Elective 19. Friends

I am making some good friends here in the village. The main reason I came along on my own is finally paying off, though there are still some lonely times. I Still think that given the choice again, I would come with a friend, but now I am here I plan on making the most of it.

I visited Tim as his house today, and spent most of my time over there. First chatting with him and his (very) extended family, and then playing cards. Tim was born in this village and educated at the local secondary school, which is renowned for its poor academic quality. He has just finished his second year of medical school in a city about 100km away, and is currently home for the holidays. Tim is effectively getting work experience at the hospital over his summer holiday, but this involves running an outpatients clinic. This is something the hospital is happy for him to do, as if saves their doctors for more important jobs. And something he is very happy to do as he gets a lot of experience from it. I am not sure I am happy with the idea of the inexperienced student being the first port of call for patients, with the power to admit, discharge and prescribe, but what do I know?

The road back from Tim's house to mine. My house is over by the water tower to the left. The water towers have had no water for years, a shame they were left to go to waste.

I only meet his mum today, as his dad is a blaster for a gold Mine, and away working. He has a very plain house, with concrete floors and walls, and no doors and open holes in the concrete walls for windows. It has a feeling a little like a jail cell. What the house lacks in decoration, however, it makes up for with the warmth of the family welcome. While I am there, I learn that two of the boys in the room are his brothers, while the other is a child from a village about 8 hours walk away - I recognise the name of this village, as a number of patients I had seen have been from there. The family are letting the boy live in this house as though he is one of their own sons for another four years, until he finishes his secondary education. With this being the nearest secondary school to this boys village, his parents have decided that it is important for him to get an education, and Tim's family have been kind enough to help. Tanzanians are very hospitable to both friends and strangers.

The house has about a dozen chickens and one cat roaming throughout it. The advantage of concrete floors is that any animal 'spillage' can be cleaned up easily, that is, if you can be bothered... Food is bought out for me to eat, and I am too polite to say that I have already eaten, and it would be rude to turn down the food. I am also poured water from a jug of slightly green liquid (obviously lake water), and offered a toast to my health (after saying grace, of course). It is an easy decision to drink the water and take the gamble with my health. The family have been far too kind to me for me to risk offending them. The cat mewls and winds between our legs, and a scoop of the spaghetti we are eating is put on the floor as a meal for kitty. When I first saw this spaghetti being served here, I baulked, but it turned out that this dish has the normal (e.g. none) amount of sugar in it. Thank god. He must have been listening during Tim's saying grace when Tim thanked him for the Edible food. 

After the meal we chat about this and that. Normally around the topic of medicine, as medical students tend to do. On the subject of the hospital, he tells me that they were given an X-ray machine by a charity about a year ago, only one of the work men contracted to install if decided the display monitor looked like a tv, and he wanted a tv, so he stole it. The hospital still (embarrassingly)  has an x-ray machine hidden away, but no moniter so it is unusable. I didn't even know about this. It seems such a waste! Regarding his medical school, Tim tells me that they hardly get any teaching from lectures, and most of learning is self directed from text books. He then proceeds to proudly show me his two text books. They are both hanging apart, and a look inside (or just a look for one, as it is missing the front cover and cover pages) shows they come from the mid 1970s a very long time ago for medicine! Things change massively between single editions of books, and this long in medicine is an age! At medical school in the UK we are told it can be dangerous if we are one edition out of date, and learning the wrong things. He tells me he also shares a BNF with some staff at the hospital, which often conflicts with what the books he owns say. This is a potential mess waiting to happen, though I admire how hard he is working at learning. I tell him that if he leaves me with his address, when I return to the UK then I can pick up some cheap second hand text books, and mail them over to him if he wants. After all, libraries often give away, or sell on books at very cheap prices, when new editions come out. I can buy these, and I am sure they will be a lot better than a book from the seventies. The problem in Tanzania seems to be supply, as even if he had the money,the only text books available to buy are at about 3x the English price.

We then go on to playing a "Tanzanian" card game which starts off really exciting me (new card game, wow!) until I realise it is almost identical to UNO, the difference being that it is played with a deck of playing cards. While playing cards, a neighbour, who has seen me go into the house, and seen me through the open hole that functions as a window, comes calling. She says that as there are two doctors in the house, she is sure we can help her. I try and protest my innocence (I do need to learn Swahili for "I am not a doctor!' but it is too late. She has bought her son to us who is about 4. On the doorstep, she lifts him up and drops his pants to show us his penis. Tim translates for me that she had the boy circumcised by someone in a neighbouring village a while ago who was not a doctor, And now he has some problems. She shows us. When he urinates, urine comes out both normally, and from where the circumcising cut was made on the underside of the base of the glans. This would have been a perfect case to show the urologist, a botched surgery. We were both stumped as to what to recommend, so we tell her we will talk to Dr Bike and Chief about this case, both of whome have extensive operating experience, and ask them whether the operation is within their capabilities. She seems happy with this answer, and thanks us profusely.. It must be amazing to be a doctor here, in among such a tight nit community, and with such repsect available.

Playing fake-UNO with Tim and his brother