Having just enjoyed the culinary masterpiece that was chapattis with strawberry jam, I feel ready to give an update on life in Ndanda. Since the strawberry jam is likely to be the only thing resembling one of my 5-a-day that I eat today I have washed it down with a multivitamin in an attempt to avoid scurvy. I actually have good intentions of cooking something healthy later in the week and have bought a pumpkin in preparation for this momentous occasion. However, it will probably take me a few days of looking at said pumpkin before I can summon the energy to attack it with a bread knife or smash it on the concrete floor (depending on how thick the skin turns out to be) and make it into soup (which I will then be able to eat for at least 5 or 6 days).
I have just returned from a long weekend in Mtwara with several of the volunteers working in nearby hospitals. Mtwara is a quiet town on the coast and thanks to the fact the Benedictine missionaries build stuff everywhere there is a house that we can stay at for a small fee as a reward for working in one of their hospitals. The house is literally on the beach and with turquoise water, snorkelling and with the promise of red wine, prawns and cornflakes, these trips are one of my most favourite parts of life here. The only slight problem is the 4-5 hour daladala ride to get there, which involves taking your life in your hands as the conductor attempts to squeeze as many adults, children and chickens as possible into a bus that isn’t actually designed to have anyone standing. I think at the worst point there were probably around 45 people squeezed into something the size of a minibus and I spent my time trying not to think too much about what would happen if the bus decided to part company with the road – especially in a country where there is no emergency service. I may get a little frustrated and ranty with the increasing number of crazy rules and regulations invented in response to the looming threat of litigation in the UK, but I have to admit there are occasions where a few strongly enforced rules might not be such a bad thing. Hopefully the pictures will help you picture the paradise that is Mtwara.
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Work continues to be interesting and frustrating in approximately equal measures. Last week I was again faced with the difficult situation of relatives requesting discharge when treatment has failed and the patient is quite obviously not going to survive. It’s not that people shouldn't have the right to die where they want but more that in the UK this decision is taken because the patient feels more comfortable in their own home, whereas here it is usually financial because transport of a dead body costs a lot more than that of a live one. The luxuries of palliative care teams, Macmillan nurses and social services don’t exist here and quite how these patients make it home at all is usually beyond me. However, since the only painkillers at my disposal are paracetamol and diclofenac (morphine being unavailable in Tanzania) I can’t exactly offer any kind of effective palliative care, even if they stay in the hospital, which makes the decision to send them home a little easier. On a more positive note the new nurses on my ward are still wonderful, with one of them even trying to swap his shifts in order to help me with some procedures tomorrow. It would also seem that my twittering has not been entirely wasted as he not only identified a pleural effusion from an x-ray but also listed possible causes and told me how examining the fluid would help to decide whether it is likely due to TB! (I realise this last bit will only really make sense to the more medically minded readers but it made me so incredibly happy I had to mention it).
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| Sunset over Ndanda |
I think that is enough for now and my newly acquired copy of the Dead Poets Society is calling me. On the subject of films though, it would seem American English is not actually the same as normal English - who'd have thought it? This I discovered while showing Take the Lead to one of the nursing students when she came round for dinner (yes I did actually cook her something – pizza in fact which was awesome). Anyway, surprisingly enough there is no direct translation for 'punk ass' into Kiswahili and really no way of explaining what it means at all – this term was used A LOT in the film! I’m going to have to be more careful with my choice next time.
