Swahili words of the day.

Swahili words of the day.
zero sifuri
1 moja
2 mbili
3 tatu
4 nne
5 tano
6 sita
7 saba
8 nane
9 tisa
10 kumi
11 kumi na moja

*Tanzania is 945,100 sq. km.
* population of 31 million, 32 persons per square kilometre.
* GDP per capita of approximately US$220 (1997). Agriculture (60 % ),services (26 %) and industry (15 %).
* Tanzania has built a successful tourist industry around its wildlife.
* 25 % live in urban areas growing at over 6 percent per annum, around twice the national rate of population growth.
* There are ten major towns with populations of over 150,000 with the major city and port, Dar es Salaam, three million
* 50 percent of the population lives on US$1 per day.
* Interest payments on international debt are $10 /person/year

Heather took this at the end of a thyroidectomy. Mary bagged the ether anaesthesia the whole case , watch her hand behind my back. Dr. Mlai "helped"-actually he usually got the right instrument from Cecelia. Cecelia is looking bored. The smell of ether coming from the exhaust tubing made us worry about the use of the bovie cautery. However, these lage symptomatic goitres would have challenged me imensely without. We did 55 cases including three thyroidectomies. They were less extensive thyroidectomies than I would have done in Canada because we had no access to lab tests or long term thyoid hormone replacement. I did have a small supply of L-thyroxine that I gave 3 months of 100 micrograms followed by 3 months of 50 micrograms to empiracally reduce the TSH surge post op. Who knows what good that does but they are coming back to see the surgeons next Feb.

The operating room at kilema!

In the picture from left to right.

1. Estha she was mostly in the clinic and translated for us or should I say she took our one question..talked with the patient for 10 minutes and then told us that yes the patient wants operation.

2. Rani Gunda .circulating here but notably the scrub nurse whenever sister operated! Always smiling and a soft spoken sweet soul.

3. (behind Rani Gunda) James one of the clinical officers who look after the hospital and also went with the caravans.

4. Dr. Kelvin Mbando. A medical officer--trained medic who does surgery including the C-sections. A wonderful man. Was reluctant to learn subcuticular stitches from Heather (Dr. Heather Redstone, the other surgeon on this mission who took this photo.) because as he said "I don't do those majic stitches!". His children's names are Innocent(his son) , Verygood and Happiness( his daughters)! When he stays in the hospital a week at a time he stays in a little house below valley house where I slept.

5. Me. wearing my safari cap.

6. Cecelia (one of 3 Cecelias)a very quiet scrub nurse who took a while to learn what instruments I was asking for. I learned quickly that what would be considered constructive criticism in Canada was taken as the end of the world there. I think she forgave me towards the end of the time there.

7.(behind) Cecelia assistant anaesthetic nurse. ("very sick")

8. Mary. A god's send. Anaesthetic nurse who never missed a spinal and who tried everyday to teach me more Swahili. Mambo? Poa!

9. Mrs. Sway stopped the OR for 10 minutes every morning (with the patient already asleep) for prayer---in Swahili and the occasional Dactari and operation.

I am starting my blog late as it should have commenced before my first visit to Africa. However better late than never. I am motivated to start now because of my upcoming return to Tanzania in January 2009. My first trip was inspired by a long time realization that I needed to do more than just north American health care delivery and the sudden finding of time on my hands. This has occurred courtesy of the Calgary health regions not allowing me to have any operating time!! I had heard of CACHA for some time because of the involvement of one of my colleagues in Ottawa, Dr. Robin Fairfull-Smith. His activities in east Africa have gone on for quite a while and I had heard him give talks on his return from trips and was quietly jealous. I had used the excuse of busy work schedule and family commitments to delay. Now with only Jacob (in grade 12) left at home I had no more excuses.

So-- First there was an aborted planned trip with another organization to Kenya. The unrest following the last elections caused a lot of violence in the area of Kizumu,where I was meant to go.

Then I hooked up with CACHA an established organization run out of Ottawa. The organisation Canada African Community Health Alliance was started by Don Kilby a family doctor who runs the student health office at the university of Ottawa. He is an inspiration.