat, close my eyes etc. That day I felt so bad that I lay down and fell asleep. It actually worked because when I woke up I felt about a billion times better :) I'm afraid that I blame my mother for this newfound nausea. (Sorry Mum but you are the only person I know that gets seasick!)
On the Sunday it was cloudy in the morning so we went to the aquarium in nungwi. Its not an aquarium in the normal sense of the word but its is a conservation program for Hawksbill Turtles. There is a natural lagoon in the coral rock where there are several turtles and a number of tropical fish and you can feed them and swim with them. I was an absolute clutz on the way to the aquarium (which was about 25 minutes walk from where we were staying) and fell over. I cut my hand and foot and didn't much fancy getting into the water with the turtles and fish. Now I know the turtles are veggie but the fish weren't! We sat for a couple of hours just watching the turtles and feeding them. It was so calm and peaceful to watch them glide effortlessly around. They are so graceful and look weightless in the clear water. It was a very pleasant way to spend the cloudy hours.
In the afternoon we sat on the beach in the sun (but with me wearing long sleeves to protect my poor arms) and I got some Henna done on my feet (LOVE IT), then we got a late afternoon shuttle back to Stone Town. Some might say this was risky, especially after reading my first statement in this blog entry, but it was not too bad and we'll do anything for a couple more hours of sun!
So that was my weekend...and the last one we are going to spend in Zanzibar. Next Sunday I'll be home. Weird. After a considerable amount of thought, I think the thing i am most looking forward to is Apples...mmmm a nice crunchy Braeburn.
This week we've been on the Surgical ward and in theatre. On Monday we went on the wardround. Its mostly Hernias, diabetic feet, trauma and prostates. One man who had been in a road traffic accident had to have his spleen removed. It cost less than 20 pounds which I thought was a bit ridiculous considering it is major surgery (but good at the same time because the people can just about afford to have it). To have your appendix out is a mere 15 pounds... Its pretty good value. Almost enough to consider having an operation for the hell of it (until you think about the risks of actually having surgery here, or you see the operating theatres). I said to Jess that maybe I should just have my spleen out. She gently reminded me that I would probably need it in the future. On Tuesday we actually went into Theatre to have a look... its not as friendly as in Muheza and I defintely didn't fancy scrubbing up. For my sins it turned out to be a day of Urology... so we watched a TURP, a cystoscopy and a prostatectomy (100,000 TSH = 50 pounds ish). It surprised me that they had the resources to do the first two but lo and behold there was a camera and a TV screen. The prostate op was interesting... the two surgeons obviously didn't get on and argued about everything and then the guy had a prostate 5 times the normal size. . I asked to take a picture of it and the surgeon willing obliged. It is massive. I was disgusted with my own curiosity.
I'm going to post this now because I have already tried 3 times and the stupid internet always failed at the crucial moment. We are at a different internet cafe now so hoefully it will work or I might actually go insane because i have written the same thing so many times!
See you soon
Salxxx
Avoid roads, in a car or near cars, in the late afternoon. Everyone is suffering from hypoglycaemia and dehydration and the driving has become noticably worse since Ramadan started.
We are on the home straight. Only a week left til we come home. I'm finding that I am torn between the desire to get home to normality and the feeling that it is going to be weird to be in England and not sleeping under a mosquito net.
This weekend we went to Nungwi on the North of the island. Its one of the more sociable resorts although not as classically beautiful. We still really liked it...its only downfall was the seaweed, of which there was an incredible quantity! On Saturday we went on a dhow round to mnemba island to do some snorkelling on the reef around it (you are not allowed to land on the island or you get arrested because it is a privately owned island). I think it was the best snorkelling that I've done since being in Zanzibar and we saw so many different fish (and an eel which scared me a little). Then we had barbequed fish for lunch on a beach on zanzibar opposite mnemba. It was yummy. I was a bit of a loser because I forgot to put any suncream on my arms and now I have pink arms and have to keep out of the sun for the next couple of days :( We sailed back round to Nungwi late afternoon...Having never been seasick in my entire life, coming to Tanzania this summer I have to say that whenever I get on a boat now I feel awful. I have been experimenting with if I feel better if I sit at watch the Horizon, watch the boat, close my eyes etc. That day I felt so bad that I lay down and fell asleep. It actually worked because when I woke up I felt about a billion times better :) I'm afraid that I blame my mother for this newfound nausea. (Sorry Mum but you are the only person I know that gets seasick!)
On the Sunday it was cloudy in the morning so we went to the aquarium in nungwi. Its not an aquarium in the normal sense of the word but its is a conservation program for Hawksbill Turtles. There is a natural lagoon in the coral rock where there are several turtles and a number of tropical fish and you can feed them and swim with them. I was an absolute clutz on the way to the aquarium (which was about 25 minutes walk from where we were staying) and fell over. I cut my hand and foot and didn't much fancy getting into the water with the turtles and fish. Now I know the turtles are veggie but the fish weren't! We sat for a couple of hours just watching the turtles and feeding them. It was so calm and peaceful to watch them glide effortlessly around. They are so graceful and look weightless in the clear water. It was a very pleasant way to spend the cloudy hours.
In the afternoon we sat on the beach in the sun (but with me wearing long sleeves to protect my poor arms) and I got some Henna done on my feet (LOVE IT), then we got a late afternoon shuttle back to Stone Town. Some might say this was risky, especially after reading my first statement in this blog entry, but it was not too bad and we'll do anything for a couple more hours of sun!
So that was my weekend...and the last one we are going to spend in Zanzibar. Next Sunday I'll be home. Weird. After a considerable amount of thought, I think the thing i am most looking forward to is Apples...mmmm a nice crunchy Braeburn.
This week we've been on the Surgical ward and in theatre. On Monday we went on the wardround. Its mostly Hernias, diabetic feet, trauma and prostates. One man who had been in a road traffic accident had to have his spleen removed. It cost less than 20 pounds which I thought was a bit ridiculous considering it is major surgery (but good at the same time because the people can just about afford to have it). To have your appendix out is a mere 15 pounds... Its pretty good value. Almost enough to consider having an operation for the hell of it (until you think about the risks of actually having surgery here, or you see the operating theatres). I said to Jess that maybe I should just have my spleen out. She gently reminded me that I would probably need it in the future. On Tuesday we actually went into Theatre to have a look... its not as friendly as in Muheza and I defintely didn't fancy scrubbing up. For my sins it turned out to be a day of Urology... so we watched a TURP, a cystoscopy and a prostatectomy (100,000 TSH = 50 pounds ish). It surprised me that they had the resources to do the first two but lo and behold there was a camera and a TV screen. The prostate op was interesting... the two surgeons obviously didn't get on and argued about everything and then the guy had a prostate 5 times the normal size. . I asked to take a picture of it and the surgeon willing obliged. It is massive. I was disgusted with my own curiosity.
I'm going to post this now because I have already tried 3 times and the stupid internet always failed at the crucial moment. We are at a different internet cafe now so hoefully it will work or I might actually go insane because i have written the same thing so many times!
See you soon
Salxxx
Monday, 17 September 2007
Bad days and Death
Friday... Jess is better enough to go into the hospital. She must actually have had malaria despite negative slide since as soon as she started the medication for it she started to perk up. We decide though to go to Paediatrics again since we know the system and Dr is nice. It was the worst morning for frustration at the system. A small boy is brought in with all of the classic signs of Meningism after fitting all night since 6.30pm. The Drs faff around. They then decide to do a Lumbar puncture before giving antibiotics but no one can find a LP tray. They wait for a while long. We are there feeling anxious but the Dr is atleast giving the child attention. They do the LP and we sit there crossing our fingers that the boy is not going to cone as the CSF comes out at such a high pressure. THEN... we ask...will the boy be given his antibiotics now? Yes Yes... Hmmm... unfortunately it means that first the family have to go and buy them and cannulae. We sit there getting more nervous. When the drugs arrive we look for veins but he is so shut down peripherally and we have never put a paeds cannula in before (and they had only bought one so we didn't want to mess up) that we ask for the nurses help. The Dr tells the nurse to do it while she carries on seeing other patients and the nurse decides to go away and do the the rest of the ward round with another Dr before coming.We continue to ask and ask...nothing gets done. We ask if we can just give it intramuscularly because it was urgent. The Dr said no it needed to be IV and the nurse would come in a minute. Feeling helpless we tried to comfort the boy a bit and cool him down. Then he started fitting again and I ran to get the nurse saying that it was now an emergency and she had to come. He was by this point so shocked that the cannula wasn't going in. She went and got another one. It took three gos and she wasted a bunch of the drug from infiltration cos she didn't check (we told her because it was swelling up). If we had known that they had spare ones we would have got one in a long while back. Even they got one in about an hour and a half after he had come in. I'm pretty sure he will have died. No one will hurry. No one will rush. Its so frustrating and we don't have the skills yet to intervene and know we are doing the absolute right thing. I think maybe the worst thing is that in England if your child has been fitting for the whole night, you would have brought him in after the first one. Also in England, if you went to the GP first, he would have stright away given a injection of penicillin. You would not be waiting for 2 hours for your first dose of antibiotics after you arrived at hospital. You would have a bed you didn't have to share with another child. You would have oxygen...the child would not be left alone by all the nursing staff and Drs and relatives. We had to stay with him holding his hand and talking to him because everyone else had gone. It was a hard morning.
At the weekend we went to the beach. Kendwa Rocks. It was cloudy and I got a dodgy tummy so we came back early on Sunday and lay by the pool at the nice hotel in the bright sunshine. I did not burn...Hooray! I think I may even be starting to go brown, which is impressive for me :)
Today we went into O&G although we didn't do anything practical just watched. An interesting place is the antenatal ward and a far cry from Labour ward in the UK. If the woman is lucky someone will check how dilated she is before she drops child. I actually mean literally drops child because the women will walk from the ward to the Delivery suite when the head is halfway out. Today none were dropped though... phew. We saw a couple of deliveries of healthy babes... amazingly the women make very little noise or fuss and they have no pain relief or support from relatives. Noone is in there with them (esp not the men) and they go through it all alone with barely a sound escaping from their lips. I admire their courage and strength. Generally, women in england have pain relief, support and they still scream the house down! We did see a really sad thing though because a women had been transferred in from a smaller clinic due to obstructed labour. She had a Csection but it was too late. Neonatal resuscitation doesn't really happen although we tried....no oxygen or anything. There was nothing we could have done. She just arrived too late.
After that we went to see the slave chambers under the anglican cathedral which is on the site where the old slave market was. The slave chambers were barely bigger than my box room (well maybe twice the size) and each one ould have had 55-75 slaves in it for 3 days with no food/water whilst awaiting being sold. The high altar of the cathedral sits on the place where the whipping post used to be. It was very interesting to see but sobering to think of so many atrocious happenings on that one now holy place.
Life is not all bad though... it is interesting at the hospital... in a very different way to what I had imagined. Think we are going to take a break from O&G tomorrow and go to a cardiology clinic tho.
I promise my next entry will be more upbeat :)
Salx
At the weekend we went to the beach. Kendwa Rocks. It was cloudy and I got a dodgy tummy so we came back early on Sunday and lay by the pool at the nice hotel in the bright sunshine. I did not burn...Hooray! I think I may even be starting to go brown, which is impressive for me :)
Today we went into O&G although we didn't do anything practical just watched. An interesting place is the antenatal ward and a far cry from Labour ward in the UK. If the woman is lucky someone will check how dilated she is before she drops child. I actually mean literally drops child because the women will walk from the ward to the Delivery suite when the head is halfway out. Today none were dropped though... phew. We saw a couple of deliveries of healthy babes... amazingly the women make very little noise or fuss and they have no pain relief or support from relatives. Noone is in there with them (esp not the men) and they go through it all alone with barely a sound escaping from their lips. I admire their courage and strength. Generally, women in england have pain relief, support and they still scream the house down! We did see a really sad thing though because a women had been transferred in from a smaller clinic due to obstructed labour. She had a Csection but it was too late. Neonatal resuscitation doesn't really happen although we tried....no oxygen or anything. There was nothing we could have done. She just arrived too late.
After that we went to see the slave chambers under the anglican cathedral which is on the site where the old slave market was. The slave chambers were barely bigger than my box room (well maybe twice the size) and each one ould have had 55-75 slaves in it for 3 days with no food/water whilst awaiting being sold. The high altar of the cathedral sits on the place where the whipping post used to be. It was very interesting to see but sobering to think of so many atrocious happenings on that one now holy place.
Life is not all bad though... it is interesting at the hospital... in a very different way to what I had imagined. Think we are going to take a break from O&G tomorrow and go to a cardiology clinic tho.
I promise my next entry will be more upbeat :)
Salx
Wednesday, 12 September 2007
The week so far ...
Waking up on Monday and going to the hospital was one of the hardest things I've done. There is such a contrast between the perfection of the beaches here and the hospital. We decided to go to Female Medical Wards on Monday and we get shown where things are by the hospital secretary (even though we actually already know and it is just a formality) but bizarrely she took us to Male Surgical and left us there with no explanation. I still don't really know how messages get mixed up like they do but nevermind! We went upstairs to the female medical ward and everything was fine. Its just a completely different system here though. The Ward round in England normally consists of the whole team going round and discussing the patient and maybe doing some teaching. Here... the students and the clinical officers just take a patient each and they see them one on one like that so the patient may in fact not get to see a qualified Doctor the whole time they are in if they are not lucky. Or lucky...I can't be sure. Anyway the aim seems to be to finish as quickly as possible.
One of the patients seemed to Jess and I to be a bit ridiculous. She had a headache and nausea, blurred vision, numbness and tingling. The Clinical officer Student said it was malaria. Fair enough except that they didn't have a fever and she hadn't had a blood film done and when I asked do you ever get numbness and tingling with malaria, he said no. It probably is Malaria now that I've expressed doubt at their diagnosis but stil lthey didn't appear to have done a Neuro exam.
On Tuesday we went to TB and Leprosy Clinic. It was pretty interesting just because I didn't really know anything about Leprosy and we got some ok teaching from the Dr. We didn't see any new cases though, it was just follow up so I think we might go back next week to see because it would be good to see.
Today.... Jess and I went to the Private clinic. Not because of our elective but because Jess got ill. It sounded suspiciously like Malaria except no fever. She also had negative blood slide but Larium can do that. The Dr said it was probably Malaria anyway and gave her some tablets to take. So we'll see if she starts perking up anytime soon. Anyway it was good to see a Dr that had a good bedside manner and did a thorough examination and it only cost 20 quid for the appointment and the drugs. Fingers crossed! I am of course being a very dutiful nurse. I've got a lot of reading done in the last couple of days because of it. Finished my last book, called Blodd Sisters which is a good (but sad) read. Now I am moving on to Nelson Mandelas autobiography which I have been wanting to read for ages but never quite got round to it.
If Jess gets better then we'll be heading up to Kendwa to the beach this weekend, which is on the North west coast so will be a bit different to Paje which was on the East coast :)
One of the patients seemed to Jess and I to be a bit ridiculous. She had a headache and nausea, blurred vision, numbness and tingling. The Clinical officer Student said it was malaria. Fair enough except that they didn't have a fever and she hadn't had a blood film done and when I asked do you ever get numbness and tingling with malaria, he said no. It probably is Malaria now that I've expressed doubt at their diagnosis but stil lthey didn't appear to have done a Neuro exam.
On Tuesday we went to TB and Leprosy Clinic. It was pretty interesting just because I didn't really know anything about Leprosy and we got some ok teaching from the Dr. We didn't see any new cases though, it was just follow up so I think we might go back next week to see because it would be good to see.
Today.... Jess and I went to the Private clinic. Not because of our elective but because Jess got ill. It sounded suspiciously like Malaria except no fever. She also had negative blood slide but Larium can do that. The Dr said it was probably Malaria anyway and gave her some tablets to take. So we'll see if she starts perking up anytime soon. Anyway it was good to see a Dr that had a good bedside manner and did a thorough examination and it only cost 20 quid for the appointment and the drugs. Fingers crossed! I am of course being a very dutiful nurse. I've got a lot of reading done in the last couple of days because of it. Finished my last book, called Blodd Sisters which is a good (but sad) read. Now I am moving on to Nelson Mandelas autobiography which I have been wanting to read for ages but never quite got round to it.
If Jess gets better then we'll be heading up to Kendwa to the beach this weekend, which is on the North west coast so will be a bit different to Paje which was on the East coast :)
Monday, 10 September 2007
The beauty of doing nothing...
As I see it...doing nothing is very beautiful indeed. Especially if you are doing nothing whilst gazing out at a clear turquoise sea. Our weekend consisted of this... We arrived at the hotel and moved into our Banda. We lay by the pool for a couple of hours and also went on a wander up the beach for a bit until the sun went down; then we had dinner and drinks and rediscovered that lost game of our youth... pickup stix! Jess, Tash (another med student from cardiff) and I battled it out to see who would become pickup stix champion. We all were fairly well matched in fact and had to call it a draw. Jess and I have now vowed to get a set for our house next year since it was such good fun! The next day we lay on the beach and built sandcastles and had a swim. It is a hard life. I cannot describe the beauty of the place. It was like looking at a Postcard picture. Amazing.
Tuesday, 4 September 2007
Catch up-
So... Amanda has gone home now and Jess has arrived. I felt the weirdest ever hanging around at the Airport waiting once Amanda had gone through and Jess hadn't arrived. Being at the airport, and feeling after 5 weeks that it might be about time to be going home (longest time I have ever been away anyway!) and yet not actually going anywhere. A kind of deep longing in the pit of the stomach... which has long gone since I lay by the pool all afternoon yesterday and then read about the beach we are going to at the weekend.
Jess and I have moved into our new accommodation and have started at the hospital. We are staying at a place run by a local family for students, mostly studying swahili at the language school down the road. Having said that actually there are only 4 of them at the moment, us and 4 architecture students from copenhagen. We get all our food cooked for us... which is yummy. I have tried lots of new things... had Ugali for the first time today (not entirely sure how I made it through 6 weeks in Tanzania without having ugali before now but nevermind!) BUT I think that I am going to put soooo much weight on from having 3 cooked meals a day. I am in a constant state of fullness but is seems impolite to not eat everything they pile on the plate!
We started at the hospital yesterday. The person that we arranged our elective with no longer exists but they let us do it anyway. We are doing Paediatrics this week which is good because the Drs are all nice and friendly. It doesn't look like we are going to get much practical experience apart from examinations here but I'm ok with that. There are probably about 10 other medical students here...we have now met most of them...apparently if you make it to the end of the morning you have had a long day, and most people take atleast a day off a week to go to beach anyway. We are going to try to be good and go in everyday atleast (even if it is only til 11am!)
At the weekend we are going to go to the beach at Paje. It looks soooo nice! CANNOT WAIT! I don't think there is much to do there apart from sunbathing and relaxing but I plan on learning the beauty of doing nothing.
Salx
Jess and I have moved into our new accommodation and have started at the hospital. We are staying at a place run by a local family for students, mostly studying swahili at the language school down the road. Having said that actually there are only 4 of them at the moment, us and 4 architecture students from copenhagen. We get all our food cooked for us... which is yummy. I have tried lots of new things... had Ugali for the first time today (not entirely sure how I made it through 6 weeks in Tanzania without having ugali before now but nevermind!) BUT I think that I am going to put soooo much weight on from having 3 cooked meals a day. I am in a constant state of fullness but is seems impolite to not eat everything they pile on the plate!
We started at the hospital yesterday. The person that we arranged our elective with no longer exists but they let us do it anyway. We are doing Paediatrics this week which is good because the Drs are all nice and friendly. It doesn't look like we are going to get much practical experience apart from examinations here but I'm ok with that. There are probably about 10 other medical students here...we have now met most of them...apparently if you make it to the end of the morning you have had a long day, and most people take atleast a day off a week to go to beach anyway. We are going to try to be good and go in everyday atleast (even if it is only til 11am!)
At the weekend we are going to go to the beach at Paje. It looks soooo nice! CANNOT WAIT! I don't think there is much to do there apart from sunbathing and relaxing but I plan on learning the beauty of doing nothing.
Salx
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