After the ward round is finished, I go to outpatients to have my last stint there, but again, I end up doing some of the consultations on my own. As I arrived at outpatients after the ward round, Tim was seeing a patient. He told me he thought they had appendicitis and should be admitted. I got him to ask a few questions, and the pain turned out to be in the back, after working a day carrying water back and forth. An examination then showed no pain in the abdomen at all. I don't think this was appendicitis, and Tim admits that he thinks he didn't ask enough questions. It is easier to do this than you might think, as Tanzanians often seem to be quite unconversational, and reply to open questions with one word, or just don't reply at all. It is very strange for me to have a question asked, and nothing said back in return, but it seems pretty normal here. Though perhaps they are so laid back they are taking their time in answering, and preparing an answer for me in an hours time... Either way, this was a very wrong diagnosis, and it is something I am worried will keep troubling me once I have returned to the UK - the knowledge that this will keep happening even though I am not there, and patients are likely to suffer from it.
The consulting desk I use in outpatients. I am not sure how old the building is, but I am assured that it was built by African slaves while the British were in rule