First day of work

So sorry to all that it has taken me so long to update this (most of all Katie, although I must say I'm pretty sure I have a better excuse... :-) ), but internet access was limited until we arrived in Arusha and it is still a bit of a trek into town to get to the internet cafe. We've been here over a week now so there is lots to tell, but since I started work today I figured I would start with the hospital.

I'm placed at a different hospital than the other girls, which I thought I wouldn't mind, but it is quite the trek out to the one I'm working at. It's about a 40 min (brisk!) walk and then a 20 min dala dala (think a big crowded full size van... all for the bargain price of 500 tanzanian shillings, about 40cents). It wasn't as terrible as I was anticipating, there was a decent breeze though the windows so I wasn't suffocating and at least today I didn't sit next to anyone too smelly (as I realized quite quickly they haven't discovered deodorant in Africa. Not entirely surprising as the majority of Europe hasn't really either, but it's a bit more evident here. It's not just if you're packed into a crowded space with someone like in France, but you can't really walk down the steet without getting a whif of BO as people walk by. I'm trying to be open to their culture and whatnot... but if there is one thing I could change so far, it wouldn't be being able to drink the water, or less dust, or airconditioning everywhere, or toilet paper, it would be giving everyone a stick of their very own deodorant. I'm thinking of taking up donations.

Anyway, I got way off track there on my little rampage about smelly people (you KNOW how sensative I am to smells!) , but the point is it takes just over an hour to get the hospital. We are technically supposed to be there at 7:30 for morning report, but I've heard from some of the other students that you don't really need to go every day. Which is nice, because although that is still late on American labor and deliver standards, it's pretty early on fourth year time.

The hospital itself is made up of lots of separate buildings. I got a very extensive tour today, I think I saw pretty much every room/office there was to see and was introduced to just about everyone who works in the hospital (including the laundry lady and the lady who makes Chi tea for break time). It struck me as odd that they would barge into the various exam rooms to introduce me to the clinicians while the patients were sitting right there. No one seemed to mind though and everyone was very friendly. There were lots of awkward moments, however, as everyone insisted on trying to speak Swahili to me, so I kept having to decide which of my limited Swahili works (Shikamoo - formal hello, Asante - thank you, Nzuri - good) was the most appropriate reponse to whatever they said. I must have said asante about a billion times for lack of anything more substantial to say.

There are separate buildings (all one floor and not very big) for the women's ward, the men's ward, the labor ward, the pediatric ward (which only goes up to 5 years old, after that you're considered an adult), and then various outpatient clinics (dentistry, peds, a special HIV clinic) which are less buildings and more just small rooms around a covered courtyard where people wait. The wards are just what you might picture, one long room lined with about 16-20 beds. The pediatric and mens wards have the option to have a private room on one side of the ward for 10,000 shillings a night (about $8), but most people can't afford that (the regular ward is only 500 shillings a night... again, about 40 cents). You don't get a whole lot extra for that either, other than three walls and sliding door because the rooms are TINY and don't have anything more special than the regular part. Although I guess you are guaranteed your own bed, as they double up the beds in the regular ward when they run out of room. It's different than at home though where the patients spend most of their day in bed. The majority of the patients I saw where just lounging about the buildings, sort of roaming willy nilly. I can't really see that flying so well at Barnes...

The labor ward itself is a long skinny building, one end is the antenatal side, where the women in labor come and hang out until they are ready to deliver. It has about 16 beds, and there were more than that number of pregnant women there. They were all surprisingly calm, only grimacing silently occasionally with a contraction, but for the most part it felt more like a sleep over than anything else. From the antenatal side, it leeds into a smaller room in the middle with three guernees (hmmm... NO idea how to spell that) for deliveries or private exams. There are curtains separating the beds from where everyone is walking though, but no curtains between the beds. The head nurse was telling me today that fathers are not allowed for the births because there could easily be another one taking place in the next bed. From there you walk though to the postpartum ward, which is identical to the antenatal ward, just usually less crowded.

I didn't get to do a whole lot today because the orientation took so long. There was one C-section but it had already started by the time I was finished. Other than that no deliveries today. I did get to listen to lots of fetal heart tones through a fetoscope, which is basically a small plastic trumpet device that you put on the women's belly and the other end pressed against your ear. They couldn't really understand when I tried to explain continuous fetal heart tone monitoring to them. They listen to heart tones about twice a day, unless the women complains of some problem. Today there was the head nurse and two other nurses who were all very nice. One of the nurses is actually named Dina! It was quite the awkward moment as we introduced ourselves because her English isn't the best and we both kept saying "Dena", thinking the other person was just repeating our name to see if they had it right until we realized we had the same name! She didn't seem quite as excited about it as I was, though. I have yet to see a doctor on the labor ward, although I'm not sure what there would have been for them to do today.

I'm running low on internet time, so I guess I'll leave it at that for today. I hope I didn't bore anyone to death, it is indeed quite hard to be witty in these things. Especially when your time is limited, so it's turned into more of a stream of consciousness thing really. So that's what I was up to today. Don't know when I'll make it back to write more, but I miss you all very much and I'm having a great time.