days 3&4

Hello to all,

Days 2 and 3 have been exciting.

Day 2: I woke up at 6am and headed to the hospital eager and ready to see whatever awaited me there. I was spending this first week in surgery and Tuesdays is a surgery day. The “surgeon” I was attached to was not actually a surgeon at all. He was the equivalent to a general who has had nearly the same training as me plus some clinical experience in the Zanzibar setting. He can basically function as a Obstetrician/gynecologist, general internist or surgeon (you are right to shudder, if it gave you that reaction). It’s not that he is incapable. On the contrary, he is actually quite gifted. He basically needs to be prepared to save a life no matter what the condition.

We had 3 surgeries. They were all done with spinal anasthesia which means that the patients were awake the entire time. Sounds intense, but they were all very comfortable and in no way distressed (which I could determine both by their facial expressions and their recorded blood pressure) during the operations. Because I was not scrubbed in an participating in the surgeries directly, I took on the role of getting supplies and doing my best to maintain sterility as well as giving the odd encouraging wink or nod to the patient who was lying there wondering what the hell was going on. The operations involved two prostate removals and one bladder stones removal. I won’t go into the details and I will save that for when I return for anyone interested. The procedures were all very interesting and I will be scrubbed in on Thursday to assist as well.

I was actually pleasantly surprised with the sterility measures. They are no where NEAR to Israeli standards, but they were nonetheless significantly better than I was expecting. Again, I won’t go into the details.

I also stopped by the pediatrics department to meet a boy who I had met in Israel when he came for surgery. I saw him last time I was in Zanzibar as well. He doesn’t speak any English but we were excited to see each other. Last time I saw him, he gave me some Zanzibari music on my cell phone and I played it for him again and he was pretty excited. Anyway, that was a nice meeting. He told me, through a translator (the nurse who was in Israel with me in 2003) that he would like for me to come to see his village on the east coast. I will try to make that happen at some point.

In the evening I just relaxed and ate a fresh pineapple and a couple mangos. The fruit on this island is exceptionally tasty. I have restricted myself to only the fruits that can be peeled (don’t worry mum). My stomach can handle the food here much better than it could in Ethiopia. There is a huge market about 2 minutes from my flat and I have gone there everyday. In the apartment, we are 7 people sharing a small fridge so I do my shopping for food on a daily basis because storage is limited. I am fine with that.

Day 3: Today consisted of ward rounds in the morning. I saw some of the patients that had been operated on yesterday. The wards was pretty run down. It was a big room with IV bags and mosquito nets handing from lines that were put up from wall to wall. We saw one case that made me think I was going to vomit. It was the health status mixed with the humidity in the room and the stench. Everything together was not a good mix.

After rounds we had a meeting with all the elective students and the hospital director and some of the staff. The hospital director was trying to improve the teaching quality of the hospital and wanted feedback from the elective students. To his fault, he hadn’t considered that all the students had come at different stages in their training. There are also students from Canada, the US, the UK, Germany and Australia so everyone is used to a different system. The meeting was useless but I didn’t really care because I am not here for very long.

After the meeting I spoke with the hospital director. I introduced myself and thanked him for having me at his hospital and told him what a great time I was having (a bit of politics to start on the right foot). I then told him all about my medical school and how I would like to see students from my school start to come to Zanzibar as one of their fourth year elective sites. I proposed to him a way that it could be done that would be mutually beneficial in the hopes of creating a sustainable relationship. I also spoke with him about Save a Child’s Heart and the recent project we did for them in Ethiopia and how I would like to repeat it in Zanzibar in 2 years when I can get some time for electives in residency. He was EXTREMELY receptive and asked to meet with me again tomorrow in a more formal setting. I am now typing everything out for him so that he can have it on paper. Hopefully something good can come of it and I will be able to do another follow up study on the children from Zanzibar that have come to Israel.

This evening I am going to head out once the heat if the day breaks a little. Zanzibar has a great market in the evenings where they cook food on the streets and it’s all very delicious. I will check that out with some of my new flat mates.

My plans for the rest of the week are to go to the hospital tomorrow, Thursday, and hopefully scrub into a couple surgeries and help out…should be a good experience. On Friday I may travel to the other side of the island to see another hospital called Makonduci. Apparently there is an American doctor there who has been there for a while and I would like to meet her. It’s probably about 1.5 hours by dalla dalla to get there. I may try to check out that boy’s village as well, if I am already going to the east coast of the island.

All for now.

Will