Notes from a dusty rider

Just returned from a fantastic mountain bike ride with Mat and the new med student Dave (from New Zealand). We went up the hill quite a distance near a village called Il'Kidinga, and close to where I have done some home visits with hospice. Then we hit a lot of the streams/paths that I had been eyeing up for the past few weeks. There was a lot of incline/downhills and numerous obstacles- very fun. We passed through a weeks worth of touring the countryside in just a few short hours. Our bikes are not great, Dave and I did our best yesterday to tighten everything up. About half way through the ride Daves pedal crank began to make death threats- sounded like a dying cat. By nightfall it was hardly turning, we poured some water on the housing and sped home with haste. We passed many groups, kids chasing us, families coming out of their bomas to say hello, large church parties along the hillside. And a beautiful sunset. It was a great dusty adventure and I know it is something I will miss on my return home to Mn.

This past week at Selian was somewhat short for me, as Laura left Monday and I was at ALMC for clinic Tuesday. I spent the remainder of my time on the medicine wards. There have been quite a few deaths lately to deal with. I had some frustrations with a very old women who was going into shock. Most of my requests for care seemed to fall on deaf ears. I finally got a non-rebreather mask on her to help her breathing and they all wanted to take it off because patients don't find them comfortable! I unplugged from the team after we left her case, as I found myself teetering between apathy and cynicism over the care being provided. By Thursday I was doing well, but there have been several patients who have passed, and many more coming in for what appears to be paliative care. I have started going in on Saturday mornings now to spend extra time at the hospital. A man came in with a large tumor the size of a cantelope- where is the pre-hospital screening that should catch these things before they are deadly? No where to be found. I think primary care development here would save A LOT of lives. Many many different patients this week: an alcoholic (local Konyagi liquor here), TB meningitis, strokes, sepsis, malaria, AIDS, and many more. I plan to spend a week now with OB/GYN, and go from there. I have recently heard from another doctor that I will travel with in late April out into the rural areas, so I am excited to get out. The 2 hospital pics: one of Selian's low-tech ICU and the other is me with the hospice team.

Exempla house has decided to throw some challenges our way. We have been without water for about one week now. We are all getting fairly rank without access to showers and this warm dusty climate. We have a slow flow from the kitchen sink (cold water only). So we can fill our toilet tanks and take sponge baths. Before church today, Bryant and I went to ALMC early and showered for the first time in a long time, it was very cold! It seems they don't have hot water there yet... But it felt good. There is a fairly significant drought here as well, in contrast to the flooding in the midwest currently. It rains very infrequently and the dust is everywhere. The crops are dying and there doesn't appear to be relief in site. Kilimanjaro appears to be fairing even worse. Today at church they ended with an open mic to talk about what verses helped everyone "get through" the day or rough spots in life. It was great to hear the diversity of text being spoken and find what gives people strength.

Two new roommates came in the night Laura left. They are an ortho surgeon and ortho physicians assistant from Stillwater. They spend a great deal of time at ALMC, but we have spent the evenings going to dinner and getting out of the house. It has been great to see Arusha at night, even if only from a range rover window.


And a public proclomation that I miss my family! I don't like Laura and Charlie being away from me for this long! Charlie said his "goodbyes" to friends made at play group.



The simba (lion) was one of Charlie's toys here and keeps me company at night.





Also, just found out we received a nice amount from St Lukes church (our home church) as a donation! We really appreciate everyones support in our work and we will do our best to find an appropriate use for the greatest good.

Eric

PS- Charlie started eating more veggies his last few days here: cucumbers, carrots and green beans. Well, not eat but chew and spit out. It's a start.