Wednesday, 19 October 2011

Elective 05. Safari

Today I head out on safari! This wasn't the usual jeep-and-tigers affair, though. At this hospital, village safaris are run where villages which are too far away to walk to the hospital are visited to carry out routine checks and treat any possible minor  illnesses. Close villages can be visited by dIrt tracks, with an hour or twos travel in a 4x4. Villages further away are visited by a light aircraft provided, with pilot,  by MAF. It was one of these rare plane -based-safaris I go on today!

Leaving the hospital before 6AM to get  to the village before the heat of  midday, the journey started in a 4x4 full of vaccination supplies in insulated ice boxes, and 10 nurses (8 of them students) and 2 doctors to do the work. The two doctors who are coming with us are the hospital anaesthetist and Dr BT (No explanations given for his name, its pretty rude). I have no idea why the hospitals dedicated full time anaesthetist is coming on a medical safari rather than being at the hospital in case of an emergency operation being required, but who am I to question how the hospital is run.

We drove for one and a half hours through the rift valley, very squashed up and deafened, as the anaesthetist was being generous enough to share the music from his mobile by pressing it against the electric megaphone used to announce the arrival of the clinic in the Village. Inside the Car, the low quality music amplified far too much by the Megaphone was almost unbearable. On the way we also stopped to pick up a number Of hitchers, somehow fitting them inside the car. This was something I fully supported, as these people often seemed to be in the middle of nowhere, walking to nowhere, miles from any villages, wandering along the winding track through the bush dotted dusty earth.

A typical view from the jeep window, here crossing an empty lake bed. There is nothing for miles, and then a person will appear just strolling along. Crazy!

Finally we arrived at our destination in the 4x4, a small hut next to a cleared area of bush, which acts as an airstrip. The plan was for the majority of the people in the car (other than the hitchers, obviously) to run a clinic at this hut, while 3 of us took a plane from this air strip to a village a lot further, over set of hills that the 4x4 wouldn't be able to cross. Weight is a very valuable commodity on a small plane, so I was privilidged to be taken along. The 'landing Strips' built at both ends turned out to be areas of ground with the bushes removed. A doctor, A nurse and a Medical student (myself, and not the Start Of a bad joke) got on the plane. I was travelling with Dr BT, and had replaced a student nurse who would usually go on these plane trips. She seemed very pleased that I was on the plane this time, as it makes her feel very sick.

The pilot of the plane was a Mzungu (white person) as well. And talking with him he told me how, when in the UK, he and his wife were praying to find out what to do with their lives. He felt God told him to become a pilot and work in Tanzania. He took lessons to pass his pilot licence and has now moved out here permanently with his wife and kids to keep doing Gods work. I am not a religious person, but the fact that religion can give Someone the drive to make such sacrifice for the good of others is surely a good thing. I am sure he now washes in a bucket  rather than a shower, and suffers other minor hardships, but the number of  lives he has Changed by ferrying countless medical personnel to and from Villages in Tanzania must be huge. Then again, the changes to his family must be immense: the children having to be educated in a Tanzanian school, the wife bought from the UK to what seems an inherently sexist culture. I am not sure I would be able to do that to a family (if I had one).

A quick prayer from the pilot (hopefully prompted by his strong religion, rather than fear of flying) and we leave. A large crowd of Tanzanians from the Village has collected to watch us leave. After all planes are exciting! The light plane is surprisingly smooth, and seeing the vastness and emptiness of the rift valley from the air is awesome.

A view from the plane, as it flies over the rift valley. A herd of cows can be seen in the middle of the picture, one third from the top.

20 minutes of flight later, we land. No need for a megaphone this time, coming into land villagers flock from the score or so of huts near the airfield to meet us. The main things we are doing on this visit are weighing all babies to record their growth progression in their books, giving them the vaccines that they are due, and carrying out antenatal checks (checks on pregnant mothers  to make sure both they and their baby are healthy)

I Start off weighing babies, a Simple Job which requires nothing More than a greeting ('Mumbo' will do, I have forgotten the rest) and a thank you (asante) words even I can manage! Weights are recorded and plotted in baby books the government provides everyone with. A bustling queue of about 50 women in the midday sun with their children never seems to decrease, as more from nearby settlements keep joining. The real struggle is to part them the children from mum to put them on the scales, but this is very much a universal healthcare healthcare problem. Children tend to love their mothers and dislike healthcare workers who stick them with needles; fair enough. Half way through, the Dr decides it is tea time and we all go to a hut to have tea and Tanzanian snacks, leaving the mothers and children milling around in the Sun. Definitely not something I am used to seeing in England, and I felt a bit awkward...

Mothers crowd around the house while the doctors take tea, trying to get shade from the sun.

After many babies weighed (around 250 by final count ) vaccinations and polio drops were given to those who needed them. I Started doing these, with the nurse helping my underdeveloped Swahili. The first time I have vaccinated anyone, and it is (unsurprisingly) very easy. Stick the needle in, and out. I had kids crying in no time, but the problem was less the needles and more my face. No need to take this personally, though, as it seemed to be less my facial features, and more the fact I  was white, and they had not Seen a white person before. Unimpressed at how upset I was making the racist babies, l went to the next room to do some antenatal screening.

I needed help here as well, to ask the questions needed (how long since last period / any movements from baby / how are you etc), But was more than happy to examine as the questions were asked by Dr BT and he filled in the notes. The room we were using was far from perfect, With a door that kept opening randomly, even when a rock was used to wedge it, to display the examination couch to the mass of women waiting outside. Somewhat embarrassing, seeing as many women took of all of the clothes on the top halves of their bodies for the examination, but it seemed I was a lot more bothered about them being seen topless by their friends than they were. I assume in a culture where people in a village are very close, and each woman breast feeds all of her 8 children, there isn't much to hide any more. As well as exposing women to their friends, I managed to Carry out plenty of antenatal examinations Successfully, and even spotted twins in a woman who last month had been told She only had one on the way (lumpy large abdomen and two foetal hearts). Not something that any real doctors would find hard, but a personal success for me!

We were thanked by the villagers by a Meal of beans and rice. Tasty as it was, I only ate one bowl full, mindful of all of the malnourished children we had just seen. The plane flight back was far worse. The sun causes lots of warm updrafts and a very bumpy ride. I Spent half of the journey feeling I would throw up and the other half feeling I was about to die. Fortunately neither happened. On getting our of the plane we were greeted  by the Villagers and I think I was  berated for not knowing enough Swahili by an important looking woman leading a group of villagers. I can only guess, though, as she knew very little English and my Swahili still consists of two words.

The plane arrives back at the village, and immediately attracts a group of interested Tanzanians

There is a good team feeling on the way back to the hospital in the 4x4 eating Nuts we bought  from a Village. When we stop at villages, children gather outside the window to stare and wave at the muzungu. Once we get home, the English girl who was volunteering at the secondary school is leaving early tomorrow, so a few people have come around to our house for some sodas. Tanzanian life revolves around soda rather than beer, which could be a lot healthier, but some people have very Bad Teeth, possibly due to excessive soda consumption (though still healthier than very bad livers...)

The children love the sight of a white person, and crowd around asking to have their picture taken!

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