A great day in Maua

What an amazing day today! Yesterday we had triaged 76 people by 9:20 am. Today we were at about 170 at the same time. When we arrived there were about 150-200 people waiting. They were all waiting in a huge circle in the front yard of the dispensary. We found out later that some of them had been waiting there since 4:30 am.

 Time and time again we are amazed at the fact that the people come to caravan in their best clothes...the women in colorful kangas, headdresses, and some in high heels; the men in pants, shirts, jackets, hats and some times with cuff links (no ties).
The rooms that we sometimes have to work in, astound us. We have been in school classrooms that are filthy, cramped, with solid cement walls (no windows) or wooden walls that reminded us of the inside of a barn because there are spaces in between the slats.Today in the duka la dawa (Swahili for pharmacy) there were about 30-40 small, wasp combs hanging from the ceiling, each with a newly hatched occupant. As the day warmed, they started flying about. Usually the dawa staff plays tunes, but today this seemed to agitate the wasps so...NO MUSIC!

Our pharmacist showing us how
she feels about the occupants



Yep...thems wasps

At one point during the day, the triage staff decided to put up tarps to keep the sun off of the patients. They got creative and moved the vans around to use as anchors.

Today everything seemed to click!! Despite the small hallways and rooms spaced close together—which caused major congestion spots—the medical and logistics people worked together to make the flow of patients so effective and swift, that we set a record at this site. This was the first caravan to not have to turn away patients!!!



Walking home



Some of the patients we saw: 2 pregnant women who we bused to Kilema hospital because they were both in active labour, and a man with acute appendicitis. There was also an orphan boy (about 13-15 years old) who was HIV positive.

We saw 549 patients and we finished so early that we were able to take the time to walk the 10 km back to Kilema, instead of taking the vans.

 

During the walk home we decided to see if there were any snack foods to bought in the local grocery stores. These rural stores are basically a one room "box" full of products from ceiling to floor and on all walls. There is no door for you to walk through, just a metal grate along the front. You just peak in through the grate and tell (or point to) the items that you want. There were no chips or nuts to be bought, just mainly toiletries and some cooking items.





A bar that we passed along the route home

 We ended up purchasing Coke Lite (which is the equivalent of Diet Coke-and difficult to find) and a bottle of a local, popular booze called Konyagi. It is kind of a cross between gin and vodka.

Every dinner consists of rice and either potatoes or spaghetti noodles with a meat dish and a side of greens. Today, for the second day we were served Ugali ( a traditional Tanzanian staple ) instead of potatoes. Our cook found out the weekend that some of the team are vegetarians, so he started to include a bean dish as well.

After every dinner we have a debriefing of the day's caravan. Statistics of the day are announced (# of patients, sex, how many saw medicine, opthamology, testing etc.) and then each group gets a few minutes to discuss anything they want to about the day. Today for the first time, one of our Tanzanian staff spoke about an issue that he was concerned about. He is the lab tech who is responsible for administering the HIV tests during caravan. He said that today he did an HIV test on a 90 year old woman, and his comment was basically-what in heck for? He was concerned that most of the tests that he is giving is to older people and not the target range of 15-35. He wanted a western view on how to change this so that the younger people would accept testing more readily. This spanned much discussion with several ideas thrown around. We decided to try and offer HIV testing to the target age range with the promise that they get fast-tracked to the front of the line. We will try this out to see if it could work.

Tomorrow is our last caravan. Were did the time go?