It’s hard to believe that I am starting my FOURTH week here in Tanzania. I feel like I’ve learned so many new things since I’ve posted last, so I’m going to attempt to fill you in on everything in this post.
Here goes, hapa tunakwenda!
1) My Swahili is certainly improving, and I am even able to go to the market and barter for supplies and food that I need! Originally, the sellers in the market charge us far more than the expected price, but they are usually pretty impressed when we are able to say “Haiwezekani! Punguza bei”, which translates to “that’s impossible, reduce the price!” Last week, for approximately one dollar and fifteen cents, I was able to buy 4 avocados (parachichi), a watermellon (tikitimaji), a pile of oranges (chungwa), and a handful of hot peppers (pilipili hoho)! For the next week and a half, all of our Swahili classes will be on technical equipment and instructions so we will be prepared as best as possible for the language barriers that will face us at the hospitals. We also learned how to tell time, which is incredibly confusing because “swahili time” operates completely differently than we are used to. They see 6am as the start of the day, or “zero hour of the day”, therefore 7am is seen as “1 o clock” or the first hour of the day. They also don’t really have a way to say minutes, so if you say you would like to meet at 6 oclock (or, noon) a person can show up anytime during that hour and still be considered on time!
2) On friday, we had a chance to really immerse ourselves in a hospital about 30 minutes from our school, Mt. Meru hospital. This hospital was much bigger than where we had worked pervious weeks, and spanned about a football field of space. One thing my classmates and I were commenting on is that we haven’t walked on stairs since coming here, because everything in Tanzania is one floor, and I have yet to see a building with multiple stories, and Mt. Meru hospital was no exception to the rule. The single story hospital was incredibly open, with all the hallways outdoors and most patient rooms having only a roof or a short wall with open spaces instead of windows. “So much for privacy…” I thought as I passed a ‘room’ full of 50 patient beds lining the walls, open for all to see. Our group was led to an office for the hospital technicians, and they welcomed us inside, where a family of kittens spunkily greeted us. Some sort of organization would have been a huge improvement, for the room was coated in boxes and piles of broken or damaged equipment. The back wall was completely stacked with “plumpy packs” a sort of fortified peanut butter designed by the World Health Organization for extremely malnourished children. My partner, Simona, and I noticed an oxygen concentrator (used to provide pure oxygen to a patient who needed assistance in breathing) which we had learned to repair earlier that week in class. Excitedly, we took it outside to examine the damages. After a few hours of replacing and resoldering broken wires, locating alternative filter options and cleaning the filters we could not replace, and a through scrubbing of the device (inside and out), we confidently proclaimed that the equipment was in great shape! To test it, we hooked it up to a gas mask and held a candle to the oxygen output to make sure it would facilitate patient breathing, and I could not help but smile as I watched the candle burn much brighter when placed next to the oxygen output.
The day was not without problems, however. We needed to make sure the machine would work for long periods of time, so we hooked it up to our power source and set our timer for an hour. However, after 16 minutes… the power went out. We turned the machine back on and soon as the power returned, only to lose power again after 22 minutes. After repeating this off an on process 3 more times, I could not imagine how frustrating being a doctor at this hospital would be– imagine trying to complete a surgery with a power outage every 20 minutes!
Another problem was in the status of the machine. A small counter lodged inside of the machine listed that this oxygen concentrator had been in use for over 80,000 hours, and the maximum for optimal usage is only 20,000. We went to the employed hospital technician and explained the need to replace the zeolite canisters which separate nitrogen from the air and provide pure oxygen for patient breathing. He got incredibly excited, thanking us for offering to purchase this replacement. We had to explain to him that we were only here to service, not to replace, and asked him to file a report to the hospital to see if they could replace this piece, because his patients were not receiving the optimal amount of pure oxygen. He nodded, showing that he understood, but his face dropped. When I returned to school, I looked up the prices of this part of the machine. Each new zeolite canister would cost about 5,000 US dollars, and each machine needed 2 canisters. My heart sank as I realized there was no chance the hospital would approve the necessary replacements.
On a more optimistic note, using our repaired oxygen concentrator was much safer for the patients then not using one at all (despite the need for replacements), so I still felt incredibly accomplished when, at the end of a very long day, we taped a sign to the side of our machine which proclaimed “Inafanya kazi”……. “It is working”!!!!
3) I am learning more and more about the culture of Tanzania, and last week Kara (my roomate) and I spent an hour preparing the traditional Tanzania dish of chapati! It is kind of like a very thick and layered tortilla, and tastes delicious. I even flipped it like a pizza by throwing it in the air and catching it in the pan!
As we ate dinner one night, I explained to the woman who is hosting us about the disappointment I felt at the hospital’s inability to replace the zeolite canisters in the oxygen concentrator we repaired. She nodded sadly, and commented how she was incredibly fortunate to never have to go to a hospital such as the ones we were working at. When Kara and I were confused, she explained to us that the hospital system in Tanzania (as it is in many developing countries) is split into a government and a private sector. The government hospitals do not fund enough doctors and technicians (and those they do employ are not paid well), new equipment and repairs, or the influx of people who attend them each day. Private hospitals, she explained, are much more similar to those in developed nations such as the United States– the doctors are paid very well and the patients are attended to regularly and thoroughly. However, that also means most skilled doctors and technicians are lost to the private sector, and the government funded hospitals, which tend to the most number of people, are left without appropriate patient care or the facilities to provide for their patients (the majority of Tanzanian people)… I understand that the work my group does here will not change the underlying issues of healthcare in this country, but I only hope we can do our best each and every day we are here to help one person at a time one piece of equipment at a time.
In other news, I swam in the Indian Ocean this weekend!
All is well here and I am excited for this week of courses and adventures. I hope you all have a marvelous monday and a wonderful week! Thank you for reading and for all the good thoughts, they are incredibly appreciated.