Fridays are slower

We were late for morning handover today, but still earlier than most.

I spent most of the morning trying to find the paediatric doctors, to no avail. I ran into the other UWA students who were also without their teams and we decided to try and locate the X-ray library we’d heard about from the hospital superintendent.

Our Kiswahili failed us however but we at least managed to obtain the days list of X-rays. We wandered down the long, external hall of the hospital to sit on some stairs at the rear side. We were framed beside a magnificent frangipani tree, though sadly it did not shade us. We held each film up to the sky and attempted to guess the pathologies before reading the reports. One case of cardiomegaly was so severe we could clearly make out several clouds behind the translucent silhouette of the enormous heart. We finished up quickly; I could feel my feet getting sunburnt.

St Augustine’s Hospital lies at the end of a slowly inclining dirt road bordered by two large, steel gates for cars and a smaller pedestrian gate that is well used and typically remains open all day. At the front of the hospital, on the left, there are offices for administrative staff (the only air-conditioning within the entire hospital). On the right are the outpatient clinics.

Further along the main hospital starts which comprises a long, external hallway with long corridors branching right and left for each ward. There are 12 wards in total; including paediatrics, maternity, surgical, general medicine, infectious diseases and ICU, plus operating theatres (I will share more on those another day). Palliative care is separate and is unique to this hospital due to the external funding received from the UK. Other Tanzanian hospitals cannot provide this service due to it not being funded.

The wards are long rooms about 10m x 70m with around 30 beds per ward. Bed heads sit against each wall facing in, leaving a narrow walk way. There is around 30cm between each bed. Mosquito nets hang above each bed from the ceilings which are erratically repaired and show signs of water leaks throughout. Floors are tiled and red from the constant dust.

Glassless windows with wooden slats span roughly one between two beds. They let the mosquitoes in, but more importantly, they let the breeze in also. It would be stifling in this humidity otherwise.

There are gardens between each ward which are green and beautiful. They have neatly manicured hedges and grass which is cut by machete when it gets too long. Cats and dogs are often seen in the gardens. The hospital is set at the foot of the mountains and I wish I could get a photograph to do justice to the view.

The other Tanzanian students weren’t around today, maybe they know Friday’s are slow? We finally start ward rounds at 10:00am.

Sadly, cases that would be novel back home are now already all too familiar; a 2 week old baby with septicaemia from an umbilicus infection, an 11 year old with HIV and oral thrush, many cases of malaria, tuberculosis and sickle cell disease.

Sometimes, I am surprised by common diseases in Australia that also present commonly here – particularly asthma.

The doctor I am working with today, Anna, does not own a stethoscope. This puts a lot of pressure on me as a student as I have to auscultate all of the children myself and my observations are final. I guess this is what being a real doctor must feel like.

I told Anna I would leave my stethoscope with her when I leave.