medicine

Doctor Duty in Tanzania

“Hujambo daktari!”

One particular lab technician liked greeting me that way. I kept saying that I was just a student but hey, if he wanted to call me daktari (doctor), no one’s complaining! I volunteered as an AIESEC intern at Mzumbe University Hospital at Morogoro, Tanzania. I was there for 6 weeks doing My Health project where I interned as a medical student and helped out where I could. The hospital serves both the university students and locals.

It was a health centre, hence there weren’t as many serious medical cases as I see back at my university, but it was good exposure nonetheless. I mean, I did an Obstetric ultrasound on the first day. Can you imagine! I don’t mean watched… but performed one! I poured the gel onto the patient’s abdomen and all that jazz. (Insert happy dance! ) Though I had no clue of how to measure the fetal head circumference and other measurements needed for the antenatal checkup. But that’s why medicine is an apprenticeship journey. Each day we learn something new from each other.

My favorite part of our journey from the AIESEC house to the hospital each morning was the view of the Uluguru Mountain range in the morning sun. I was in awe each morning and I bet Maggie and Makini wondered how I never failed to marvel at them; “Look at the mountains!” I said, every single day. Also, there was a young girl who lived in a house along the road we used. We nicknamed her ‘Mzungu’ since she always, and I mean always, ran after us (mostly Maggie) shouting “Mzungu! Mzungu!”

We had various duties at the hospital; we helped out at the laboratory, labour ward, inpatient wards, outpatient clinic and the dispensary. On that note, this is a message to all doctors (and my fellow doctors to be). Kindly write prescriptions in a GOOD handwriting. My goodness! God surely gives grace to all nurses& pharmacists who read prescriptions. I guess by now you can clearly tell that my days on duty at the dispensary weren’t particularly my favorite.

Besides that, talk about half-life of information! (Some medical slang there; half-life is a pharmacological term that is used as slang to mean ‘the time needed to forget something’. eg. Person 1: What was the name of that drug? Person 2: I don't remember. Hee...Halflife! ) Each drug prescribed had me flipping mental pages trying to remember what I had learnt about them…drug classification, adverse effects, indications…etc. Dr. Lilian, who was in charge of us as interns made sure we knew our stuff. She assigned topics to us and we’d give presentations of our research every alternate day. Read as ; sleepless nights of research, calling friends back home to help me with soft-copy notes on certain topics I didn’t have, understanding what a partogram is for maternal labour recording…all this while our fellow AIESEC interns at the house told us stories of their days teaching kindergarten children at a nearby school. (They were doing an Education project, quite different from ours I must say :) ).

Who were my partners in crime at the hospital?

Maggie. Yu Hsin is her Taiwanese name. She’s a ball of energy and talent! (That’s a story for another post…today were talking business!) She’s a third grade medical student, but because they have a different curriculum, her medical knowledge is equivalent to a first year medical student back home.

The gentleman is Makini, a fellow Kenyan and dear classmate of mine. Besides being a student, he doubles up as a photographer and business man. Don’t mess ya’ll!

To be honest, labour ward had the most memorable experiences. I’ll spare you the gory details as I know some have already cringed at the bare mention of ‘labour ward’. However, I’ll never forget the first delivery we helped out with. This first-time mother had no idea that she was bearing twins and was also severely anemic at the time of delivery. We ordinarily would have referred her to Morogoro Referral hospital, but she had come during second stage of labour and it was too risky to take her there.  It was 25kms away and who knows what would have happened in the ambulance? So baby number one comes out; healthy looking. The nurse proceeds to deliver the placenta as I weighed the baby, but he was shocked to feel another baby, who was in breech presentation. Don’t ask me how we didn’t find out about her multiple pregnancy earlier. To be honest, she didn’t have any ultrasound or clinic records and said she had travelled to our health centre to give birth (since her friend had recommended the place to her, compared to hospitals in her hometown.)

Anyway, baby number 2 came out but there was a lot of post-partum bleeding. From this point, it seemed more like a scene right out of a movie. All I remember is…

Dr. Lillian comes to check on the going and finds a relatively calm nurse handling an obstetric emergency. Being the doctor, the buck falls on her to handle the situation and she begins barking orders left, right and centre.

“Joy, rub her abdomen. It’ll help in uterine retraction to reduce the bleeding.”

“Nurse, we need oxytocin STAT.”

“Maggie, bring normal saline for resuscitation.”

The mother is in shock. Medical shock. Low blood pressure. Severe palor.

“Nurse, insert another IV line.”

“Maggie, squeeze the IV fluid bottles. We need as much fluid to get to her system as fast as possible.”

“Let’s lift her onto the wheelchair so that we take her to Morogoro Hospital.”

Mother faints.

A moment of sheer panic.

“Put her in shock position. No time to carry her back onto the delivery table.”

“Call an ambulance. Quick!”

“Place mother on stretcher.”

Filled in referral forms quickly and baam…Dr. Lillian, the patient, her twins and her friend sped off in the ambulance towards Morogoro Hospital. After that, we all just slipped into the doctor’s room and took a breather for an hour. That was too much to handle all at once.

For the next couple of days, that’s all Dr. Lillian made us read about! Shock, twin pregnancies, anemia in pregnancy, post-partum hemorrhage…all in a bid to try to  theoretically understand what we’d seen before our eyes.

Hospital life is really unpredictable! Seems I have so much to say about the hospital so... I'll continue in the next post which will be up tomorrow morning! #WhileIwasAway #42daysinTanzania

by Mueni Muli