tuna kuhara

kiswahili for "we have the runs..."

Laura caught it early last week, Charlie and I are home today. But I can update the blog at least! Charlie is napping while Laura is at a bible study with Linda.

fact of the week: when a toddler develops an attachment to a blanket do not wash it unless there is a dryer nearby. He will tantrum until he can sleep with his wet "night-night".


Sunday we went to church- Laura could tell you more as I had to leave with our little wanderer. We played soccer with some kids outside. The church is right next to ALMC (the new hospital), and while Joel rounded on patients, we walked to the big grocery- Shoprite. It's about 15 minutes walk, but the way back to church with a tired toddler, heavy groceries and under a hot sun strained our composure! We cooled off with 2 cold Cokes (all glass bottles here!) and that evening we had dinner at Matt & Jane's home down the road. They are from Australia and New Zealand (respectively) working to build up the ICU at ALMC. We had an awesome vegetarian/couscous dinner with mojitos and beer! They have quite a nice place, and we sat until dark around the chimenea talking.

On Monday we had a terrific dinner at the Jacobson's to commemorate Joel's last days with Selian. Pictured L to R: Charlie, Eric, Laura, Linda, Mark, Libby, Rebekka, Joel, Bryant. Joel left Wednesday morning. Since that time I realized how active we had been covering 2 hospitals! The most noticeable change since his departure is that we instilled "tea time" into the day. And I lost my ride to Selian... The day at Selian now basically ends about 1PM with lunch and then waiting for the bus to leave at 3:30PM. We take admissions until then. I am dropped at the base of "Ilboro" road and walk home. Yesterday there was a nice little rain to cool me off on the walk. I dried off on the porch while talking with our Masi gaurd Mbutuai. We are trading languages v-e-r-y s-l-o-w-l-y at this point.

I am staying on the pediatric ward through the end of this or next week. There are several opportunities available that I still want to visit (no order here): hospice, surgery, ob/gyn, adult medicine, and the ICU at the new hospital. Near the end of the trip I will join the flight team that travels for Selian to various villages/Niarobi for medical transport. There is also a doctor not involved with Selian who travels amongst several villages that I might try to catch up with once Laura leaves Tanzania.

Monday I began care of a child with fever, abdominal pain, fatigue and vomiting. Our differential diagnosis was short: malaria or acute gastroenteritis (stomach flu). We treated the malaria with IV quinine and just pour liquid into her for the stomach virus to cover our bases. Tuesday morning, mother tells us she threw up a worm. Ascariasis! It is an intestinal roundworm that 25% of the world population carries- although this % is much smaller in the US. One dose of Albendazole should cure it. As we moved around the ward visiting patients that pharmacy cart came around dispensing medications. This pic is a fair representation of what we are working with at times. I have glimpsed through the stock rooms lately, and this is about what you will find. Last week we ran out of Ceftriaxone, an antibiotic that covers several bacteria well. Not the worst thing in the world to happen, but a headache to change numerous peoples drugs around. AND this would not happen in the US!

Rebekka (a nurse practitioner rounding with us) mentioned a book this week while performing newborn exams: The Man with the Key Has Gone. It's a metaphor to explain the slow pace of working here. You want to do something, like chart about completing the newborn exam, but there is no charting paper around- so you have to wait 10 minutes for that to be found. There is a lot of waiting like that here, no matter how fast you want to go, you will wait.

Kwa heri,
Eric